The effectiveness of intranasal corticosteroids and antihistamines combination - mometasone furoate and azelastine hydrochloride nasal spray in adults with seasonal allergic rhinitis (The results of clinical trial)

Background. Intranasal corticosteroids and antihistamines are the basis of pharmacotherapy of allergic rhinitis (AR). The aim of this study was to evaluate the efficacy, safety and tolerability of Momat Rhino Advance (fixed combination of azelastine hydrochloride 140 mcg + mometasone furoate 50 mcg) intranasal spray in seasonal rhinitis patients. Materials and methods. Momat Rhino Advance was administered within 14 days in adults with seasonal AR in comparison with the original azelastine hydrochloride and mometasone furoate, used in combination with each other from separate devices against nasal (TNSS) and non-nasal (TNNSS) rhinitis symptoms. In total, 220 patients 18-65 years old with moderate/severe seasonal AR, were randomized in an open, parallel-group, multicenter clinical trial conducted in 16 centers in the Russian Federation during the period from April to September 2014. Results and conclusion. As a result of the study a marked decreasing of nasal symptoms using scale TNSS (in 89,6% relatively to the initial visit, p

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Prescription Profile and Clinical Outcomes in Patients with Allergic Rhinitis Treated with Oral Antihistamines or Nasal Corticosteroids

International Archives of Otorhinolaryngology ◽

10.1055/s-0039-1688968 ◽

2019 ◽

Vol 23 (03) ◽

pp. e325-e330

Author(s):

Guillermo Sánchez ◽

Carlos Castro

Keyword(s):

Allergic Rhinitis ◽

Cohort Study ◽

Clinical Outcomes ◽

Second Generation ◽

Mometasone Furoate ◽

Intranasal Corticosteroids ◽

Nasal Symptoms

Introduction Oral antihistamines and intranasal corticosteroids have been shown to be effective and safe for the treatment of allergic rhinitis; however, the evidence suggests a level of superiority of corticosteroids, so they should be preferred over the former. Objective To know the prescription profile of two second generation antihistamines (cetirizine and levocetirizine) and two nasal corticosteroids (mometasone and furoate-ciclesonide) in a cohort of patients with allergic rhinitis, and to compare the clinical outcomes obtained. Methods A cohort study was carried including patients with allergic rhinitis treated with cetirizine, levocetirizine, mometasone furoate or ciclesonide. The improvement was evaluated with the total nasal symptoms score (TNSS). This scale yields results between 0 and 12. Zero indicates absence of symptoms. Results A total of 314 patients completed 12 weeks of follow-up. Seventy-five percent were treated with antihistamines, 20% with corticosteroids, and 5% with a combination of the above. The TNSS median for corticosteroid was 2.5 points; for antihistamines, its was 5 points, and for combination, it was 4 points. We found differences between corticosteroids and antihistamines. Conclusion The prescription percentage of second generation oral antihistamines is higher than that of intranasal corticosteroids. However, patients with allergic rhinitis treated with the second option obtained better control of symptoms.

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New opportunities in the allergic rhinitis therapy

Medical Council ◽

10.21518/2079-701x-2021-18-118-124 ◽

2021 ◽

pp. 118-124

Author(s):

K. S. Pavlova ◽

D. S. Mdinaradze

Keyword(s):

