Modern principles of allergic rhinitis treatment in children: The role of intranasal corticosteroids and features of fluticasone furoate

Allergic rhinitis (AR) is one of the most common chronic disorders in childhood and is associated with impaired sleep, school performance and quality of life as well as bronchial asthma. Contemporary management includes family education, reduction of clinically relevant allergen and irritant exposure, pharmacotherapy, and allergen immunotherapy when indicated. Intranasal corticosteroids (INCS) are first-line treatment for moderate-to-severe pediatric AR. This review summarizes evidence published in 2021–2026, focusing on fluticasone furoate (FF), fluticasone propionate (FP), and mometasone furoate (MF). A 2024 network meta-analysis of 43 randomized trials involving 10.897 children ranked FF among the most effective INCS for nasal symptom outcomes, although certainty was limited by study quality. A 2025 network meta-analysis confirmed the overall efficacy and safety of intranasal therapies in children. FF is a distinct fluticasone ester rather than a prodrug of FP and combines high local glucocorticoid activity with very low systemic exposure. Once-daily dosing is a practically relevant feature in pediatric long-term therapy. FLERZINI®, registered in the Russian Federation, contains fluticasone furoate 27.5 μg per actuation and is indicated for nasal symptoms of seasonal and perennial AR in children aged ≥2 years. In children aged 2–11 years, the recommended initial dose is 55 μg/day. FF is therefore a rational option for maintenance treatment of pediatric AR, particularly when regimen simplicity may support adherence.