scholarly journals A comparative study to assess the efficacy of fluticasone and mometasone in allergic rhinitis

Author(s):  
Waqar Ul Hamid ◽  
Deepshikha Sumbria ◽  
Ihsan Ali ◽  
Rauf Ahmad

<p class="abstract"><strong>Background:</strong> Allergic rhinitis is the most prevalent of allergic diseases in the world. Pharmacotherapy remains the mainstay of treatment.  Nasal corticosteroids being the most applicable drugs for its treatment. The objective of this study was to compare the efficacy of fluticasone propionate (FP) and mometasone furoate (MF) nasal sprays in the treatment of allergic rhinitis based on total nasal symptom score (TNSS) questionnaire.</p><p class="abstract"><strong>Methods:</strong> A prospective, randomized, open-label, parallel-group, comparative study was conducted among 80 allergic rhinitis patients fulfilling the inclusion and exclusion criteria. They were randomly assigned to two groups: FP and MF groups. FP group received 200 µg dose of FP nasal spray (1 spray/nostril) daily and the MF group received 100 µg dose of MF nasal spray (1 spray/nostril) daily for 8 weeks. The effects of the two agents were compared based on TNSS questionnaire in 0, 4 and 8 weeks after the beginning of the treatment.  </p><p class="abstract"><strong>Results:</strong> At the end of eight weeks of treatment, both groups showed statistically significant (p&lt;0.005) improvements from their baseline TNSS. Mean TNSS was reduced from to 9.46 to 2.716 in FP group and from 10.18 to 2.504 in MF group.</p><p class="abstract"><strong>Conclusions:</strong> Both the groups showed a significant therapeutic benefit in patients with allergic rhinitis. Even though, the difference between the two is not significant for 8 weeks therapy.   </p>

Author(s):  
Mahshid Sadat Mirmoezzi ◽  
Mohammad Shurideh Yazdi ◽  
Omid Gholami

Objective: Allergic rhinitis is the most prevalent of allergic diseases in the world. Nasal corticosteroids are the most applicable drugs for the treatment of allergic rhinitis. In this study, we compared the efficacy of fluticasone propionate (FP) and mometasone furoate (MF) nasal sprays in the treatment of allergic rhinitis based on total nasal symptom score (TNSS) questionnaire.Methods: For this study, 75 allergic rhinitis patients based on skin prick test and inclusion criteria were randomly assigned to two groups: FP and MF groups. FP group received 200 µg dose of FP nasal spray (1 spray/nostril) daily and the MF group received 100 mg dose of MF nasal spray (1 spray/nostril) daily for 8 w. The effects of the two agents were compared based on TNSS questionnaire in 0, 4 and 8 w after the beginning of the treatment.Results: Results showed that patients in both groups exhibited significant improvement in their TNSS (P Value<0.001). A detailed TNSS analysis showed MF to be more effective for relieving all symptoms than FP. The most difference is in decreasing postnasal discharge (PND) symptom. However, the difference for relieving all symptoms is not significant (P value>0.05).Conclusion: In conclusion, FP and MF are significantly effective in relieving of allergic rhinitis symptoms. Even though, the difference between the two is not significant for 8 w therapy. 


1995 ◽  
Vol 4 (7) ◽  
pp. S11-S15 ◽  
Author(s):  
Ralph Mösges ◽  
Joachim Spaeth ◽  
Ludger Klimek

Levocabastine and azelastine are currently the only antihistamines available as nasal sprays for the topical therapy of seasonal allergic rhinitis. The present study was undertaken to compare the onset of action, efficacy and tolerability of these two agents in a total of 242 patients with this condition. This was an international, multicentre, open-label, randomized, parallel-group trial with 123 patients treated with levocabastine (0.5 mg/ml, two puffs per nostril twice daily) and 119 with azelastine (1 mg/ml, one puff per nostril twice daily). Onset of action was comparable for the two drugs with over 50% of patients in each group reporting significant symptomatic relief within 30 min of administration of the first dose of study medication. Therapeutic efficacy was also found to be comparable in the two groups with no statistically significant intergroup differences reported for any of the parameters evaluated, although assessments of global therapeutic efficacy revealed a trend favouring levocabastine. Levocabastine appeared to be better tolerated than azelastine (p = 0.06), with the incidence of the most common adverse experiences, application site reactions and taste disturbances, significantly higher on azelastine than with levocabastine (5% versus 1%; p = 0.05 and 5% versus 0%; p = 0.01, respectively). In conclusion, levocabastine nasal spray appears to be at least as effective as, but better tolerated than, azelastine nasal spray for the treatment of seasonal allergic rhinitis.


