Intranasal corticosteroid and antihistamine combinations in the treatment of allergic rhinitis: the role of the novel formulation olopatadine/mometasone furoate

ABSTRACT

Introduction

Allergic rhinitis (AR) is a common disease with an important impact on the quality of life and very high management costs. In many patients, the poor control of rhinitis symptoms often requires the use of different drugs, and polytherapy tends to reduce therapeutic adherence. According to the latest version of ARIA guidelines, the currently recommended drugs for the treatment of moderate-to-severe AR are second-generation antihistamines, intranasal corticosteroids, and their combination, even in a single nasal spray device. A single medication with a rapid onset of action, acting on breakthrough symptoms too, would be advantageous, also in terms of patient compliance.

Areas covered

GSP301 (olopatadine 600 µg – mometasone furoate 25 µg) is a novel intranasal formulation, combining the second-generation antihistamine olopatadine hydrochloride with mometasone furoate. Here, we review the evidence for GSP301, especially concerning the efficacy and safety profile of this intranasal combination in the treatment of AR.

Expert opinion

The evidence provided in the current review clearly supports the use of GSP301 as a novel intranasal corticosteroid/antihistamine combination with a well-documented efficacy and safety profile in terms of rapid symptom relief and good tolerability.

KEYWORDS:

• Allergic rhinitis
• anti-histamine
• corticosteroid
• olopatadine hydrochloride
• mometasone furoate
• intranasal combinations

Article highlights

• Allergic rhinitis (AR) is a common disease with an important impact on the quality of life and very high management costs.

• The poor control of rhinitis symptoms often requires the use of different drugs, and polytherapy tends to reduce therapeutic adherence.

• ARIA guidelines recommend second-generation antihistamines, topical nasal steroids, and a combination of both drugs as first choice for the treatment of moderate-to-severe and persistent AR, possibly in the same device.

• GSP301 is a novel fixed-dose intranasal formulation combining the second-generation antihistamine olopatadine 600 µg and the intranasal steroid mometasone furoate 25 µg.

• Olopatadine is a potent selective antihistaminic agent that exerts its effects by antagonizing histamine and preventing histamine-induced inflammatory cytokine production by human conjunctival epithelial cells.

• Mometasone furoate is a topical glucocorticosteroid with local anti-inflammatory properties, which acts by inhibiting the release of mediators of allergic reactions.

• Overall, available evidence suggests that GSP301 is an effective option for the management of patients with SAR and PAR, providing prompt and long-lasting symptom control and contributing to improve quality of life.

• On the other hand, available evidence suggests that GSP301 is safe and well tolerated, with similar incidences of AEs compared with placebo or individual monotherapies, even in the long term.

• The evidence provided in the current review supports the use of GSP301 in clinical practice, in light of four major values in AR treatment: i) rapid onset of action, ii) efficacy on symptoms, iii) safety, and iv) easy to use route of administration.

Acknowledgments

The editorial assistance was provided by CONTENT ED NET. The medical writing service was provided by Elena Sarugeri on behalf of CONTENT ED NET.

Declaration of interest

E Ridolo received no research grants, sponsorship, or materials for this work and declares to have received personal fees from Alk Abello’ and Novartis outside of the submitted work. GW Canonica reports having received research grants as well as being lecturer or having received advisory board fees from Menarini, Anallergo, Allergy Therapeutics, AstraZeneca, Chiesi Farmaceutici, Faes, Firma, Genentech, Guidotti-Malesci, Glaxo Smith Kline, Hal Allergy, Innovacaremd, Novartis, OmPharma, RedMaple, Sanofi-Aventis, Sanofi-Genzyme, Stallergenes-Greer, Uriach Pharma, ThermoFisher, Valeas. G Paoletti reports having received advisory board fees from Glaxo Smith Kline and Novartis. E Heffler reports receiving grants and personal fees from AstraZeneca, Sanofi, Novartis, GSK, Circassia, Nestlè, Purina, Regeneron, Stallergenes-Greer, outside the submitted work. L Malvezzi received grants and personal fees from Sanofi, Novartis, AstraZeneca and GSK outside the submitted work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers in this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The medical writing service for this work was supported by Menarini. The funder had no role in reviewing the literature, defining recommendations, drafting the paper, or in the decision to submit the manuscript for publication. All views expressed are solely those of the authors.