Comparison of Fluticasone Furoate and Cetirizine Versus Fluticasone Furoate and Montelukast in Allergic Rhinitis

Abstract

Background: The complexity of treatment in allergic rhinitis remains to be a global challenge. The medical treatment option for moderate-severe persistent allergic rhinitis is the combination of intranasal corticosteroid (INCS) and oral antihistamine or leukotriene receptor antagonist (LTRA). The combination INCS with LTRA is selected based on the presence of asthma. Purpose: To determine the effect of fluticasone furoate plus cetirizine administration comparing fluticasone furoate plus montelukast on nasal eosinophils count and clinical improvement in patients with moderate-severe persistent allergic rhinitis. Method: This study was purely experimental research with the study design randomized clinical trial, double-blind, pre and post test control. Patient were divided into two group. Group-1 received intranasal fluticasone furoate 110 μg once daily and oral cetirizine 10mg and Group-2 received intranasal fluticasone furoate 110 μg once daily and Montelukast 10mg. The treatment efficacy is assessed from nasal eosinophil count and total five symptoms score (T5SS) based on Visual Analogue Scale (VAS) before and 4 weeks after treatment. Result: Both groups show a decrease in the nasal eosinophil count and T5SS score based on VAS before and after treatment (p< 0.05). The group-2 shows a statistically significant improvement in nasal obstruction and rhinorrhea compare to the group-1 (p <0.05). The decrease in nasal eosinophil count and T5SS is higher in the group-2 than the group-1, however, it is not statistically significant. Conclusion: The combination of fluticasone furoate and montelukast is more effective in reducing nasal obstruction and rhinorrhea than the combination of fluticasone furoate and cetirizine.