Allergic Rhinitis ◽

Nasal Spray ◽

Fixed Combination ◽

Allergic Inflammation ◽

Allergic Diseases ◽

Developed Countries ◽

Rapid Onset ◽

Mometasone Furoate ◽

High Efficacy ◽

Intranasal Corticosteroids

Allergic rhinitis (AR) is one of the most common allergic diseases, especially in economically developed countries, including Russia. The main goal of AR therapy is the control achievement over the disease symptoms, the minimizing of the future exacerbations risks and side effects. Antihistamines and glucocorticosteroids are the main classes of medicines used in all allergic diseases, including AR. According to the Federal Clinical Guidelines for Allergic rhinitis the use of the intranasal corticosteroids in combination with antihistamines is recommended on the second stage of therapy and higher. Both classes of medicines have a complementary effect on the allergic inflammation pathogenesis main stages. The intranasal corticosteroids and antihistamines using allows the delivery of the medicines to the allergic inflammation area directly. Modern intranasal corticosteroids have a high affinity that provides the high efficacy in the low concentrations using and the insignificant systemic bioavailability. The review presents the key characteristics of the olopatadine and mometasone furoate nasal spray in a fixed combination, which registered in the Russian Federation recently. This combination is recommend for use in adults and children over 12 y.o. with allergic rhinitis. The pharmacological characteristics of the nasal spray components including the action mechanism described. The main clinical studies results presented, that confirmed the high efficacy and safety of olopatadine/mometasone furoate combination in AR patients. The olopatadine and mometasone furoate fixed combination ensures the rapid onset and the long-lasting effect with minimal adverse events risks that increases compliance and leads to the control achievement over the AR symptoms.

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Improvement of Nasal Symptoms with Mometasone Furoate Nasal Spray Administered for 2 Weeks to Japanese Patients with Perennial Allergic Rhinitis

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2008.12.493 ◽

2009 ◽

Vol 123 (2) ◽

pp. S133-S133

Author(s):

N. Soh ◽

M. Kumai ◽

T. Oda ◽

P. Jensen

Keyword(s):

Allergic Rhinitis ◽

Nasal Spray ◽

Japanese Patients ◽

Mometasone Furoate ◽

Perennial Allergic Rhinitis ◽

Nasal Symptoms

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Treatment Evaluation with Mometasone Furoate, Alone or in Combination with Desloratadine/ Montelukast in Moderate Severe Allergic Rhinitis

Acta Medica Marisiensis ◽

10.2478/amma-2014-0022 ◽

2014 ◽

Vol 60 (3) ◽

pp. 106-108 ◽

Cited By ~ 2

Author(s):

Nona-Aura Florincescu-Gheorghe ◽

Florica Popescu ◽

D.O. Alexandru

Keyword(s):

Allergic Rhinitis ◽

Allergic Inflammation ◽

Allergic Diseases ◽

Nasal Secretion ◽

Mometasone Furoate ◽

Line Treatment ◽

First Line ◽

Nasal Symptoms ◽

A Prospective Study ◽

First Line Treatment

Abstract Introduction: Allergic rhinitis is one of the most common allergic diseases, characterized by the inflammation of the nasal mucosa. Eosinophils play a predominant pro-inflammatory role in allergic inflammation. This study assesses the effect of mometasone furoate alone or in combination with desloratadine/montelukast in patients with moderate-severe allergic rhinitis. Material and method: This is a prospective study that took place over 8 weeks on 70 patients diagnosed with moderate-severe allergic rhinitis with sensitization to the pollen of Ambrosia elatior. The patients were evaluated on the basis of their symptoms using the total score of nasal symptoms, the score of individual nasal symptoms and the number of eosinophils in the nasal secretion. Results: All 3 groups of patients had an improvement on the total nasal symptoms score. However, the combination of mometasone furoate with desloratadine provided statistically significant benefits on the total score of symptoms and on nasal itching as compared with mometasone furoate alone. Conclusions: The association of mometasone furoate with desloratadine should be considered first-line treatment of moderate-severe allergic rhinitis due to the benefit both on the total symptom score and on of nasal itching.

