The fluticasone exhalation delivery system (EDU-FLU, XHANCE; Optinose US; Yardley, PA) is a novel topical steroid delivery system that is an important adjunct therapy for sinonasal inflammatory disease, according to a study published in the International Forum of Allergy & Rhinology.1

Intranasal steroids are often used for long-term management of chronic rhinosinusitis. Currently, intranasal steroid medications are administered in sprays, which are generally limited to treatment of the anterior nasal cavity, and rinses, and are not approved by the United States Food and Drug Administration (FDA) for this condition.1 EDS-FLU is the first exhalation delivery system that uses patient-initiated exhalation to deliver fluticasone to the deeper and higher areas within the nasal cavity and that is FDA approved specifically for the treatment of nasal polyps.2,3

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Researchers evaluated current evidence on the efficacy of EDS-FLU in the treatment of chronic rhinosinusitis without polyps and chronic rhinosinusitis with nasal polyps through a comprehensive literature review.1 They found that recent large-scale studies have suggested that EDS-FLU is effective and safe for patients with both chronic sinusitis with polyposis and without polyps. A decreased Sinonasal Outcome Test score of 20 points following treatment has been reported, as has improvement of polyp grade by ≥1points in >60% of patients. In addition, there was a 60% to 70% decreased indication for surgery following EDS-FLU use.

The researchers concluded that treatment with EDU-FLU “provides significant improvement in patient-reported symptoms and objective measures of inflammation, and may decrease the need for sinus surgery.”

Disclosures: Drs Bosso and Adappa are consultants for OptiNose US.

References

1. Kuan EC, Kovacs AJ, Workman AD, Bosso JV, Adappa ND. Efficacy of fluticasone exhalation delivery system in the management of chronic rhinosinusitis: what is the evidence? Int Forum Allergy Rhinol. 2019;9:S16-S21.

2. Djupesland PG, Skretting A, Winderen M, Holand T. Breath actuated device improves delivery to target sites beyond the nasal valve. Laryngoscope. 2006;116:466-472.

3. Djupesland PG, Messina J, Mahmoud R. New exhalation delivery systems (EDS) enhance topical steroid delivery in chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol. 2017;139:AB65.