Efficacy of intranasal fluticasone propionate and budesonide in management of allergic rhinitis\u2014a prospective comparative study

P. Kiruba Shankari,Rukaiah Fatma Begum,Swathi Suresh

doi:10.1186/s43163-021-00181-y

P. Kiruba Shankari, Rukaiah Fatma Begum + Show 1 more

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https://doi.org/10.1186/s43163-021-00181-y

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Abstract

BackgroundAllergic rhinitis (AR) or Hay fever is a chronic inflammation of the nasal mucosa induced by IgE-mediated hypersensitivity due to exposure of various allergens. AR occurs as a response against these inhaled allergens that cause inflammation of nasal mucosal membranes. In this study, a reliable treatment for allergic rhinitis with maximum effectiveness and minimal side effects was assessed. This study compared the effectiveness of intranasal Fluticasone propionate (FUP) and intranasal Budesonide (BUD) in reducing the eosinophil count and in improving the nasal and ocular symptoms. This prospective study was conducted on 62 cases of allergic rhinitis and patients with mild-to-moderate allergic rhinitis were selected for the study. They were randomly divided into two groups; group I consists of 30 patients who received intranasal Fluticasone propionate aqueous spray, total daily dose of 200 μg (50 μg/spray) as 2 sprays in each nostril administered once daily, whereas the group II consists of 32 patients who received intranasal Budesonide aqueous spray, total daily dose of 400 μg/day (100 μg/spray) as 1 spray in each nostril administered twice daily.ResultsAnalysis on patient-based symptom scores revealed that both the groups showed statistically significant reduction in symptoms. Fluticasone propionate was found to be significantly more effective (P < 0.05) than Budesonide in reducing sneezing, nasal itching and majority of symptoms of individual symptom scores. Budesonide showed somewhat similar effect in reducing nasal blockage at 4 weeks of treatment.ConclusionClinically, both the drugs showed statistically significant improvement when compared to baseline, but Fluticasone propionate was superior at reducing nasal symptoms, ocular symptom and eosinophil count.

Highlights

Allergic rhinitis (AR) or Hay fever is a chronic inflammation of the nasal mucosa induced by immunoglobulin E (IgE)-mediated hypersensitivity due to exposure of various allergens
Random assignment of 30 patients to intranasal fluticasone propionate taken as group I and 32 patients to intranasal budesonide taken as group II and these subjects completed the follow up of 8 weeks period
Parameters considered in efficacy analysis were visual analogue total nasal symptom scores (VATNSS), visual analogue total ocular symptom scores (VATOSS) and Absolute eosinophil counts

Summary

Introduction

Allergic rhinitis (AR) or Hay fever is a chronic inflammation of the nasal mucosa induced by IgE-mediated hypersensitivity due to exposure of various allergens. This study compared the effectiveness of intranasal Fluticasone propionate (FUP) and intranasal Budesonide (BUD) in reducing the eosinophil count and in improving the nasal and ocular symptoms This prospective study was conducted on 62 cases of allergic rhinitis and patients with mild-to-moderate allergic rhinitis were selected for the study. Allergic rhinitis is a symptomatic disorder triggered after inhalation of allergens such as house dust, mites, pollens, Allergens in the environment can synthesize allergen-specific immunoglobulin E production which interacts with B cells, T cells, mast cells, basophil and starts accumulation in nasal mucosa which involves a Shankari et al The Egyptian Journal of Otolaryngology (2021) 37:123 pathophysiology of allergic rhinitis and asthma This receptor-bound accumulation due do exposure of allergens leads to the production of mediators such as histamines, leukotriene and other mediators that shows allergic responses as nasal and ocular symptoms [8]. Budesonide relieves symptoms caused by hay fever or other allergies [14]

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