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Clinical effectiveness of fluticasone furoate nasal spray for perennial allergic rhinitis in children: a comprehensive review

Published online by Cambridge University Press:  16 June 2023

Paola Andrea Rivera Open the ORCID record for Paola Andrea Rivera [Opens in a new window]
Paola Andrea Rivera*
Affiliation:
Escuela de Posgrado, Universidad Privada Antenor Orrego, Trujillo, Peru
*
Corresponding author: Paola Andrea Rivera; Email: priverar2@upao.edu.pe
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Abstract

Objective

To assess the clinical effectiveness of fluticasone furoate nasal spray (FFNS) versus placebo on nasal symptoms and safety in children with perennial allergic rhinitis (AR).

Methods

A comprehensive review was conducted with data obtained from Medline and Embase databases up to April 2023. The population of interest was patients aged 2–12 years with perennial AR. The selection was limited to randomized controlled trials (RCTs), comparing FFNS with placebo. Outcomes of interest included the reflective total nasal symptoms scores (rTNSS) and safety. To assess the minimal clinically important difference for rTNSS, the Cohen’s guideline was used. If the pooled standardized mean difference (SMD) and the lower limit of the 95 percent confidence interval (CI) exceeded the threshold of −0.20, effects were considered clinically significant.

Results

Three RCTs (959 pediatric patients) were selected. One study evaluated the short-term use of FFNS, another evaluated the long-term use of FFNS, and another evaluated both the short-term and long-term use of FFNS. FFNS produced a statistically significant reduction over placebo in rTNSS (SMD −0.18; 95 percent CI −0.35 to −0.01, p = 0.03) in long-term treatment studies, but not in short-term treatment studies. However, since the mean reduction did not reach the minimum clinically important difference (SMD −0.20), these results were considered clinically not relevant. Safety outcomes with FFNS were similar to placebo.

Conclusions

The currently available evidence suggests that FFNS, 110 μg once daily, compared to placebo, does not produce a meaningful clinical effect on nasal symptom in children with perennial AR.

Keywords

Allergic rhinitischildrenfluticasone furoateintranasal corticosteroids
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 39 , Issue 1 , 2023 , e35
Copyright
© The Author(s), 2023. Published by Cambridge University Press

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