Introduction
A significant proportion of allergic rhinitis (AR) patients experience ocular symptoms like itching, redness and congestion which can adversely impact their quality-of-life and increase the burden on the healthcare cost. Intranasal corticosteroids (INC) are effective in reducing the nasal and ocular symptoms of allergic rhinitis. However, there is lack of comparative data on the impact of fluticasone furoate and mometasone furoate on the ocular symptoms of AR.
Aim
This study compared the efficacy of mometasone furoate nasal spray and fluticasone furoate nasal spray in reducing the nasal and ocular symptoms of AR.
Method
Study Design
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Single-center randomized clinical study
Patient Profile
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Patients >18 years with persistent AR with ocular symptoms
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Had a positive skin prick test
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Had a baseline total ocular symptom score (TOSS) >4
Treatment Strategy
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The cohort was randomized into 2 groups
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Group A (n=46) received 200 µg of mometasone furoate nasal spray once daily for 3 months
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Group B (n=44) received 110 µg of fluticasone furoate nasal spray once daily for 3 months
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The follow-up was taken at 2, 6 and 12 weeks
End Points
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TOSS
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Total nasal symptom score (TNSS)
Results
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The baseline TOSS and TNSS scores of both the groups were comparable
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TOSS and TNSS scores reduced significantly in both the groups as seen in Table 1.
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Group demonstrated better improvement in the TOSS score by 6 weeks (p=0.0009), which continued till the 12 weeks (p=0.045).
Table 1. TOSS and TNSS scores at baseline and during the study period
|
Baseline |
2 weeks |
6 weeks |
12 weeks |
TOSS |
||||
Group A |
4.85+2.15 |
3.80+1.42 |
3.12+1.20 |
2.55+1.08 |
Group B |
4.80+2.41 |
3.86+1.35 |
2.30+1.06 |
2.10+1.02 |
P value |
0.914 |
0.837 |
0.0009 |
0.045 |
TNSS |
||||
Group A |
5.56+2.24 |
4.87+2.12 |
3.48+1.76 |
2.37+1.23 |
Group B |
5.40+2.31 |
4.60+1.90 |
3.14+1.85 |
2.15+1.41 |
P value |
0.739 |
0.526 |
0.378 |
0.431 |
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The incidence of adverse effects was 22.6% in group A vs 14.8% in group B
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Common adverse effects were drying and crusting of nose, pharyngitis and mild burning sensation in the nose.
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All these effects were mild and did not require discontinuation of the nasal spray
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None of the patients reported epistaxis
Conclusions
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Fluticasone furoate and mometasone furoate were safe and effective in managing the ocular and nasal symptoms of allergic rhinitis
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However, intranasal fluticasone furoate was more effective in reducing the ocular symptoms associated with AR
Int J Otorhinolaryngol Head Neck Surg. 2017 Oct; 3(4):918-922.