Treating nasal polyps

Where do you want to deliver a topical steroid when treating nasal polyps?

Deposition with conventional intranasal steroids (INS) occurs predominantly in the anterior portion of the nasal cavity.¹

Graphic of example of single-photon emission computed tomography (SPECT)/MRI image for QNASL® deposition in the nasal cavity

Graphic of example of single-photon emission computed tomography (SPECT)/MRI image for Flonase® deposition in the nasal cavity

Graphic of example of single-photon emission computed tomography (SPECT)/MRI image for Nasonex® deposition in the nasal cavity

Legend of external markers from examples of single-photon emission computed tomography (SPECT)/MRI images for QNASL®, Flonase®, and Nasonex® deposition in the nasal cavity

Example of single-photon emission computed tomography (SPECT)/MRI images for QNASL^®, Flonase^®, and Nasonex^®. Images show 2 external fiducial markers used to align SPECT with MRI data.¹ All trademarks are the property of their respective owners.

Minimal deposition within the turbinates, ostiomeatal complex, and posterior nasal regions where most polyps originate^1-4
Most studies suggest that conventional INS do not reach the paranasal sinuses even after endoscopic sinus surgery⁵
The clinical relevance of different deposition patterns has not been established

Curious to see the deposition with XHANCE?

See how XHANCE deposits medication high and deep in the nasal passages to regions where nasal polyps originate and sinuses drain and ventilate.^4,6

See the Deposition

The clinical trials for XHANCE evaluated over 1500 patients.⁷

See what makes XHANCE different.

Watch MOD Video

IMPORTANT SAFETY INFORMATION

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS:
Hypersensitivity to any ingredient in XHANCE.

WARNINGS AND PRECAUTIONS:

Local Nasal Adverse Reactions: epistaxis, erosion, ulceration, septal perforation, Candida albicans infection, and impaired wound healing. Monitor patients periodically for signs of possible changes on the nasal mucosa. Avoid use in patients with recent nasal ulcerations, nasal surgery, or nasal trauma until healing has occurred.
Close monitoring for glaucoma and cataracts is warranted.
Hypersensitivity reactions (e.g., anaphylaxis, angioedema, urticaria, contact dermatitis, rash, hypotension, and bronchospasm) have been reported after administration of fluticasone propionate. Discontinue XHANCE if such reactions occur.
Immunosuppression and Risk of Infection: potential increased susceptibility to or worsening of infections (e.g., existing tuberculosis; fungal, bacterial, viral, or parasitic infection; ocular herpes simplex). Use with caution in patients with these infections. More serious or even fatal course of chickenpox or measles can occur in susceptible patients.
Hypercorticism and adrenal suppression may occur with very high dosages or at the regular dosage in susceptible individuals. If such changes occur, discontinue XHANCE slowly.
Patients with major risk factors for decreased bone mineral content should be monitored and treated with established standards of care.

ADVERSE REACTIONS:
The most common adverse reactions (incidence ≥ 3%) are epistaxis, nasal septal ulceration, nasopharyngitis, nasal mucosal erythema, nasal mucosal ulcerations, nasal congestion, acute sinusitis, nasal septal erythema, headache, and pharyngitis.

DRUG INTERACTIONS:
Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. May increase risk of systemic corticosteroid effects.

USE IN SPECIFIC POPULATIONS:
Hepatic impairment. Monitor patients for signs of increased drug exposure.

INDICATION
XHANCE is a corticosteroid indicated for the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) in patients 18 years of age or older.

Please see Full Prescribing Information pdf opensfull Prescribing Information, including Instructions for Use.

References:

Leach CL, Kuehl PJ, Chand R, McDonald JD. Nasal deposition of HFA-beclomethasone, aqueous fluticasone propionate and aqueous mometasone furoate in allergic rhinitis patients. J Aerosol Med Pulm Drug Deliv. 2015;28(5):334-340.
Zhong C, Jiang Z, Zhang X. Effect of distribution of nasal polyps in ostiomeatal complex on long-term outcomes after endoscopic surgery. Eur Arch Otorhinolaryngol. 2015;272(12):3757-3762.
Larsen PL, Tos M. Origin of nasal polyps: an endoscopic autopsy study. Laryngoscope. 2004;114(4):710-719.
Djupesland PG. Nasal drug delivery devices: characteristics and performance in a clinical perspective — a review. Drug Deliv Transl Res. 2013;3(1):42-62.
Siu J, Johnston JJ, Pontre B, Inthavong K, Douglas RG. Magnetic resonance imaging evaluation of the distribution of spray and irrigation devices within the sinonasal cavities. Int Forum Allergy Rhinol. 2019;9(9):958-970.
Full Prescribing Information for XHANCE (fluticasone propionate). OptiNose US, Inc.; 2023.
Data on file. OptiNose US, Inc.