Patient preference and sensory comparisons of nasal spray allergy medications

In a double-blind crossover study, 94 symptomatic adult patients with allergic rhinitis rated sensory preferences for single exposures (2 sprays in each nostril) to three intranasal corticosteroids: triamcinolone acetonide AQ, beclomethasone dipropionate AQ, and fluticasone propionate. Each patient was given the medication and then immediately asked to use a 100-point scale to rate 13 attributes: comfort to take the medicine, medicine run-off irritation, strength of urge to sneeze, strength of odor, liking odor, strength of taste, strength of bitter taste, liking taste, and moistness of nose and throat, and then (at least 2 min after administration) irritation, medicine run-off and overall liking. The order of drug presentation was randomized across patients and a 30-min rest interval occurred between drug administrations. Triamcinolone was lower in odor strength than both beclomethasone and fluticasone (mean scopes of 8 vs 57 and 52, respectively; P<0.001) and the odor of triamcinolone was preferred to the odor of the two other sprays (mean score of 72 vs 55 and 55, respectively, P<0.001). While the taste intensity ratings of the three sprays were not significantly different, the triamcinolone taste was liked more than that of fluticasone (mean scores of 55 vs 41, P<0.04). Overall, triamcinolone was liked more than fluticasone (P<0.05). In summary, patient preference testing has shown that triamcinolone is preferred over beclomethasone and/or fluticasone in terms of odor and taste. Such preferences may be important in treatment compliance and outcomes.