Comparative study of fluticasone propionate combined with azelastine versus fluticasone propionate alone as nasal spray in allergic rhinitis
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20210683Keywords:
Allergic rhinitis, Fluticasone propionate, Azelastine, Total symptom scoreAbstract
Background: Allergic rhinitis (AR) is a symptomatic disorder of the nose induced after allergen exposure due to an IgE-mediated inflammation of membranes lining the nose. Allergic rhinitis is subdivided into intermittent (IAR) or persistent (PER) disease and the severity into mild or moderate/severe. The most widely used and effective medications to treat allergic rhinitis are oral or topical antihistamines and topical nasal steroids.
Methods: This prospective case series study included 80 patients of PER divided randomly in to 2 groups of 40 each with group 1 receiving fluticasone propionate and azelastine and group 2 receiving fluticasone propionate alone. Individual symptom scores and total symptom score (TSS) were recorded before treatment and after 4 weeks of treatment.
Results: The difference in mean TSS before and after 4 weeks study period were statistically significant in both groups (p<0.01 in both). Group 1 had TSS of 1.525±1.06 and group 2 had TSS of 3.275±1.75 after 4 weeks of treatment and the difference between them was statistically significant (p<0.01).
Conclusions: In allergic rhinitis, both fluticasone propionate + azelastine nasal spray and fluticasone propionate nasal spray are effective in relieving symptoms. But, fluticasone propionate and azelastine has significant reduction of symptoms when compared with fluticasone propionate alone.
References
Varshney J, Varshney H. Allergic Rhinitis: a Overview Indian J Otolaryngol Head Neck Surg. 2015;67(2):143-9.
Ellis AK, Soliman M, Steacy L, Boulay ME, Boulet LP, Keith PK et al. The allergic rhinitis-clinical investigator collaborative (AR-CIC): nasal allergen challenge protocol optimization for studying AR pathophysiology and evaluating novel therapies. Allergy Asthma Clin Immunol. 2015;11:16.
Meltzer EO. Quality of life in adults and children with allergic rhinitis. J Allergy Clin Immunol. 2001;108(1):S45-53.
Gardiner Q. Allergic rhinitis. In: Watkinson JC, Clarke RW, Clark LJ, Mehanna HM, Donne AJ, McGarry GW, et al editors. Scott-brown’s otorhinolaryngology head and neck surgery. 8th ed. Vol 1. Florida: CRC press; 2018: 999-1010.
Gaur SN, Gupta K, Rajpal S, Singh AB, Rohtagi A. Prevalence of bronchial asthma and allergic rhinitis among urban and rural adult population of Delhi. Indian J Allergy Asthma Immunol. 2006;20:90-7.
Ologe FE, Adebola SO, Dunmade AD, Adeniji KA, Oyejola BA. Symptom Score for Allergic Rhinitis. Otolaryngol Head and Neck Surg. 2013;148(4):557-63.
Annesi-Maesano I, Didier A, Klossek M, Chanal I, Moreau D, Bousquet J. The score for allergic rhinitis (SFAR): a simple and valid assessment method in population studies. Allergy. 2002;57:107-14.
Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126:466-76.
Horak F. Effectiveness of twice daily azelastine nasal spray in patients with seasonal allergic rhinitis. Therap Clin Risk Management. 2008:4(5):1009-22.
Nielsen LP, Dahl R. Comparison of intranasal corticosteroids and antihistamines in allergic rhinitis:
a review of randomized, controlled trials. Am J Respir Med. 2003;2(1):55-65.
Havle A, Jain V, Ahmed MF, Shedge S, Dokania V, Bagwe V, et al. Olopatadine Hydrochloride and Fluticasone Propionate in Topical Treatment of Allergic Rhinitis: A Single Blind Randomised Study. J clin diagn res. 2016;10(12):MC04-07.
Bhadouriya SKS, Srivastava M, Saxena R, Srivastava A. Comparative clinical evaluation of effect of topical verses systemic anti -allergic drug in allergic rhinitis: a prospective study. Int J Otorhinolaryngol Head Neck Surg. 2018;4:141-7.
Hagy GW, Saltipane GA. Risk factors for developing asthma and allergic rhinitis. J Allergy Clin Immunol. 1976;58:330-6.
Dalvi R, Havle AD. Comparitive analysis of treatment of allergic rhinitis utilising azelastine and fluticasone. Int j res pharma sci. 2020;11(3):4636-43.
Dykewicz MS, Kaiser HB, Nathan RA, Goode-Sellers S, Cook CK, Witham LA et al. Fluticasone propionate aqueous nasal spray improves nasal symptoms of seasonal allergic rhinitis when used as needed (prn). Ann Allergy, Asthma Immunol. 2003;91(1):44-8.
Ratner PH, Hampel F, Bavel JV, Amar NJ, Daftary P, Wheeler W et al. Combination therapy with azelastine hydrochloride nasal spray and fluticasone propionate nasal spray in the treatment of patients with seasonal allergic rhinitis. Ann Allergy, Asthma Immunol. 2008;100(1):74-81.