Author(s):  
M.A. Ryabova ◽  
◽  
L.V. Georgieva ◽  

The prevalence of allergic diseases is increasing: according to recent data, about 20% of the worlds' population suffers from allergic rhinitis. About 30% of the reproductive age women are known to suffer from allergic rhinitis, and in a third of cases, symptoms of allergic rhinitis increase during pregnancy. Allergic inflammation is the result of contact with a causative allergen and elimination of causative allergens is not always possible. The creation of a protective barrier preventing the adhesion of allergens on the surface of the nasal mucosa reduces the penetration of allergens and helps control allergic rhinitis. Aqua Maris® Nasal Spray Ectoin is a completely natural remedy that creates a physical barrier (“barrier”) for attaching allergens to the nasal mucosa and prevents the development of allergic rhinitis. Aqua Maris® Ectoin can be used for allergic rhinitis treatment in pregnant and nursing women. Non-comparative open-label trial investigating the efficacy and safety of the Aqua Maris® Nasal Spray Ectoin was carried out from September to June 2019 at the Center of early diagnosis of allergic diseases in women of childbearing age Pavlov First Saint Petersburg State Medical University. The study included 45 pregnant women with allergic rhinitis. Clinical efficacy was evaluated by the severity of clinical symptoms and rhinoscopic data of patients in dynamics during treatment. As a result of the use of Aqua-Maris Ectoin in pregnant women, a significant reduction in complaints on the 10th day of therapy and a decrease in inflammatory phenomena in the nasal cavity were observed. In addition, a significantly significant decrease in secretory nasal IgE was noted. This indicates the effectiveness of the Aqua Maris® Nasal Spray Ectoin in the treatment of allergic rhinitis in pregnant women. Adverse events associated with the use of Ectoin Aqua Maris® Nasal Spray in pregnant women were not detected. Aqua Maris® Nasal Spray Ectoin can be used for effective and safe treatment of allergic rhinitis in pregnant women.


Author(s):  
Ganesh S. Pentewar ◽  
Ranjit J. Wagh ◽  
Aparna S. Chincholkar

Background: A successful treatment of allergic rhinitis is considered not only as relief from sneezing, itching, rhinorrhoea, congestion but also as the functional impact on the patient’s daily life. The cost of treating allergic rhinitis and indirect costs related to loss of workplace productivity are substantial.Methods: The present study was single centered, open label, randomized, four Arm, parallel-group, comparative clinical study between orally administered Cetirizine, Levocetirizine, Loratadine and Fexofenatidine in patients with allergic rhinitis conducted at MIMER Medical college and Dr. Bhausaheb Sardesai hospital in rural Maval Taluka in Pune district of Maharashtra State.Results: Total Nasal Symptom Score differs significantly for all the treatment groups. Subsequent pairwise contrasts using a Bonferroni adjustment reveals maximum reduction of symptoms in Levocetirizine group. Cost effectiveness ratio was effective for Levocetirizine followed by Cetirizine, Loratadine, and Fexofenadine.Conclusions: From the analysis of results, the study shows that both Levocetirizine and Cetirizine control the symptoms of allergic rhinitis better as compared to Loratadine and Fexofenadine but Levocetirizine was a better choice in comparison to others due to its cost effectiveness.


2021 ◽  
Author(s):  
Julian Nehrig ◽  
Nicole Grosse ◽  
Ilja P Hohenfeld ◽  
Fabio Fais ◽  
Thomas Meyer ◽  
...  

