Wiseman L R, Benfield P
Adis International Limited, Auckland, New Zealand.
Drugs. 1997 May;53(5):885-907. doi: 10.2165/00003495-199753050-00014.
The intranasal corticosteroid fluticasone propionate is an effective agent for the treatment of rhinitis, demonstrating potent local anti-inflammatory activity and little, if any, systemic activity. Intranasal fluticasone propionate has shown clinical efficacy similar to that of other intranasal corticosteroids, including beclomethasone (administered at up to a 2-fold higher dosage than fluticasone), budesonide, flunisolide and triamcinolone acetonide, and provides greater relief from nasal symptoms (including nasal blockage) than antihistamine agents and intranasal sodium cromoglycate. Its efficacy in the treatment of seasonal allergic rhinitis and perennial allergic and nonallergic rhinitis has been demonstrated in large well-controlled studies in which the drug maintained adequate control of symptoms when administered in a once daily dose of 200 micrograms. In addition, fluticasone propionate has shown similar efficacy to that of beclomethasone in the treatment of nasal polyps; however, its use in the postoperative setting requires further investigation. Intranasal fluticasone propionate is well tolerated in the majority of patients, the incidence of adverse events being similar to that seen with placebo. Pharmacoeconomic analyses indicate that intranasal fluticasone propionate is significantly more cost-effective than the antihistamines terfenadine and loratadine. Overall quality of life was improved to a similar extent by fluticasone propionate and beclomethasone. In conclusion, recent clinical experience has confirmed that intranasal fluticasone propionate is a convenient, effective and well tolerated alternative to other intranasal corticosteroids and antihistamines for the treatment of rhinitis when administered once daily.
鼻内用皮质类固醇丙酸氟替卡松是治疗鼻炎的有效药物，具有强大的局部抗炎活性，全身活性极小（如果有的话）。鼻内用丙酸氟替卡松已显示出与其他鼻内用皮质类固醇相似的临床疗效，包括倍氯米松（给药剂量比氟替卡松高2倍）、布地奈德、氟尼缩松和曲安奈德，并且比抗组胺药和鼻内用色甘酸钠能更有效地缓解鼻部症状（包括鼻塞）。在大型严格对照研究中已证实其在治疗季节性变应性鼻炎和常年性变应性及非变应性鼻炎方面的疗效，该药物每日一次剂量为200微克时能维持对症状的充分控制。此外，丙酸氟替卡松在治疗鼻息肉方面已显示出与倍氯米松相似的疗效；然而，其在术后环境中的应用需要进一步研究。大多数患者对鼻内用丙酸氟替卡松耐受性良好，不良事件的发生率与安慰剂相似。药物经济学分析表明，鼻内用丙酸氟替卡松比抗组胺药特非那定和氯雷他定具有显著更高的成本效益。丙酸氟替卡松和倍氯米松在改善总体生活质量方面程度相似。总之，最近的临床经验证实，鼻内用丙酸氟替卡松是一种方便、有效且耐受性良好的药物，可作为其他鼻内用皮质类固醇和抗组胺药的替代药物，每日一次给药用于治疗鼻炎。
