{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:27:04Z","timestamp":1786976824476,"version":"build-2736575974"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T00:00:00Z","timestamp":1600905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Standard nasal steroid sprays are often first\u2010line treatment for chronic rhinosinusitis (CRS), but many patients remain symptomatic despite their use. The exhalation delivery system with fluticasone (EDS\u2010FLU) has been shown to be efficacious in mixed populations of symptomatic patients, but the question remains whether benefits would be similar in those already on traditional steroid sprays. The goal of this study was to compare EDS\u2010FLU treatment outcomes in patients who have previously failed nasal steroids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using pooled data from the NAVIGATE I and II trials, EDS\u2010FLU efficacy was compared in the subgroup treated with a conventional nasal steroid at trial entry (mean duration, \u22483 years) to efficacy in the overall study population. Sensitivity analyses were performed for more restrictive definitions of the subgroup changing from prior standard nasal steroids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of\u00a0482 total subjects, 218 (45.2%) reported using standard nasal steroid sprays at entry (mean duration, 1051 days). Across multiple outcome measures, improvements for \u201cswitchers\u201d receiving EDS\u2010FLU (least squares mean change from baseline vs EDS plus placebo) were comparable with improvements in the overall population. For EDS\u2010FLU 372 \u03bcg, comparable improvements were observed in congestion (\u22120.73 vs \u22120.62), rhinorrhea (\u22120.71 vs \u22120.57), facial pain\/pressure (\u22120.48 vs \u22120.41), and sense of smell (\u22120.35 vs \u22120.30) at week 4 and 22\u2010item Sino\u2010Nasal Outcome Test (\u221221.01 vs \u221220.52), Patient Global Impression of Change, and other outcomes at week 16. Results for EDS\u2010FLU 186 \u03bcg were similar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EDS\u2010FLU comparably improves symptoms, irrespective of whether patients are symptomatic while using conventional nasal steroids before treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.22693","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T14:39:34Z","timestamp":1600958374000},"page":"837-845","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Efficacy of the exhalation delivery system with fluticasone in patients who remain symptomatic on standard nasal steroid sprays"],"prefix":"10.1002","volume":"11","author":[{"given":"Brent A.","family":"Senior","sequence":"first","affiliation":[{"name":"Division of Rhinology, Allergy, and Skull Base 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