Triamcinolone Acetonide Aqueous Nasal Spray Research Articles

The ideal nasal corticosteroid: balancing efficacy, safety and patient preference

SummaryTopical corticosteroids represent first‐line treatment in patients with moderate–severe persistent allergic rhinitis. Topical steroids have a wide range of anti‐inflammatory properties, particularly suppression of the release of Th2‐type cytokines from T cells and also from mast cells and basophils. Topical corticosteroids are effective against all nasal symptoms including nasal blockage. They are more potent than oral antihistamines and topical cromones. They may also improve seasonal asthma. Potential disadvantages include a slightly slower onset of effect (days), the need for regular treatment and occasional local irritation/bleeding. The properties of an ideal intranasal corticosteroid include high efficacy against all nasal symptoms, a rapid onset of action and a proven once‐daily dosing schedule. Local corticosteroid preparations should be acceptable to patients with low or absent local/systemic side‐effects. There should be no long‐term adverse effects on the nasal mucosa. Triamcinolone acetonide (TAA) aqueous nasal spray meets these criteria and a particular advantage is its lack of taste and smell, which may improve acceptability and compliance in some patients.

Triamcinolone acetonide aqueous nasal spray versus loratadine in seasonal allergic rhinitis: efficacy and quality of life

The new aqueous formulation of triamcinolone acetonide (TAA) was compared with loratadine in patients with seasonal allergic rhinitis. The primary objective of the study was to compare the safety and efficacy of TAA aqueous with loratadine in relieving the symptoms of seasonal allergic rhinitis. A total of 351 patients were enrolled into this 4-week, double-blind, double-dummy, randomized, parallel group study. Patients received either TAA aqueous nasal spray (220 microg) or loratadine (10 mg) once daily. Efficacy variables were rhinitis symptom changes from baseline, physician global evaluations, and the patient dropout rate due to insufficient treatment effect. Safety and quality of life also was evaluated. Both TAA aqueous-treated and loratadine-treated patients had improvement in symptoms as early as day 1. Overall, TAA aqueous was significantly (P < .05) more effective than loratadine in reducing total nasal symptoms and individual symptoms of nasal congestion, nasal itch, and sneezing. Ocular symptoms improved from baseline in both groups. There was no statistically significant difference between groups based on physician global evaluation. A similar number of patients in each group discontinued the study due to ineffective treatment. Triamcinolone acetonide aqueous patients maintained a significantly (P < .05) better quality of life in three of the dimensions (activity, nasal symptoms, and practical problems) and for overall quality of life. There were no differences between the two treatment groups in the incidence of adverse events, none of which were clinically significant. Both TAA aqueous and loratadine were effective and well-tolerated in the treatment of patients with seasonal allergic rhinitis. Triamcinolone acetonide aqueous was significantly (P < .05) more effective than loratadine in controlling nasal symptoms of seasonal allergic rhinitis and maintaining a better quality of life for the patients.

1115 Comparison of efficacy and safety of triamcinolone acetonide aqueous nasal spray versus fluticasone propionate in perennial allergic rhinitis

1115 Comparison of efficacy and safety of triamcinolone acetonide aqueous nasal spray versus fluticasone propionate in perennial allergic rhinitis

604 Long term treatment with triamcinolone acetonide (TAA) aqueous nasal spray and its effect on mucociliary function in patients

604 Long term treatment with triamcinolone acetonide (TAA) aqueous nasal spray and its effect on mucociliary function in patients

The effects of triamcinolone acetonide aqueous nasal spray on adrenocortical function in children with allergic rhinitis

Background: Suppression of adrenocortical function, a risk associated with oral corticosteroids, is minimized with intranasal corticosteroids. Triamcinolone acetonide (TAA) aqueous nasal spray, at therapeutic doses, has no measurable effect on adrenocortical function in adults with allergic rhinitis. Objective: This double-blind, placebo-controlled study compared the effect of once-daily TAA aqueous nasal spray (220 or 440 μg) with placebo on adrenocortical function after 6 weeks of treatment in pediatric (children 6 to 12 years of age) patients with allergic rhinitis. The pharmacokinetic profile of TAA was examined after once-daily intranasal administration of TAA aqueous nasal spray 440 μg for 6 weeks. Methods: Eighty children received TAA aqueous nasal spray 220 μg or 440 μg or placebo for 6 weeks. Adrenocortical function was assessed by analyzing plasma cortisol levels before stimulation (0 hour) and at 30 and 60 minutes after a rapid 1-hour intravenous cosyntropin stimulation test performed before treatment and after 6 weeks of treatment. Samples for pharmacokinetic evaluation were collected from 19 patients at baseline (0 hour) and at 0.5, 1, 1.5, and 6 hours after the final dose of study medication. Results: After 6 weeks, no significant effects on adrenocortical function were observed at 30 or 60 minutes after cosyntropin stimulation with either dose of TAA aqueous nasal spray. TAA concentrations in plasma showed rapid elimination of the drug, with little or no accumulation. Conclusions: TAA aqueous nasal spray (220 or 440 μg/day) has no measurable effect on adrenocortical function in pediatric patients with allergic rhinitis. Pharmacokinetic parameters after 440 μg/day of TAA aqueous nasal spray indicate a rapid decline of plasma drug levels, with little or no systemic accumulation of study drug. (J Allergy Clin Immunol 1998;101:157-62.)

