title: No mucosal atrophy and reduced inflammatory cells: active-controlled trial with yearlong fluticasone furoate nasal spray.
abstract: BACKGROUND
  Fluticasone furoate nasal spray (FFNS) and mometasone furoate nasal spray (MFNS) are well tolerated and more effective than placebo at relieving the symptoms of seasonal and perennial allergic rhinitis. Effects of FFNS on the nasal histology have not been previously  reported. This study examines the effects of FFNS and MFNS, administered daily for 1 year, on the nasal mucosa in subjects with perennial allergic rhinitis.
  
  
  METHODS
  Subjects with perennial allergic rhinitis were randomized 1:1 to q.d., open-label treatment with FFNS, 110  μg, or MFNS, 200 μg, for 1 year. These groups and a healthy control group that did not receive study medication underwent nasal biopsies at baseline and 12 months.
  
  
  RESULTS
  The nasal biopsy population comprised 96 participants (37 using FFNS, 42 using MFNS, and 17  healthy controls). Epithelial thickness did not change appreciably from baseline to week 52 in any of the groups and mean change from baseline did not differ between FFNS and MFNS (least square mean difference, -0.001 mm, 95% confidence interval, -0.007, 0.006). Although not tested  for significance, improvements over baseline were observed in epithelial histology in the FFNS group with more epithelium including intact columnar and ciliated epithelial cells. No appreciable change in the percentage of goblet cells was established. FFNS and MFNS were associated with decreases  in epithelial and subepithelial nasal mucosal eosinophils and basophils from baseline to week 52. The percentage of subjects with no inflammatory cells at week 52 was 49 and 33% for eosinophils and 46 and 24% for basophils, for FFNS and MFNS, respectively.
  
  
  CONCLUSIONS
  Yearlong  therapy with either FFNS or MFNS showed no changes in epithelial thickness or the percentage of goblet cells as well as a reduction in inflammatory cell infiltrate. FFNS was associated with improvements in epithelial histology. These data support the long-term safety of FFNS in subjects with  perennial allergic rhinitis.
authors.affiliation: Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Wytske J
authors.initials: WJ
authors.lastname: Fokkens
authors.forename: Bas
authors.initials: B
authors.lastname: Rinia
authors.forename: Cornelis M
authors.initials: CM
authors.lastname: van Drunen
authors.forename: Peter W
authors.initials: PW
authors.lastname: Hellings
authors.forename: Greet
authors.initials: G
authors.lastname: Hens
authors.forename: Ad
authors.initials: A
authors.lastname: Jansen
authors.forename: Henk
authors.initials: H
authors.lastname: Blom
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.forename: Diane S
authors.initials: DS
authors.lastname: Clements
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Lee
authors.forename: Edward E
authors.initials: EE
authors.lastname: Philpot
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D000730:Androstadienes / Q000008:administration & dosage* / Q000009:adverse effects; D001284:Atrophy / Q000473:pathology; D001491:Basophils / Q000187:drug effects* / Q000473:pathology; D002465:Cell Movement / Q000187:drug effects; D004804:Eosinophils / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D009297:Nasal Mucosa / Q000187:drug effects / Q000473:pathology*; D059085:Nasal Sprays; D011244:Pregnadienediols / Q000008:administration & dosage / Q000009:adverse effects; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology; D013997:Time Factors; D055815:Young Adult
chemical_list: D000730:Androstadienes; D059085:Nasal Sprays; D011244:Pregnadienediols; D000068656:Mometasone Furoate; C523187:fluticasone furoate