The Effect of Combined Medical Treatment on Quality of Life in Persistent Allergic Rhinitis

Abstract

Allergic rhinitis may significantly affect the patients' quality of life. The aim of this study was to compare the effects of nasal steroids alone, to nasal steroids plus Levocetirizine or Montelukast, on quality of life in persistent allergic rhinitis. This is a prospective, randomized study and included 56 patients with moderate to severe persistent allergic rhinitis. All patients had house dust mite allergy on skin prick test and we divided the patients into three groups. 1 month long medical treatment was; topical Mometasone furoate 200 mcg/day in the first group (n:14), Mometasone furoate 200 mcg/day plus oral Levocetirizine 5 mg/day in the second group (n:21), and Mometasone furoate 200 mcg/ day plus oral Montelukast 10 mg/day in the third group (n:21). We evaluated the patients before treatment and at the first month after treatment with mini rhinoconjunctivitis quality of life questionnaire (miniRQLQ) and nasal symptom scores. In the first group nasal symptom and mini RQLQ scores were not improved but in second and third group, both scores were improved significantly (p \ 0.05). Nasal obstruction symptom score was better in the third group after treatment (p \ 0.01), but other nasal symptom scores (rhinorrhea, sneezing and nasal itching) were better in the second group (For each symptom p \ 0.05). Improvement of quality of life scores in the second group were better than the third group (p \ 0.05). In persistent allergic rhinitis, combination of levocetirizine or montelukast to nasal steroids was better than the topical mometasone furoate alone in terms of quality of life.

Leukotriene receptor antagonist addition to intranasal steroid: systematic review and meta-analysis

“…The diagnosis of AR was confirmed by skin tests or serum-specific IgE in 298 patients. Three RCTs studied paediatric and adult patients (19,20,23) while three RCTs studied only adult patients (21,22,24) . Two RCTs studied patients with seasonal AR (SAR) (19,24) , while two studied perennial AR (PAR), one with persistent disease (21,22) .…”

“…Three RCTs studied paediatric and adult patients (19,20,23) while three RCTs studied only adult patients (21,22,24) . Two RCTs studied patients with seasonal AR (SAR) (19,24) , while two studied perennial AR (PAR), one with persistent disease (21,22) . Concerning severity, four RCTs studied moderate to severe AR (19,(22)(23)(24) .…”

“…Two RCTs studied patients with seasonal AR (SAR) (19,24) , while two studied perennial AR (PAR), one with persistent disease (21,22) . Concerning severity, four RCTs studied moderate to severe AR (19,(22)(23)(24) . One trial included AR patients with comorbid mild asthma, but the data were not reported separately (21) .…”

“…One trial included AR patients with comorbid mild asthma, but the data were not reported separately (21) . Patients with asthma were excluded from five trials (19,20,(22)(23)(24) .…”

“…One RCT used mometasone furoate 200µg per day (22) , three used fluticasone propionate 200µg per day (50 µg /actuation, two actuations into each nostril once a day) (19,21,23) , one used fluticasone propionate 400µg per day (200 µg into each nostril once a day) (20) , and one used budesonide 256µg per day (64 µg into each nostril twice daily) (24) . All RCTs used oral montelukast (10mg/day) as the LTRA (19)(20)(21)(22)(23)(24) . Treatment duration ranged from 2 to 8 weeks.…”