Allergic rhinitis (AR) is a common condition that affects millions of people worldwide. It is characterized by inflammation of the nasal lining due to an allergic reaction to environmental allergens such as pollen, dust mites, and animal dander. Symptoms of AR include sneezing, runny nose, nasal congestion, and itching, which can have a significant negative impact on the patient's quality of life. A clinical trial investigated the efficacy of Montelukast and intranasal antihistamine in combination with intranasal corticosteroid (INCS) in moderate to severe AR on the patient's quality of life and AR control.
The study was a double-blind randomized clinical trial that was carried out on 66 moderate to severe AR patients from 2020 to 2021. The patients were randomly divided into three groups. Group one received Montelukast add-on therapy and Budesonide nasal spray. The second group received intranasal antihistamine (Azelastine) add-on therapy and Budesonide nasal spray, and the third group was the control group and received intranasal Budesonide spray with a placebo tablet.
To measure the impact of each medication on the patient's quality of life and allergic rhinitis control, the Sino-Nasal Outcome Test-22 questionnaire (SNOT 22) was used. The patient's symptoms were evaluated and compared at baseline, one and three months after the start of treatments. Spirometry was performed to investigate the possibility of co-morbid asthma at baseline and end of the study.
The average age of the patients was 30 years old, and most of them had perennial allergic rhinitis. The scores from the SNOT22 questionnaire showed a difference between the groups, meaning that the treatments had varying effects on the patient's symptoms. After three months of treatment, the group that received Azelastine along with a nasal corticosteroid had a significant improvement in their symptoms compared to both the Montelukast and control groups. However, there was no significant difference between the Montelukast and control groups.
Out of the 66 patients, 23 were diagnosed with asthma, and they received treatment for it. The amount of change in lung function after treatment for AR was not statistically significant between the groups of asthmatic patients.
Based on the findings of this study, the researchers recommend Azelastine in conjunction with an intranasal corticosteroid for the treatment of moderate to severe allergic rhinitis. In moderate to severe AR or even asthma management, Montelukast has no greater impact than intranasal corticosteroid (INCS).
The combination of Azelastine and an intranasal corticosteroid appears to be an effective treatment for moderate to severe allergic rhinitis, based on the results of this clinical trial.
It is crucial to consult a healthcare professional before starting any new medication, and the treatment plan should be individualized based on the patient's unique medical history and condition.