Effect of nasal glucocorticoid combined with loratadine or montelukast on allergic rhinitis

Abstract

Objective:To evaluate the effect of nasal glucocorticoid combined with second-generation antihistamines or leukotriene receptor antagonists on the treatment of moderate severe allergic rhinitis, and explore the optimal scheme of personalized treatment for AR patients.Method:Fiftyseven patients with persistent moderatesevere allergic rhinitis were randomly divided into three groups and treated by mometasone furoate aqueous nasal spray (group MOM), mometasone furoate aqueous nasal spray combined with loratadine (group MOM+L), mometasone furoate aqueous nasal spray combined with montelukast (group MOM+M) for 4 weeks. Four major clinical symptoms of allergic rhinitis: nasal congestion, nose itching, sneezing and runny nose were evaluated by "symptom rating score" before treatment and after treatment for 4 weeks.Result:After treatment, the total nasal symptom scores of each group showed a decreasing tendency, and the differences between various time points were statistically significant (P< 0.05). For the symptom of nasal congestion, the symptom score of MOM+M group was significantly lower than that of MOM group and MOM+L group at the 2nd and 4th week after treatment. For the symptoms of sneezing and nasal itching, MOM+L group had the lowest score at each time point after treatment and the difference was statistically significant compared with MOM group (P< 0.05), but there was no significant difference between MOM group and MOM+M group (P> 0.05). For the symptom of runny nose, the score of MOM+L group was significantly lower than MOM group (P< 0.05) at the 1st and 2nd week, MOM+M group was significantly lower than MOM group (P< 0.05) at the 2nd and 4th week, while there was no significant difference between MOM+L group and MOM+M group (P> 0.05).Conclusion:Nasal glucocorticoid alone or combined with secondgeneration antihistamines or leukotriene receptor antagonists can effectively control nasal symptoms of moderatesevere allergic rhinitis, yet the effect of combination therapy is better. For nasal congestion, nasal glucocorticoid combined with leukotriene receptor antagonists have a better effect. For nasal itching and sneezing, the choice of nasal glucocorticoid combined with second-generation antihistamines may be more sensible. For runny nose, nasal glucocorticoid combined with second-generation antihistamines or leukotriene receptor antagonists have similar efficacy.