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Intranasal Mometasone Furoate for Treatment of Allergic Rhinitis

Clinical Medicine Insights Therapeutics ◽

10.4137/cmt.s4767 ◽

2010 ◽

Vol 2 ◽

pp. CMT.S4767 ◽

Cited By ~ 4

Author(s):

Marco Berlucchi ◽

Barbara Pedruzzi

Keyword(s):

Allergic Rhinitis ◽

Clinical Picture ◽

Mometasone Furoate ◽

Upper Respiratory Tract ◽

Nasal Symptoms ◽

Pharmacodynamic Profile ◽

Nasal Disease ◽

Oral Steroids ◽

Adults And Children ◽

Upper Respiratory

Allergic rhinitis (AR) is a chronic nasal disease that affects the upper respiratory tract. This disorder is characterized by inflammation of the mucous membranes and it manifests with several nasal symptoms accompanied sometimes by non-nasal symptoms. Best therapy aims to prevent and improve the AR-clinical picture. Steroids have an important role in the treatment of AR. The development of steroids administrated directly on nasal mucosa has much reduced the systemic adverse affects associated with oral steroids therapy. Mometasone furoate aqueous nasal spray is a synthetic steroid assessed for intranasal use in the therapy of adults and children affected by AR. Such topical nasal steroid is an effective molecule improving clinical picture of AR and it is also approved as prophylactic therapy. In this article, apart from a careful description of its successful clinical use the authors review pharmacokinetic/pharmacodynamic profile, mechanism of action, safety, and efficacy of such steroid molecule.

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Development of questionnaires to measure patient preferences for intranasal corticosteroids in patients with allergic rhinitis

Otolaryngology ◽

10.1016/j.otohns.2004.10.010 ◽

2005 ◽

Vol 132 (2) ◽

pp. 197-207 ◽

Cited By ~ 8

Author(s):

Eli O. Meltzer ◽

James Hadley ◽

Michael Blaiss ◽

Michael Benninger ◽

Miriam Kimel ◽

...

Keyword(s):

Clinical Trial ◽

Clinical Trials ◽

Allergic Rhinitis ◽

Focus Groups ◽

Questionnaire Development ◽

Cognitive Debriefing ◽

Intranasal Corticosteroids ◽

Larger Sample ◽

Practice Preference ◽

Trial Setting

OBJECTIVE: To develop a questionnaire to evaluate preferences for attributes of intranasal corticosteroids (INSs) in clinical trials with allergic rhinitis (AR) patients. STUDY DESIGN AND SETTING: Established questionnaire development practices were used, including performance of a literature review and use of patient and physician focus groups, cognitive debriefing interviews, and pilot testing before validation. RESULTS: Findings from patient and physician focus groups suggest that sensory attributes are relevant to AR patients when choosing INSs. Physician focus groups identified the need for 2 distinct preference instruments, a clinical trial patient preference questionnaire (CTPPQ) and a clinical practice preference questionnaire (CPPPQ). A pilot study suggests that the CTPPQ is capable of discriminating between 2 INSs in the clinical trial setting. CONCLUSIONS: Initial findings suggest that items in the CTPPQ and CPPPQ are easy to understand and relevant to patients. Further validation studies with larger sample sizes are needed to assess the psychometric properties of both questionnaires. EBM rating: B-20.

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Control of allergic rhinitis symptoms in adults in the Russian Federation: online survey results

Russian Medical Inquiry ◽

10.32364/2587-6821-2021-5-1-25-31 ◽

2021 ◽

Vol 5 (1) ◽

pp. 25-31

Author(s):

N.M. Nenasheva ◽

◽

V.V. Shilenkova ◽

Keyword(s):

