Fluticasone - Effects in treating nasal polyps

Fluticasone (International name: Fluticasone propionate) is a synthetic corticosteroid with a fluoride atom attached to the steroid skeleton.
1. Pharmacology and mechanism of action of Fluticasone
The mechanism of action of Fluticasone is a combination of three important properties: anti-inflammatory, anti-itch and vasoconstrictor effects.

Chemical structure of Fluticasone propionate

Corticosteroids reduce inflammation by stabilizing the lysosomal membrane of leukocytes, inhibiting macrophage concentration in inflamed areas, reducing leukocyte adhesion to capillary endothelium, reducing capillary wall permeability, and reducing complement components, antagonize the effects of histamine and the release of kinin from substrates, reduce the proliferation of fibroblasts, reduce collagen deposition and subsequently reduce tissue scar formation.
Asthma treatment
Inflammation is an important factor in the pathogenesis of asthma, and the effectiveness of glucocorticoids in treating asthma is due to the anti-inflammatory effect of the drug. Fluticasone propionate inhaled nebulizer is indicated for maintenance treatment and prevention of asthma attacks.
Fluticasone propionate works relatively quickly and improves asthma within 24 hours of inhalation, although maximum effect is not achieved for 1 - 2 weeks or longer after starting treatment.
Treatment of year-round or seasonal allergic rhinitis
The effect of Fluticasone propionate in the treatment of allergic rhinitis is due to the drug reducing the release of inflammatory mediators that cause allergic symptoms such as itching, sneezing, runny nose and edema.
Symptoms usually ease within 12 - 48 hours after starting the drug, however in some patients it takes up to 2 - 4 days to achieve maximum treatment effect.
2. Fluticasone treats nasal polyps
Nasal polyps are benign mass lesions, originating from inflammation and degeneration of the nasal sinus mucosa. Although benign, nasal polyps and their underlying disease can greatly affect a patient's quality of life. Fluticasone has been shown to be an effective and safe treatment for allergic and non-allergic rhinitis and is used as a medication to reduce the inflammatory response, increase nasal airflow, and shrink polyp size.
Results from a preliminary study in patients with moderate to severe polyposis demonstrated that it was effective in reducing polyp size and related symptoms such as: nasal congestion, decreased or loss of sense of smell, expectoration, facial pain, headache, sleep disturbance.
Reference sources:
Vietnam National Pharmacopoeia 2015
EMC: https://www.medicines.org.uk/emc/product/8267/pil
PubMed: https://pubmed.ncbi.nlm.nih.gov/9604976/