Background Symptoms of allergic rhinitis can be reduced by nonpharmacological nasal sprays that create a barrier between allergens and the nasal mucosa. A new nasal spray (AM-301) containing the clay mineral bentonite was tested for its ability to reduce symptoms to grass pollen. Methods This open label, crossover, noninferiority trial compared the efficacy and safety of AM-301 to that of hydroxypropyl methylcellulose (HPMC; Nasaleze Allergy Blocker), an established barrier method. Adults with seasonal allergic rhinitis were exposed to Dactylis glomerata pollen, in the Fraunhofer Allergen Challenge Chamber, first without protection and then protected by HPMC or AM-301 (7 days apart). Efficacy was assessed from total nasal symptom score (TNSS), nasal secretion weight, and subjective rating. The primary endpoint was the difference, between AM-301 and HPMC, in least square mean change in TNSS over a 4-hour exposure to allergen. Results The study enrolled 36 persons, and 35 completed all study visits. The mean TNSS was 5.91 during unprotected exposure, 5.20 during protection with HPMC, and 4.82 during protection with AM-301. The difference in least square means between the two treatments was -0.39 (95% CI, -0.89 to 0.10), establishing the noninferiority of AM-301. No difference in mean weight of nasal secretions was observed between the treatments. Efficacy was rated as good or very good for AM-301 by 31% and for HPMC by 14% of subjects. 16 subjects reported adverse events with a relationship to AM-301 or HPMC; most adverse events were mild and none was serious. Conclusions AM-301 demonstrated noninferiority towards HPMC in the primary endpoint and was perceived better in subjective secondary endpoints. Both barrier-forming products had a persisting protective effect over 4 hours and were safe. Trial registration German Clinical Trial Register (DRKS00024356). EUDAMED (CIV-20-10-034870). Key words: Allergen challenge, Allergy, Bentonite, Dactylis glomerata, Hydroxypropyl methylcellulose, Medical device, Nasal spray, Pollen, Rhinorrhea, Thixotropy


2021 ◽  
Vol 4 (3) ◽  
pp. 106-114
Author(s):  
Syed Khadeer ◽  
B Jagannath

Rhinitis is inflammation of nasal mucosa which characteristically presents as running nose, blocked nose, itching on nose or sneezing. Allergic rhinitis is more common than non-allergic rhinitis. Anti-histamines are the mainstay of SAR treatment. Desloratadine, rupatadine and ketotifen are the commonly prescribed anti histamines in our region. In this study, we have compared efficacy and tolerability of desloratadine, rupatadine and ketotifen in SAR. This was a prospective, randomized, three arm, open label comparative study of desloratadine, rupatadine and ketotifen in SAR, conducted at Department of ENT, Kempegowda Institute of Medical Sciences, Bangalore; between January 2014 and December 2014. Patients’ severity of SAR symptoms were assessed by TNSS, QoL was measured using Medical Outcomes Study questionnaire (SF-12). SF-12 was administered at the start of study and then at the end of study. Adverse effects were monitored during clinical examination at each visit. Study subjects were systemically randomized into three groups – desloratadine (DES), rupatadine (RUP) and ketotifen (KET). Based on the assigned group; desloratadine was given orally in dose of 10mg OD, rupatadine orally 10 mg OD and ketotifen orally 1mg BD. All medications were given for 4 weeks. Follow up was done for all patients every week during treatment period of 4 weeks. The primary outcome measure was change in mean TNSS from baseline; secondary outcome measures were changes in the individual nasal symptom scores, change in the quality of life and tolerability to the study medications. Total 150 patients were recruited for this study, divided into 3 groups. DES and RUP were equally effective but significantly better than KET in improving rhinorrhea, nasal congestion, TNSS and AEC. (p=0.05). All the drugs were equally effective with no statistically significant intergroup difference in improving sneezing, nasal itching and QoL. RUP appeared to have better tolerability as the total number of adverse events were marginally less. DES and RUP are comparatively more effective and faster acting than KET. All the study medications were well tolerated with few mild, self-limiting, transient adverse events requiring no intervention.


2016 ◽  
Vol 7 (4) ◽  
pp. ar.2016.7.0185 ◽  
Author(s):  
Anahi Yanez ◽  
Alex Dimitroff ◽  
Peter Bremner ◽  
Chae-Seo Rhee ◽  
Graham Luscombe ◽  
...  

