Placebo-controlled, randomized, double-blind study evaluating the efficacy of fluticasone propionate nasal spray for the treatment of patients with hyposmia/anosmia.
OBJECTIVE
To compare the effect on olfaction of topical glucocorticoid treatment versus placebo given for an extended period in addition to oral short-term glucocorticoids in patients with anosmia/hyposmia.


METHODS
This was a randomized, double-blind, placebo-controlled study. The criterion for inclusion in the blinded phase was an improvement of at least 2 steps in the butanol odor threshold test following open treatment for 10 days with oral and nasal corticosteroids. Forty patients were included: 20 were randomized to treatment with fluticasone propionate, 10 to placebo and 10 others as controls. The topical treatment was continued for 6 months.


RESULTS
The 3 groups showed similar improvements in their sense of smell after the initial 10-day treatment with combined oral and nasal corticosteroids. Patients who continued the local treatment maintained the same level of improvement throughout the study, whether or not they had been given nasal corticosteroids or placebo. We found no significant differences between the treatment groups.


CONCLUSIONS
In patients with anosmia/hyposmia partly caused by local inflammation, no further improvement in the olfactory threshold is achieved by continuing with a topical intranasal glucocorticoid after an initial combined topical and systemic glucocorticoid treatment.
Department of Otorhinolaryngology, Karolinska Hospital, Stockholm, Sweden. ebba.heden-blomqvist@ks.se
Ebba Hedén
EH
Blomqvist
Lars
L
Lundblad
Hans
H
Bergstedt
Pär
P
Stjärne
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000730:Androstadienes / Q000494:pharmacology / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D008875:Middle Aged; D000857:Olfaction Disorders / Q000188:drug therapy* / Q000503:physiopathology; D012903:Smell / Q000187:drug effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D000068298:Fluticasone