Allergic Rhinitis ◽

Visual Analog Scale ◽

Russian Federation ◽

Online Survey ◽

Nasal Congestion ◽

Analog Scale ◽

Intranasal Corticosteroids ◽

Runny Nose ◽

Survey Results ◽

The Russian Federation

Aim: subjective assessment by patients with allergic rhinitis (AR) of the efficacy in control of the main symptoms, seeking medical care for AR symptoms and general treatment methods. Patients and Methods: from April to August 2020, a study was conducted of 328 adult respondents (buyers of medicines for the AR treatment: antihistamines and/or intranasal corticosteroids), who voluntarily agreed to an online survey. 164 respondents purchased medicines based on the prescription or doctor recommendation, while other 164 chose medicines independently. Visual analog scale (VAS) was used to assess the severity of individual AR symptoms (nasal congestion, runny nose/nasal discharge, sneezing, itchy nose, cough), as well as eye and general symptoms (general malaise, drowsiness, headache). Results: 56% of respondents had persistent AR symptoms. Herewith, 60% of respondents suffered from seasonal AR, 40% — perennial AR. 52% of respondents had a mild AR form. However, the main triad of AR symptoms (nasal congestion, rhinorrhea and sneezing), despite the non-severe AR form in the absolute majority of respondents corresponded to moderate or severe severity (VAS>5) and indicated a lack of AR control. 31% of those surveyed experienced severe AR symptoms that disrupted daytime activity and sleep. The respondents were most concerned about nasal congestion, runny nose/rhinorrhea, and sneezing (the average VAS score was 7.3, 7.1, and 6.5, respectively). The frequency of visits to the doctor for AR was very low: 95% of respondents visited their doctor no more than once a year, while 48% of them — every few years. The first choice in therapy was antihistamines, regardless of the presence or absence of doctor’s recommendation. In second place were decongestants, in third — intranasal corticosteroids, which were more commonly purchased on the doctor’s recommendation. Conclusion: adult respondents with a suspected diagnosis of AR, despite uncontrolled and marked symptoms, underestimate their disease, rarely consult a doctor, and prefer to follow the recommendations of relatives and friends or pharmacists for treatment. The lack of AR control among adults in our country is obvious and requires the active participation of the medical and pharmaceutical community for salvation of such problem. KEYWORDS: allergic rhinitis, visual analog scale, control of allergic rhinitis symptoms, survey, therapy choice, severity of allergic rhinitis symptoms. FOR CITATION: Nenasheva N.M., Shilenkova V.V. Control of allergic rhinitis symptoms in adults in the Russian Federation: online survey results. Russian Medical Inquiry. 2021;5(1):25–31. DOI: 10.32364/2587-6821-2021-5-1-25-31.

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A comparative study to evaluate the effects of intranasal steroid spray, isotonic saline nasal irrigation and combination therapy in patients with allergic rhinitis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212123 ◽

2021 ◽

Vol 7 (6) ◽

pp. 1004

Author(s):

Smitha Soubhagya Gangaraju ◽

Nikitha Pillai ◽

Vijaylaxmi Manthal

Keyword(s):

Allergic Rhinitis ◽

Combination Therapy ◽

Isotonic Saline ◽

Treatment Modalities ◽

Nasal Irrigation ◽

Intranasal Corticosteroids ◽

Nasal Symptoms ◽

Before And After ◽

Group A ◽

Group B

Background: Allergic rhinitis (AR) is characterized by inflammatory changes in the nasal mucosa caused by exposure to inhaled allergens. AR clinically having 2 or more symptoms of anterior or posterior rhinorrhea, sneezing, nasal blockage or itching of the nose during two or more consecutive days for more than 1 hour on most days which are caused by allergen exposure leading to an IgE mediated reaction. Nasal steroids and antihistamines are considered as gold standard treatment of choice in moderate to severe AR. This study was taken to evaluate the efficacy of intranasal steroid spray, isotonic saline nasal irrigation, combination therapy and to compare all 3 treatment modalities.Methods: 75 patients of AR who met inclusion criteria were sequentially divided into 3 groups. Group A was intranasal steroid spray, group B was isotonic saline nasal irrigation, group C was combination of both intranasal steroid spray and saline nasal irrigation. Total nasal symptoms score was compared before and after 1 month of treatment.Results: Mean total nasal symptoms score before treatment in groups A, B and C was found to be 13.72, 12.96 and 13.68 respectively and after 1 month of treatment total nasal symptoms score was seen 8.28, 8.76 and 3.72 respectively.Conclusions: The combined use of saline nasal irrigation along with intranasal corticosteroids is found to be more effective in reducing the symptoms of patients with allergic rhinitis when compared to individual therapies.

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