Efficacy of the Exhalation Delivery System With Fluticasone for Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis.

The Annals of otology, rhinology, and laryngology Pub Date : 2025-07-05 DOI:10.1177/00034894251349397

Yeon Hee Im, Gulnaz Stybayeva, Se Hwan Hwang

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Abstract

Objectives: Novel biomechanics of the exhalation delivery system can deliver fluticasone (EDS-FLU; XHANCE) to sinonasal areas above the inferior turbinate, especially sinus drainage pathways not reached by standard nasal sprays. This study aimed to evaluate the effectiveness of EDS-FLU in treating chronic rhinosinusitis (CRS).

Methods: Studies were retrieved from PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases up to April 2024. We analyzed 5 studies that compared EDS-FLU with a control group (exhalation delivery system with placebo) on various outcomes, including the 22-item Sinonasal Outcome Test (SNOT-22), nasal symptom scores (congestion, facial pain, olfactory dysfunction, and rhinorrhea), nasal polyp scores, surgical indication rate, and the incidence of adverse effects.

Results: Five studies with 2129 patients were included. EDS-FLU significantly improved SNOT-22 score (-20.9657 [-23.5639; -18.3674]) and the polyp score (-1.5099 [-1.7810; -1.2388]) after 6 months. The incidence of epistaxis was significantly higher in the treatment group compared to the control group (OR = 5.7954 [2.1004; 15.9909]). Effects of EDS-FLU on polyp score (-0.6497 [-0.8186; -0.4807]), responder rate (OR = 2.1755 [1.2784; 3.7020]), complete responder rate (OR = 2.0423 [1.0109; 4.1262]), surgical indication rate (OR = 0.7313 [0.5459; 0.9797]), and SNOT-22 score (-6.1513 [-11.3054; -0.9972]) were significantly higher in the treatment group than in the control group.

Conclusions: This study demonstrated that EDS-FLU (372 µg twice daily) produced statistically significant improvements compared to EDS-placebo in multiple subjective and objective outcomes, although some adverse effects, such as epistaxis, may occur.

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氟替卡松呼气输送系统治疗慢性鼻窦炎的疗效：系统评价和荟萃分析。

目的：新型生物力学呼气给药系统能给药氟替卡松（EDS-FLU）；下鼻甲以上的鼻窦区域，特别是标准鼻喷雾剂无法到达的鼻窦引流通道。本研究旨在评价EDS-FLU治疗慢性鼻窦炎（CRS）的疗效。方法：从PubMed、SCOPUS、Embase、Web of Science和Cochrane数据库检索到2024年4月的研究。我们分析了5项比较EDS-FLU与对照组（呼气输送系统与安慰剂）各种结果的研究，包括22项鼻窦结局测试（SNOT-22）、鼻症状评分（充血、面部疼痛、嗅觉功能障碍和鼻漏）、鼻息肉评分、手术指征率和不良反应发生率。结果：纳入5项研究，共2129例患者。EDS-FLU显著提高SNOT-22评分(-20.9657 [-23.5639；-18.3674])和息肉评分(-1.5099 [-1.7810；-1.2388])， 6个月后。治疗组鼻出血发生率明显高于对照组(OR = 5.7954 [2.1004；15.9909])。EDS-FLU对息肉评分的影响(-0.6497 [-0.8186；-0.4807])，应答率(OR = 2.1755 [1.2784；3.7020])，完全应答率(OR = 2.0423 [1.0109；4.1262])，手术指征率(OR = 0.7313 [0.5459；0.9797])， SNOT-22评分(-6.1513 [-11.3054；-0.9972])，治疗组显著高于对照组。结论：该研究表明，与eds -安慰剂相比，EDS-FLU（372µg，每日两次）在多个主观和客观结果上产生了统计学上显著的改善，尽管可能会出现一些不良反应，如鼻出血。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The Annals of otology, rhinology, and laryngology

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