Is Fluticasone effective for treating sinusitis?

From the Guidelines

Fluticasone is effective for treating sinusitis.

Evidence Summary

• The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 states that intranasal corticosteroids, including fluticasone, are efficacious in controlling symptoms of sinusitis 1.
• Fluticasone is preferred for safety reasons due to its negligible bioavailability and less potential to cause side effects 1.
• A study published in the Journal of Allergy and Clinical Immunology in 2005 suggests that intranasal corticosteroids, such as fluticasone, may be beneficial in treating recurrent acute and chronic sinusitis as an adjunct to antibiotic therapy 1.
• The use of intranasal corticosteroids, including fluticasone, has been shown to decrease inflammation and improve symptoms in patients with sinusitis 1.

Key Points

• Fluticasone is a type of intranasal corticosteroid that can be used to treat sinusitis.
• It is preferred for its safety profile and efficacy in controlling symptoms.
• Fluticasone can be used as an adjunct to antibiotic therapy in treating recurrent acute and chronic sinusitis.
• It is essential to use fluticasone under the guidance of a healthcare professional, especially in cases of chronic or recurrent sinusitis.

From the FDA Drug Label

Fluticasone Propionate Nasal Spray, USP, is indicated for the management of the nasal symptoms of seasonal and perennial allergic and nonallergic rhinitis in adults and pediatric patients 4 years of age and older. The answer to whether Fluticasone is effective for treating sinusitis is not directly stated, as the label mentions rhinitis but not sinusitis. However, rhinitis and sinusitis are related conditions, and some symptoms may overlap.

• The label does mention that Fluticasone Propionate Nasal Spray, USP, is effective in reducing nasal symptoms, including nasal congestion, rhinorrhea, sneezing, and nasal itching.
• However, it does not explicitly state its effectiveness for sinusitis. Therefore, based on the information provided, no conclusion can be drawn about the effectiveness of Fluticasone for treating sinusitis 2, 2.

From the Research

Efficacy of Fluticasone for Sinusitis

• Fluticasone has been shown to be effective in treating sinusitis in several studies 3, 4, 5, 6, 7.
• A study published in JAMA found that the addition of fluticasone to antibiotic therapy improved clinical success rates and accelerated recovery in patients with acute rhinosinusitis 3.
• Another study published in Nihon Jibiinkoka Gakkai kaiho found that fluticasone propionate aqueous nasal spray was effective in treating chronic sinusitis with eosinophils 4.
• A randomized, double-blind, placebo-controlled study published in the Primary care respiratory journal found that fluticasone furoate nasal spray reduced symptoms of uncomplicated acute rhinosinusitis 5.
• A review of the current literature on exhalation delivery system-fluticasone (EDS-FLU) published in Current opinion in otolaryngology & head and neck surgery found that EDS-FLU demonstrated significant improvements in patients' sinonasal symptoms and overall inflammatory control as well as quality of life measures 6.
• A placebo-controlled trial published in Allergy and asthma proceedings found that fluticasone propionate aqueous nasal spray provided significant relief of symptoms of sinus pain and pressure in patients with allergic rhinitis 7.

Mechanism of Action

• Fluticasone is a corticosteroid that works by reducing inflammation in the nasal passages and sinuses 3, 4, 5, 6, 7.
• The exact mechanism of action of fluticasone in treating sinusitis is not fully understood, but it is thought to involve the reduction of inflammatory mediators and the suppression of the immune response 3, 4, 5, 6, 7.

Clinical Implications

• The use of fluticasone for the treatment of sinusitis has been shown to be effective in reducing symptoms and improving quality of life 3, 4, 5, 6, 7.
• Fluticasone may be a useful treatment option for patients with sinusitis who have not responded to other treatments or who have underlying conditions such as allergic rhinitis 3, 4, 5, 6, 7.