Triamcinolone acetonide aqueous nasal spray does not alter adrenocortical function in children with allergic rhinitis

Triamcinolone acetonide aqueous nasal spray does not alter adrenocortical function in children with allergic rhinitis

A comparison of effects of triamcinolone acetonide aqueous nasal spray, oral prednisone, and placebo on adrenocortical function in male patients with allergic rhinitis

Background: One of the risks associated with the use of oral corticosteroids is suppression of adrenocortical function. Triamcinolone acetonide (TAA) aqueous nasal spray administered once daily (110 μg and 220 μg) has been shown to reduce allergic rhinitis symptoms. Objective: This multicenter, placebo-controlled, double-blind study determined the effects of TAA aqueous nasal spray, placebo, and oral prednisone on adrenocortical function in patients with allergic rhinitis. Methods: Sixty-four patients received TAA aqueous nasal spray (220 μg or 440 μg), oral prednisone (10 mg), or placebo once daily for 6 weeks. Adrenocortical function was assessed after cosyntropin stimulation for 6 hours before treatment and after 6 weeks of treatment. Results: There was no statistically significant effect on adrenocortical function in patients who received either dose of TAA aqueous nasal spray compared with placebo. In contrast, prednisone produced statistically significant ( p < 0.001) reductions in adrenocortical function compared with placebo; reductions occurred in both the mean 6-hour plasma cortisol levels and mean change in 6-hour plasma cortisol levels from pretreatment. Conclusion: This study demonstrated that, unlike oral prednisone, TAA aqueous nasal spray, in therapeutic doses, did not alter adrenocortical function and was comparable to treatment with placebo in its absence of measurable effects on adrenocortical function. (J A LLERGY C LIN I MMUNOL 1996;98:32-8.)

60 Efficacy and safety of once-daily triamcinolone acetonide aqueous nasal spray in pediatric patients with spring grass seasonal allergic rhinitis

60 Efficacy and safety of once-daily triamcinolone acetonide aqueous nasal spray in pediatric patients with spring grass seasonal allergic rhinitis

1002 Comparison of once-daily triamcinolone acetonide aqueous nasal spray and twice-daily beconase AQ® for the treatment of seasonal allergic rhinitis due to ragweed

1002 Comparison of once-daily triamcinolone acetonide aqueous nasal spray and twice-daily beconase AQ® for the treatment of seasonal allergic rhinitis due to ragweed

Triamcinolone acetonide aqueous nasal spray for the treatment of patients with perennial allergic rhinitis: a multicenter, randomized, double-blind, placebo-controlled study

In this multicenter, randomized, double-blind blind, placebo-controlled study, 178 patients with with symptoms of perennial allergic rhinitis (PAR) were treated with either triamcinolone acetonide (TAA) Aqueous nasal spray (200 μg once daily) or placebo for 4 weeks. Symptoms of PAR (nasal stuffiness, nasal discharge, sneezing, nasal index, and nasal itching) were evaluated throughout the treatment period through the use of patient diaries. In addition, both patients and physicians completed independent global evaluations of treatment efficacy at the conclusion of the study. TAA Aqueous provided clinically and statistically ( P ≤ 0.05) greater improvements in nasal stuffiness, sneezing, nasal index, and nasal itching over the 4-week study period than did placebo. Significant improvements in sneezing ( P = 0.022) were observed as early as the first day (within 12 to 16 hours based on treatment in the morning and assessment of symptoms at bedtime), and in the nasal index ( P = 0.009) by the third day after treatment with TAA Aqueous. Patients' and physicians' global evaluations of overall efficacy were concordant: 65% of patients rated their nasal symptoms greatly or somewhat improved with TAA Aqueous administered once daily was well tolerated and provided relief of PAR symptoms in adults and adolescents.

Triamcinolone acetonide aqueous nasal spray in patients with seasonal ragweed allergic rhinitis: A placebo-controlled, double-blind study

Because some patients may prefer aqueous nasal sprays and once-daily dosing for relief of seasonal allergic rhinitis symptoms, a new aqueous formulation of triamcinolone acetonide (TAA Aqueous) was developed. We conducted a randomized, placebo-controlled, double-blind study to compare the efficacy and safety of once-daily administration of 220 μg/d of TAA Aqueous for 1 week, followed by either 220 μg/d or 110 μg/d for an additional 2 weeks, with that of placebo in 429 patients with seasonal allergic rhinitis. Patients recorded the severity of symptoms (nasal stuffiness, discharge, sneezing, nasal index [the sum of the first three variables], nasal itching, and eye symptoms) on daily diary cards. Patients' and physicians' global evaluations of efficacy were made at the end of the 3-week study period. Both regimens of TAA Aqueous significantly improved symptoms compared with placebo at most time points. Patients demonstrated significant improvements in nasal symptoms as early as the first day of treatment (within 12 to 16 hours based on treatment in the morning and symptom assessment at bedtime). Although TAA Aqueous 220 μg/d provided numerically greater reductions in nasal symptoms compared with 110 μg/d, these differences in efficacy over the last 2 weeks were not statistically significant. The incidence of adverse effects with both TAA Aqueous regimens was low and comparable to that of placebo. In summary, during the first week of therapy, TAA Aqueous 220 μg/d significantly reduced nasal symptoms. During the last 2 weeks of therapy, the 110 μg/d regimen of TAA Aqueous was effective as continued therapy for most patients. Both the 110 μg/d and 220 μg/d regimens of TAA Aqueous provided significantly better relief of nasal symptoms than did placebo.