Prescription Profile and Clinical Outcomes in Patients with Allergic Rhinitis Treated with Oral Antihistamines or Nasal Corticosteroids

Abstract

Introduction Oral antihistamines and intranasal corticosteroids have been shown to be effective and safe for the treatment of allergic rhinitis; however, the evidence suggests a level of superiority of corticosteroids, so they should be preferred over the former. Objective To know the prescription profile of two second generation antihistamines (cetirizine and levocetirizine) and two nasal corticosteroids (mometasone and furoate-ciclesonide) in a cohort of patients with allergic rhinitis, and to compare the clinical outcomes obtained. Methods A cohort study was carried including patients with allergic rhinitis treated with cetirizine, levocetirizine, mometasone furoate or ciclesonide. The improvement was evaluated with the total nasal symptoms score (TNSS). This scale yields results between 0 and 12. Zero indicates absence of symptoms. Results A total of 314 patients completed 12 weeks of follow-up. Seventy-five percent were treated with antihistamines, 20% with corticosteroids, and 5% with a combination of the above. The TNSS median for corticosteroid was 2.5 points; for antihistamines, its was 5 points, and for combination, it was 4 points. We found differences between corticosteroids and antihistamines. Conclusion The prescription percentage of second generation oral antihistamines is higher than that of intranasal corticosteroids. However, patients with allergic rhinitis treated with the second option obtained better control of symptoms.

Non-sedative Antihistamines: Assessment of Efficacy Based on Total Nasal Symptom Score in Patient with Allergic Rhinitis.

“…12 In this study, the majority of patients with allergic rhinitis were females. This is consistent with several studies worldwide, 4,[13][14][15][16] Greater cough reflex sensitivity of the airway, hormonal influence, physiological differences between men and women in airway reactivity to allergens are common attributing factor for higher prevalence rate in female. 4 58.33% patients with allergic rhinitis were in the age group of 18 to 37 years.…”

“…In several studies, the difference in TNSS for each subject was calculated, seeking to establish the reduction gradient in the score. 1,4,6,[13][14][15]17,21 In the present study, a significant (p<0.05) and progressive decrease in the TNSS was observed from baseline over the 14 day treatment period with different non-sedative antihistamines. Rupatadine was found to be more significant (P-value .000897) in reducing TNSS and improving signs of allergic rhinitis after 2 weeks of treatment.…”

Alerginis Rinitas: Diagnostika Ir Gydymas

“…Nuolatinio AR klinika ne visada gali būti tokia ryški, kaip sergant sezoniniu AR, todėl medikamentinis gydymas gali skirtis. Dvigubai koduotas placebu kontroliuojamas tyrimas parodė, jog antrosios kartos geriamieji antihistamininiai preparatai pacientams, sergantiems NAR, buvo efektyvesni [25].Taigi, cetirizinas bei levocetirizinas yra indikuotini NAR gydymui bei gerai toleruojami [26]. Pacientams, kuriems pasireiškia lengva NAR forma, gydymas pradedamas antros kartos antihistamininiais preparatais, o vėliau, jei simptomatika išlieka, rekomenduojama papildomai skirti intranazalinį kortikosteroidą arba intranazalinį antihistamininį preparatą [27,28].…”