Integrating in Vitro Performance and In Vivo Patient-Reported Outcomes of a Mometasone Furoate Nasal Spray Device: A Translational Evaluation

Background: Intranasal corticosteroids (INCSs) are widely prescribed for allergic and nonallergic rhinitis and chronic rhinosinusitis, frequent causes of upper airway cough syndrome (UACS). In UACS, adherence is strongly influenced not only on pharmacological efficacy but also on device performance and sensory tolerability. Despite this, few studies have linked in vitro spray characteristics with patient-reported outcomes. Objective: To evaluate the technological characteristics and clinical acceptability of mometasone furoate administered via the liquid VP3 nasal spray device by integrating in vitro performance testing and in vivo patient-reported outcomes in individuals with chronic cough and UACS. Methods: In vitro experiments assessed deposition patterns in a silicone nasal cast, dripping behavior on inclined gel surfaces, viscosity, and spray plume geometry. An observational study enrolled 10 patients (80% female, mean age 56 ± 8.4 years) referred to a tertiary cough clinic for chronic cough (mean duration 3.5 years) associated with postnasal drip. Patients switched from conventional mometasone sprays to the device and completed Anchored Best-Worst Scaling evaluations of 11 sensory and treatment-related attributes. Global satisfaction was rated using a visual analog scale (VAS) and Treatment Satisfaction Index (TSI). Results: Deposition was reproducible (27.9 ± 1.7% of cast surface) with distribution into middle and lower turbinates. Moderate viscosity (14.4 ± 3.2 mPa·s) and stable plume geometry supported retention. In vivo, overall satisfaction scores remained stable following switching (TSI: 64.3 ± 3.4 vs 63.8 ± 4.6; VAS: 6.8 ± 3.2 vs 6.1 ± 1.6). However, patients reported significantly greater satisfaction in two sensory domains and rated three domains as more important (p < 0.05). No deterioration in any attribute was observed. Conclusion: The liquid VP3 nasal spray device delivering mometasone furoate demonstrated reliable in vitro performance and favorable patient acceptability in UACS. The correspondence between deposition behavior and patient-reported tolerability supports its suitability for INCS delivery and warrants further evaluation in larger, longer-term studies.