Intranasal fluticasone propionate in the pharmacotherapy of allergic rhinitis

Rhinitis is one of the most common diseases and this term is used as an umbrella diagnosis for patients with different clinical phenotypes of the disease (allergic, non-allergic, infectious, etc.). Recognizing the high socio-economic burden of the disease and complexities of choosing an optimal therapy, it is important to focus on interdisciplinary interactions, which are reflected in modern clinical guidelines created by experts from ARIA, EAACI, EPOS, as well as national and professional societies. Patients with rhinitis symptoms often self-medicate, use the advice of pharmacist, receive recommendations from general practitioners in outpatient practice, and very few patients get specialists (ENT or allergist-immunologist) advice; herefore, in many cases, optimal criteria for disease control (symptoms, quality of life, objective measurements) cannot be achieved. Currently international professional communities have developed innovative therapeutic approaches based on knowledge of the phenotypes/endotypes of rhinitis to achieve such a control. Physicians in both primary and specialized care are encouraged to use step therapy. This approach to treatment is based on the control of disease symptoms, and intranasal corticosteroids (InGCS) are considered to be the most effective anti-inflammatory drugs for long-term control of rhinitis, especially in moderate-severe/severe cases. This well-proven efficacy of InGCS and their advantages over other classes of drugs make them the first-line therapy in the treatment of allergic rhinitis (evidence level A), as well as the drugs of choice for non-allergic rhinitis and rhinosinusitis. This review discusses fluticasone propionate, one of the in-demand InGCS, which has been the cornerstone of the treatment of allergic rhinitis for many years.

allergic rhinitis, pharmacotherapy, intranasal corticosteroids, fluticasone propionate