Exhalation Delivery System (EDS) Intranasal Steroid Vs Conventional Inhaled Nasal Steroids (INS): Patient Preference, Comfort and Ease of Use

Intranasal steroids, usually by inhalation (INS), are first-line therapy for chronic rhinosinusitis, but most patients are frustrated with treatment efficacy. We compare patient satisfaction and ease-of-use with INS vs an exhalation delivery system (EDS-FLU; XHANCE™), that can help achieve better superior/posterior drug deposition. Analysis of ease-of-use and comfort in two 24-week (16 double-blind+8 open-label; N=322/321) RCTs with EDS-FLU in patients with CRS with nasal polyps. Patients reported current (or most recent) prescription intranasal steroid at screening and compared to EDS-FLU at weeks 4, 16, and 24. Self-reported “real world” survey results from patients prescribed EDS-FLU outside clinical trials were also evaluated. In the RCTs, at screening, 77-84% and 71-74% of patients reported their current/most recent inhaled INS was easy-to-use and comfortable-to-use, respectively. At weeks 4, 16, and 24, 86-88%, 87-91%, and 90% reported EDS-FLU was easy-to-use and 80-85%, 82-88%, and 83-85%, reported it was comfortable to use, respectively. Compared to their current/most recent inhaled nasal steroid, at 4 weeks, EDS-FLU patients reported less loss of drug to drip down the back of the throat (61-67.0%) or out the front of the nose (55-64%). In a “real world” patient survey (N=2733), 89% of patients electing to complete the survey reported treatment satisfaction and 77% preferred EDS-FLU to prior inhaled steroids or steroid rinses. Large RCTs and a large survey of ‘real-world’ patients suggest that patients find EDS-FLU easy-to-use, comfortable, and associated with improved symptoms and high patient satisfaction.