A Comparative Study to Evaluate the Effects of Fluticasone Nasal Spray with Oral Bilastine Versus Mometasone Nasal Spray with Oral Bilastine in Patients of Moderate to Severe Rhinitis

Shiva Mishra

doi:10.17605/cajmns.v4i3.1529

Shiva Mishra Junior Resident, Department of Pharmacology, BRD Medical College, Gorakhpur

DOI: https://doi.org/10.17605/cajmns.v4i3.1529

Keywords: Allergic rhinitis, Non-allergic rhinitis, Intranasal corticosteroids, total symptom score

Abstract

Background: Rhinitis is defined as inflammation of the lining of the nose and is characterized by nasal symptoms including rhinorrhea, sneezing, nasal blockage and itching of the nose. Rhinitis is categorized into three types (a) Allergic rhinitis (b) Non-allergic rhinitis (c) Infectious rhinitis. Rhinitis is a global health problem that causes major illness and disability worldwide. The burden of allergic rhinitis is enormous, estimated to affect about 10-25% of world population. Reported incidence of allergic rhinitis in India also ranges between 20-30%. This study was conducted to compare the safety and efficacy of fluticasone furoate nasal spray with oral bilastine and mometasone furoate nasal spray with oral bilastine in patients of moderate to severe rhinitis.
Methods: The randomized controlled study was conducted in the Department of Pharmacology and Otorhinolaryngology, at BRD Medical College, Gorakhpur over a period of 12 months. 156 patients diagnosed with rhinitis in the Department of Otorhinolaryngology of BRD Medical College were included in the study and divided into two groups of 78 patients .Each patient in the study were subjected to a detailed history and clinical examination. Subjective scoring for rhinitis symptoms, serum IgE level, and the eosinophilic count was done in all patients.
Results: 94 of the 156 patients were women. The age group 26 to 50 made up the majority (57.7%).Majority of patients (60.3%) had allergic rhinitis followed by non-allergic rhinitis (39.7%). Sneezing (97.4%) was the most common symptom among study subjects followed by rhinorrhea (69.2%), nasal congestion (57.7%), and nasal itching (49.4%). In comparison to fluticasone furoate nasal spray, mometasone nasal spray had higher mean TNSS, TOSS and TSS scores in patients with allergic and non-allergic rhinitis after treatment.
Conclusion: Fluticasone/Bilastine combination was more effective than Mometasone/Bilastine combination. Also, Fluticasone/bilastine combination was more safe and cost-effective as compared to Mometasone/Bilastine combination.

References

1. Sullivan JB, Krieger GR (2001). Clinical environmental health and toxic exposure p 341.
2. Quillen DM, Feller DB (May 2006). “Diagnosing rhinitis:allergic vs. nonallergic”. American Family Physician.73(9):1583-90
3. Bernstein J a. Nonallergic rhinitis:therapeutic options. Curr Opin Allergy Clin Immunol 2013; 13:410-416
4. Varshney J, Varshney H. Allergic Rhinitis: an overview.Indian J otolayngol Head Neck Surg.2015; 67(2):143-9
5. Bjorksten B, Clayton T, Ellwood P, StewartA, Strachan D, Group I.P.I.S Worldwide time trends for symptoms of rhinitis and conjunctivitis:Phase 3 III of the international study of asthma and allergies in childhood.Pediatr Allergy Immunol.2008; 19(2):110-124
6. Shah A, Pawanlar R. Allergic rhinitis and co-morbid asthma:perspective from India-ARIA Asia-Pacifi Mahesh P.A, Jayaraj B.S, Prabhakar A.K, Chaya S.K, Vijaysimha R. Identification of a threshold for biomass exposure index for chronic bronchitis in rural women of Mysore district, Karnataka, India, Indian J Med Res.2013; 137(1):87-94..c Workshop report. Asian Pac J A llergy Immunol.2009; 27(1):71-977
7. Settipane RA. Epidemiology of vasomotor rhinitis. World Allergy Organ J 2009; 2:115-118.
8. Settipane RA. Lieberman P. Update on nonallergic rhinitis.Ann Allergy Asthma Immunol 2001; 86:494-507-8.
9. Linneberg A, Dam Petersen K, Hahn Pedersen J, Hammerby E, Serup-Hansen N, Boxall N. Burden of allergic repiratory disease: a systematic review. Clin Mol Allergy 2016; 14:12.
10. Devillier P, Bousquet J, Salvator H, Naline E, Grassin -Delyle S, de Beaumont O.In allergic rhinitis, work, classroom and activity impairments are weakly related to other outcome measures. Clin Exp Allergy 2016; 46:1456-1464.
11. Lamb CE, Ratner PH, Johnson CE, Ambegaonkar AJ, Joshi A V, Day D et al.Economic impact of workplace productivity losses due to allergic rhinitis compared with select medical conditions in the United States from an employer perspective. Curr Med Res Opin2006; 22:1203-1210
12. Craig TJ, McCann JL, Gurevich F, Davies MJ. The correlation between allergic rhinitis and sleep disturbance. J Allergy Clin Immunol 2004; 114. doi:10.1016/j.jaci.2004.08.044
13. Juniper EF. Measuring health-related quality of life in rhinitis. J Allergy Clin Immunol 1997; 99:S742–S749
14. Robert A Nathan -The burden of allergic rhinitis -Allergy Asthma Proc.2007 Jan-Feb
15. Proctor DF, Anderson IB. The nose-upper airway physiology and the atmospheric environment. Amsterdam (Netherlands): Elsevier Biomedical Press; 1982.
16. Sur DK, Plesa ML (December 2015). “Treatment of Allergic Rhinitis ”.American Family Physician.92 (11):985-92
17. Settipane RA, Lieberman P. Update on nonallergic rhinitis. Ann Allergy Asthma Immunol; 2001; 86:494-507
18. Blaiss MS. Allergic rhinitis: direct and indirect costs. Allergy Asthma Proc. 2010; 31:375-80
19. Translation, adaption and validation of the total nasal symptom score (TNSS) for Lithunian population. -Laura Tamasauskiene .Health Qual Life Outcomes 2021.
20. Total Ocular Symptom Score (TOSS) and Dry Eyes-Milton M.Hom-The Journal of Allergy and Clinical Imuunology 2013