Nasal steroids safe for allergic rhinitis

The side effects and tolerability of steroid nasal sprays for the treatment of allergic rhinitis have always been subject to controversy. Perennial or recurrent allergic rhinitis is typically caused by allergens in the environment such as dust mites, cigarette smoke, chemicals, temperature changes and stress. Apart from anti-histamine tablets, corticosteroid nasal sprays are an effective way of treating seasonal and perennial allergic rhinitis. There exists a long-term ongoing debate on the side effects of such sprays. Despite the apparent safety and tolerability of nasal steroids, concerns have been raised about their potential for adverse effects during long-term use. Fluticasone furoate nasal spay (available as Veramyst in the US or Flohale in India) is one such steroid, which is believed to be safe for the treatment of perennial allergic rhinitis. To assess the side effects and tolerability of fluticasone furoate taken daily in people suffering from perennial allergic rhinitis, researchers from the Hospital Dr Sotero del Rio, Santiago, Chile studied 806 patients of allergic rhinitis for 12 months. Out of these, 605 patients received fluticasone once daily and 201 received a placebo. Safety was assessed by monitoring side effects, 24-hours urinary cortisol excretion, nose and eye examinations, electrocardiograms (ECG) and clinical laboratory tests. Plasma concentrations of fluticasone furoate were found from blood samples. The results showed that fluticasone was well tolerated with no serious side effects associated with long-term use. Apart from nosebleeds, which occurred more commonly with fluticasone, most adverse events occurred with similar frequency in the fluticasone and placebo groups. Therefore, long-term use of nasal steroids such as fluticasone furoate can be considered as a safe option for treatment of perennial allergic rhinitis.