Comparative clinical evaluation of effect of topical verses systemic anti -allergic drug in allergic rhinitis: a prospective study

Abstract

INTRODUCTIONThe term 'allergy', coined by von Pirquet, he proposed the term allergy, to describe a change of the living tissues, with increased or reduced sensitiveness due to the formation of specific antibodies.1 On exposure to the foreign protein the allergen combines with cell-bound reagenic antibodies to release histamine and similar amines and other factors.2 Allergy is used to define the series of events which occurs when an antigen, which is not harmful in itself, causes an immune response, leading to symptoms and disease in genetically predisposed individuals. The various manifestations of atopy and allergy are allergic rhinitis, allergic asthma, allergic conjunctivitis, allergic dermatitis, drug allergies, bee stings and urticaria/angioedema. Nasobronchial allergies i.e. asthma or rhinitis alone or asthma with rhinitis are the commonest allergic manifestations with 75.4% of patients belonging to this group. 3 Vangham and Bray stated that roughly 10% of general population is frankly allergic and 50% given history of transient episodes. 4 Allergic rhinitis is the most common allergy encountered in clinical practice and constitutes about 55% of allergies seen in India 5 .Shambough stated that at least 90% of chronic nasal infections and 70% of chronic sinus ABSTRACT Background: Nasal passages form one of the chief sources of contact of the human with his environment. Hence, it is natural that the mucosa of the area is the victim of assault with multitudes of potential allergens. Allergic rhinitis is an inflammatory disease with worldwide prevalence of 10-40%. Allergic rhinitis is a disease with low mortality but significantly lowers the quality of life and functioning. Both oral and intranasal antihistamines are approved for the first-line treatment of allergic rhinitis and both formulations result in a reduction in symptoms and an improvement in quality of life. Methods: The following study was designed to assess the efficacy and safety of the azelastine nasal spray in comparison to levocetrizine in patients with allergic rhinitis. Out of the 68 patients, 34 cases were treated with topical azelastine (group A), while remaining 34 with systemic levocetrizine (group B). The effects of anti-allergic drugs have been studied on the basis of relief of symptoms and change in histopathology. Results: The effect of levocetrizine has been studied on the basis of relief of symptoms and change in histopathology and found to have complete response in 58% and fair response in 23.5% patients of allergic rhinitis. The effect of topical azelastine nasal spray have complete response in 70.5% and fair response in 23.5% patients of allergic rhinitis. Conclusions: Comparing the post therapy clinical and histopathological results in this study, azelastine nasal spray was found to be more effective and safe in the treatment of allergic rhinitis than levocetrizine.

Comparative study of fluticasone propionate combined with azelastine versus fluticasone propionate alone as nasal spray in allergic rhinitis

“…This is comparable to study by Bhadouriya et al, in which most cases were in age group of 21-30 years with mean age of 31.5 years and the study of Negus and Hagy. 12,13 There were 21 females in group 1 as compared to 27 females in group 2 in the study. The gender distribution difference was not significant.…”

“…The study done by Dalvi et al showed significant reduction in both sneezing and nasal obstruction with nasal spray of fluticasone propionate combined with azelastine compared to fluticasone propionate alone. 14 The topical azelastine relieves symptoms of AR rapidly and effectively according to study by Bhadouriya et al 12 The topical effect of various corticosteroids and antihistamines in allergic rhinitis, however, needs to be studied further.…”