As-Needed Intranasal Corticosteroids for Allergic Rhinitis?

We have told patients for years that intranasal corticosteroids must be used consistently for 2 weeks to receive the full benefit for managing allergic rhinitis (AR) symptoms. But now that as-needed inhaled corticosteroids are endorsed in national guidelines for asthma, this approach is being studied for AR.

Researchers from Thailand performed a randomized trial to compare as-needed versus daily fluticasone furoate nasal spray in 108 patients with perennial AR. In the as-needed group, patients used 2 sprays once daily for 1 week, followed by as-needed use for 5 additional weeks; in the daily group, patients used 2 sprays once daily for 6 weeks. After 6 weeks, the daily group experienced somewhat more improvement in the Total Nasal Symptoms S…