Krishnakumar Dhanya, Faizal Bini, Nair Anjaly S
Department of Otorhinolaryngology, Amrita Institute of Medical Sciences, Kochi, Kerala India.
Department of Biostatistics, Amrita Institute of Medical Sciences, Amrita Vidyapeetham, Kochi, Kerala India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1632-1637. doi: 10.1007/s12070-021-02686-7. Epub 2021 Aug 2.
Allergic rhinitis is a highly prevalent, allergen-induced disease. Intranasal corticosteroids are currently the first-line therapy for these patients. It is uncertain whether intranasal antihistamines have comparable efficacy. This study compares effects of Azelastine and Fluticasone nasal spray in patients with allergic rhinitis. Prospective comparative study including 240 patients with allergic rhinitis was conducted with 120 each in fluticasone and azelastine group. Nasal sprays were given for period of three months along with an oral antihistamine. Follow up was done after three months. Pre and post treatment symptom assessment were done using Total nasal symptom score. The median TNSS in pre and post treatment of group A (fluticasone) is 10(4) and 1(3) which shows statistical significance with value < 0.001. Median TNSS in pre and post treatment of group B (azelastine) is 9(4) and 1(2) which shows statistical significance with value < 0.001. The median TNSS in pre and post treatment value between Group A and B shows no statistically significant difference between two groups with value 0.56 and 0.06 respectively. Intranasal azelastine and fluticasone had comparable efficacy in symptom control in patients with allergic rhinitis. Azelastine due to its lesser side effects, can be safely used in children, patients with glaucoma and cataract. Azelastine may be considered as a safer replacement to fluticasone for long term use in patients with allergic rhinitis. A larger multicentric study with a bigger sample size may be required to confirm the efficacy and safety profile of azelastine nasal spray.
变应性鼻炎是一种高发性的、由变应原诱发的疾病。鼻内用糖皮质激素是目前这些患者的一线治疗方法。鼻内用抗组胺药是否具有相当的疗效尚不确定。本研究比较了氮卓斯汀和氟替卡松鼻喷雾剂对变应性鼻炎患者的疗效。进行了一项前瞻性对照研究，纳入240例变应性鼻炎患者，氟替卡松组和氮卓斯汀组各120例。鼻喷雾剂与口服抗组胺药一起使用三个月。三个月后进行随访。使用总鼻症状评分对治疗前后的症状进行评估。A组（氟替卡松）治疗前和治疗后的中位数总鼻症状评分为10(4)和1(3)，差异具有统计学意义，P值<0.001。B组（氮卓斯汀）治疗前和治疗后的中位数总鼻症状评分为9(4)和1(2)，差异具有统计学意义，P值<0.001。A组和B组治疗前后的中位数总鼻症状评分在两组之间无统计学显著差异，P值分别为0.56和0.06。鼻内用氮卓斯汀和氟替卡松在变应性鼻炎患者的症状控制方面具有相当的疗效。氮卓斯汀由于副作用较小，可安全用于儿童、青光眼和白内障患者。对于变应性鼻炎患者的长期使用，氮卓斯汀可被视为氟替卡松的更安全替代药物。可能需要进行一项更大样本量的多中心研究来证实氮卓斯汀鼻喷雾剂的疗效和安全性。
