The role of budesonide and mometasone furoate on the nasal and sinus symptoms in allergic rhinosinuitis: a randomized study

Authors

  • Sriram Govindaraj Department of ENT, Vinayaka Mission Medical College and Research Institute, KezhaKasasakudi Medu, Karaikal, Puducherry, India http://orcid.org/0000-0003-4761-3077
  • Ganeshbala Arivazhagan Department of ENT, Vinayaka Mission Medical College and Research Institute, KezhaKasasakudi Medu, Karaikal, Puducherry, India http://orcid.org/0000-0002-9941-1234
  • Jayendiran Subramani Department of ENT, Vinayaka Mission Medical College and Research Institute, KezhaKasasakudi Medu, Karaikal, Puducherry, India
  • Jinu Vadakkanethu Iype Department of ENT, Vinayaka Mission Medical College and Research Institute, KezhaKasasakudi Medu, Karaikal, Puducherry, India
  • Ilango Chakkravarthy Department of ENT, Vinayaka Mission Medical College and Research Institute, KezhaKasasakudi Medu, Karaikal, Puducherry, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20195193

Keywords:

Allergic rhinitis, Allergic rhino-sinusitis, Symptoms, Budesonide, Mometasone furoate, SNOT, TNSS, Intranasal steroids

Abstract

Background: Allergic rhinosinuitis is one of the common clinical problems that otorhinolaryngologist faces daily. Sinusitis symptoms like headache, facial pain and eyelid oedema are frequent in patients with allergic rhinitis, which in turn will affect the cognitive function, productivity and quality of life which impair the efficiency of the individual work performance. It may result in a prescription for antibiotics but the role of antibiotics is debated. Anti-inflammatory drugs such as intranasal steroids play a major role in reducing the symptoms of allergic rhinitis. We plan to compare the efficacy of budesonide nasal spray with mometasone furoate nasal spray in reducing the nasal and sinus symptoms of allergic rhinosinusitis.

Methods: 146 patients of allergic rhinitis with sinusitis symptoms were randomly divided into 2 groups as Group A (n=70) received 256 μg budesonide nasal spray of once daily and Group B (n=76) received 200 μg of mometasone furoate nasal spray daily. The patients were assessed by sino-nasal outcome test (SNOT) score and total nasal symptom score (TNSS) at 2, 6 and 12 weeks interval.  

Results: There is significant reduction in both the groups, in respect to the SNOT and TNSS scores. We also observed significant improvement in the SNOT score in the budesonide group when compared with the mometasone furoate group by 6weeks which continued till the 12 weeks (p=0.001).

Conclusions: Budesonide nasal spray is more effective than mometasone furoate spray in managing both sinus and nasal symptoms in allergic rhinitis.

Metrics

Metrics Loading ...

Author Biographies

Sriram Govindaraj, Department of ENT, Vinayaka Mission Medical College and Research Institute, KezhaKasasakudi Medu, Karaikal, Puducherry, India

Assistant Professor

Derpartment of ENT

Vinayaka mission's medical college and hospital, Karaikkal, Puducherry- 609609

Ganeshbala Arivazhagan, Department of ENT, Vinayaka Mission Medical College and Research Institute, KezhaKasasakudi Medu, Karaikal, Puducherry, India

Professor

Derpartment of ENT

Vinayaka mission's medical college and hospital, Karaikkal, Puducherry- 609609

Jayendiran Subramani, Department of ENT, Vinayaka Mission Medical College and Research Institute, KezhaKasasakudi Medu, Karaikal, Puducherry, India

Senior Resident

Derpartment of ENT

Vinayaka mission's medical college and hospital, Karaikkal, Puducherry- 609609

Jinu Vadakkanethu Iype, Department of ENT, Vinayaka Mission Medical College and Research Institute, KezhaKasasakudi Medu, Karaikal, Puducherry, India

Post Graduate

Derpartment of ENT

Vinayaka mission's medical college and hospital, Karaikkal, Puducherry- 609609

References

Howarth PH. Mediators of nasal blockage. Allergy. 1997;52:12-8.

Lethbridge-Cejku M, Schiller JS, Bernadel L. Summary health statistics for US adults: National Health Interview Survey, 2002. Vital Health Stat 10. 2004;222:1-151.

Kari O, Saari KM. Diagnostics and new developments in the treatment of ocular allergies. Curr Allergy Asthma Rep. 2012;12(3):232-9.

Stempel DA, Thomas M. Treatment of allergic rhinitis: an evidence-based evaluation of nasal corticosteroids versus non-sedating antihistamines. Am J Manag Care. 1998;4:89-96.

Brogden RN, McTavish D. Budesonide. An updated review of its pharmacological properties, and therapeutic efficacy in asthma and rhinitis. Drugs. 1992;44:375-407.

Rodrigo GJ, Neffen H. Efficacy of fluticasone furoate nasal spray vs. placebo for the treatment of ocular and nasal symptoms of allergic rhinitis: a systematic review. Clin Exp Allergy. 2011;41(2):160-70

Lavigne F, Cameron L, Renzi PM, Planef JF, Christo Doulopoulos P, Lamkiched B. Intrasinus administration of topical budesonide to allergic patients with chronic rhinosinusitis following surgery. Laryngoscope. 2002;12:858-64.

Lund V, Black JH, Szabo LZ, Schreweling C, Akerlund A. Efficacy and tolerability of budesonide aqueous nasal spray in chronic rhinosinusitis patients. Rhinol. 2004;42:57-62.

Bielory L. Ocular symptom reduction in patients with seasonal allergic rhinitis treated with the intranasal corticosteroid mometasone furoate. Ann Allergy Asthma Immunol. 2008;100(3):272-9.

Rodríguez-Martínez CE, Sossa-Briceño MP, Lemos EV. Cost-effectiveness analysis of mometasone furoate versus beclomethasone dipropionate for the treatment of pediatric allergic rhinitis in Colombia. Adv Ther. 2015;32(3):254-69.

Keith PK, Scadding GK. Are intranasal corticosteroids all equally consistent in managing ocular symptoms of seasonal allergic rhinitis?. Curr Med Res Opin. 2009;25(8):2021-41.

Small CB, Hernandez J, Reyes A, Schenkel E, Damiano A, Stryszak P, et al. Efficacy and safety of mometasone furoate nasal spray in allergic rhinitis, acute rhinosinusitis and nasal polyposis. J Allergy Clin Immunol. 2009;6(3):393-406.

Zitt M, Kosoglou T, Hubbell J. Mometasone furoate nasal spray. A review of safety and systemic effects. Drug Saf. 2007;30:317-26.

Samolinski B, Nowicka A, Wojas O, Lipiec A, Krzych-Fałta E, Tomaszewska A. Intranasal glucocorticosteroids- not only in allergic rhinitis In the 40th anniversary of intranasal glucocorticosteroids’ introduction. Otolaryngol Pol. 2014;68(2):51-64.

Blaiss MS. Safety considerations of intranasal corticosteroids for the treatment of allergic rhinitis. Allergy Asthma Proc. 2007;28(2):145-52.

Jang TY, Kim YH. Recent Updates on the Systemic and Local Safety of Intranasal Steroids. Curr Drug Metab. 2016;17(10):992- 6.

Sachanandani NS, Piccirillo JF, Kramper MA, Thawley SE, Vlahiotis A. The effect of nasally administered budesonide respules on adrenal cortex function in patients with chronic rhinosinusitis. Arch Otolaryngol Head Neck Surg. 2009;135(3):303-7.

Downloads

Published

2019-12-23

Issue

Section

Original Research Articles