Effectiveness of azelastine nasal spray in patients with a history of intranasal steroid use

Abstract

Rationale This study was an open-label evaluation of patient experiences with azelastine (Astelin) nasal spray in the treatment of SAR, VMR, or mixed rhinitis (allergic rhinitis with nonallergic triggers). The effect of azelastine nasal spray in treating rhinitis symptoms was compared in patients who had previously used intranasal steroids versus patients with no history of intranasal steroid use. Methods Patients were treated for 2 weeks with azelastine nasal spray at a dosage of 2 sprays per nostril bid, and completed a questionnaire that assessed onset of action, symptom improvement, satisfaction with therapy, and quality of life. Results Of the 4364 patients who received azelastine monotherapy during the 2-week study period, 55% had been treated with intranasal steroids during the 12 months prior to study enrollment. Compared to patients with no prior steroid use, these patients had more severe rhinitis (19% vs 11%), were more likely to have mixed rhinitis (57% vs 45%), and were more troubled by nasal congestion (55% vs 49%). Comparing prior intranasal steroid use versus no prior use, the percentage of patients reporting some or great improvement in individual symptoms of nasal congestion (85% vs 87%), postnasal drip (81% vs 81%), sneezing (88% vs 89%), runny nose (85% vs 86%), and itchy nose (88% vs 90%) was similar after 2 weeks of treatment with azelastine nasal spray. Conclusion Azelastine nasal spray was equally effective in treating rhinitis symptoms in patients who had previously used intranasal steroids when compared with patients who had not used intranasal steroids.