Background Corticosteroid nasal sprays are the mainstay of treatment for allergic rhinitis. These sprays have sensory attributes such as scent and/or odor, taste and aftertaste, and run down the throat and/or the nose, which, when unpleasant, can affect patient preference for, and compliance with, treatment. Objective This study examined patient preference for fluticasone furoate nasal spray (FFNS) or mometasone furoate nasal spray (MFNS) based on their sensory attributes after administration in patients with allergic rhinitis. Methods This was a multicenter, randomized, double-blind, cross-over study. Patient preferences were determined by using three questionnaires (Overall Preference, Immediate Attributes, and Delayed Attributes). Results Overall, 56% of patients stated a preference for FFNS versus 32% for MFNS (p < 0.001); the remaining 12% stated no preference. More patients stated a preference for FFNS versus MFNS for the attributes of “less drip down the throat” (p < 0.001), “less run out of the nose” (p < 0.05), “more soothing” (p < 0.05), and “less irritating” (p < 0.001). More patients responded in favor of FFNS versus MFNS for the immediate attributes, “run down the throat” (p < 0.001), and “run out of the nose” (p < 0.001), and, in the delayed attributes, “run down the throat” (p < 0.001), “run out of the nose” (p < 0.01), “presence of aftertaste” (p < 0.01), and “no nasal irritation” (p < 0.001). Conclusion Patients with allergic rhinitis preferred FFNS versus MFNS overall and based on a number of individual attributes, including “less drip down the throat,” “less run out of the nose,” and “less irritating.” Greater preference may improve patient adherence and thereby improve symptom management of the patient's allergic rhinitis.


2021 ◽  
Author(s):  
Patricia Volkow ◽  
Leslie Chavez-Galan ◽  
Lucero Ramon-Luing ◽  
Judith Cruz-Velazquez ◽  
Patricia Cornejo-Juarez ◽  
...  

High HHV-8 viral load (VL) in Kaposi Sarcoma (KS) has been associated with severe Immune reconstitution inflammatory syndrome (S-IRIS-KS), which can occur after initiating cART, and is linked with high mortality particularly in patients with pulmonary involvement. We investigate if valganciclovir initiated before cART decreases HHV-8 VL and assess if it reduces the incidence of S-IRIS-KS and its attributable mortality. Methods: Open-label parallel-group randomized clinical trial in AIDS cART naive patients with disseminated KS (DKS) as defined by at least two of the following: pulmonary, lymph-node or gastrointestinal involvement, lymphedema, or equal or more 30 skin lesions. In the experimental group (EG), patients were randomized to valganciclovir 900 mg BID four weeks before cART and continued until week-48; in the control group (CG), cART was initiated on week-0. Non-severe-IRIS-KS was defined as: increase in the number of lesions plus equal or more than one log10 HIV-VL decrease or equal or more than 50 cells/mm3 increase or equal or more than 2-fold rise in baseline CD4+ cells. S-IRIS-KS was defined as abrupt clinical worsening of KS lesions and/or fever after ruling out another infection following cART initiation, and at least three of the following: thrombocytopenia, anemia, hyponatremia, or hypoalbuminemia. Results: 40 patients were randomized and 37 completed the study. In the ITT analysis, the overall mortality did not differ between groups. In the per-protocol analyses, the difference showed a trend for higher S-IRIS-KS mortality in the CG 3/19 (15.7%), compared to EG 0/18 (p=0.07). The incidence of S-IRIS KS was significantly lower in the EG; two patients, one each had S-IRIS-KS episode (0.038 per 100 patient-days) compared to CG group, four patients developed 12 S-IRIS-KS episodes (0.21 per 100 patient-days); incidence rate of 0.09 (95% CI 0.02-0.5 p=0.006). Mortality in patients with pulmonary KS was significantly lower in EG, 3/4 in CG vs 0/5 in EG. S-IRIS-KS was associated with higher HHV-8-VL; IL6 and CRP; valganciclovir was protective. Of survivors at week 48, 82% achieved more than 80% remission. No difference was found between groups in the number of non-S-IRIS-KS events. Conclusions: Valganciclovir significantly reduced the episodes of S-IRIS-KS although attributable KS mortality was lower in the EG the difference was not significant (p=0.07). Mortality was significantly lower in EG patients with pulmonary KS.


Sign in / Sign up

Export Citation Format

Share Document