Fluticasone Propionate Nasal Spray Is Superior to Montelukast for Allergic Rhinitis While Neither Affects Overall Asthma Control

Nathan, Robert A.; Yancey, Steven W.; Waitkus-Edwards, Kelli; Prillaman, Barbara A.; Stauffer, John L.; Philpot, E.; Dorinsky, Paul; Nelson, Harold S.

doi:10.1016/s0012-3692(15)52583-x

Cited by 58 publications

(42 citation statements)

References 23 publications

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“…These findings led the authors to conclude that the combination of ICS and intranasal corticosteroids is optimal for these patients. 25 In the second study, 27 therapy with intranasal fluticasone conferred no additional benefit in overall asthma control for patients with comorbid rhinitis and asthma who were also receiving inhaled fluticasone propionate and salmeterol, possibly because the lower airways were already effectively treated. Moreover, the length of the aforementioned studies (6 and 4 weeks, respectively) was insufficient to capture less frequent evidence of uncontrolled asthma, such as exacerbations.…”

Section: Discussionmentioning

confidence: 99%

Observational study comparing intranasal mometasone furoate with oral antihistamines for rhinitis and asthma

Price

Kemp

Sims

et al. 2010

Primary Care Respiratory Journal

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Aims: Retrospective database study comparing upper and lower airway-related outcomes for patients with rhinitis and co-morbid asthma receiving mometasone furoate -an intranasal corticosteroid with low systemic bioavailability -or an oral antihistamine.Methods: 395 patients prescribed intranasal mometasone were matched on 10 demographic and respiratory-related criteria in a 1:2 ratio to 790 patients prescribed oral antihistamine. Asthma and rhinitis control were assessed over one year using predefined composite proxy measures.Results: Asthma control was achieved by 309/395 (78.2%) versus 580/790 (73.4%; p=0.071) patients in the mometasone and antihistamine cohorts, respectively. Rhinitis control was achieved by 293 (74.2%) versus 539 (68.2%; p=0.035), respectively. The adjusted odds ratios for antihistamines, relative to mometasone, were 0.71 (95% CI, 0.52-0.98) for achieving asthma control and 0.74 (95% CI, 0.56-0.97) for achieving rhinitis control. Conclusions:Patients with rhinitis and co-morbid asthma initiating rhinitis therapy achieved significantly better upper as well as lower airway outcomes with intranasal mometasone than with oral antihistamine.

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Section: Discussionmentioning

confidence: 99%

Observational study comparing intranasal mometasone furoate with oral antihistamines for rhinitis and asthma

Price

Kemp

Sims

et al. 2010

Primary Care Respiratory Journal

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“…50 Nathan et al randomized 863 adult and adolescent patients who received combination fluticasone propionate salmeterol (FSC) to receive either blinded fluticasone propionate aqueous nasal spray (FPANS) 200 mcg per day or montelukast 10 mg per day or placebo. 51 Montelukast was found to be inferior to FPANS in control of allergic rhinitis in these patients with persistent asthma treated with FSC, and the addition of either montelukast or FPANS resulted in no additional improvements in overall asthma control compared with FSC alone. These clinical data from the RCT performed by Nathan et al in a large sample of patients with persistent asthma appear to add support to the challenge to the economic value of montelukast brought by Heaton et al in …”

Section: E D I T O R I a L S U B J E C T S -I N T H I S I S S U E A Nmentioning

confidence: 74%

Chasing Quality - Clinical Practice Guidelines and HEDIS Measures of Asthma and Depression Therapy Management

Curtiss¹

2006

JMCP

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“…In the second group, using nasal corticosteroid with antihistaminic resulted in improvement of both nasal symptom scores and RQLQ scores. In many sudies, it has been reported that leukotriene receptor antagonists are more effective than placebo, equivalent to oral H1-antihistaminics and inferior to intranasal glucocorticosteroids in the treatment of seasonal allergic rhinitis [18][19][20][21]. In one study of perennial rhinitis, montelukast was found to be superior to placebo [22], but in another study its effects were not superior to placebo and were similar to cetirizine after 1 month of treatment [23].…”

Section: Discussionmentioning

confidence: 99%

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

Tatar

Sürenoğlu

Özdek

et al. 2012

Indian J Otolaryngol Head Neck Surg

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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.

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Fluticasone Propionate Nasal Spray Is Superior to Montelukast for Allergic Rhinitis While Neither Affects Overall Asthma Control

Cited by 58 publications

References 23 publications

Observational study comparing intranasal mometasone furoate with oral antihistamines for rhinitis and asthma

Observational study comparing intranasal mometasone furoate with oral antihistamines for rhinitis and asthma

Chasing Quality - Clinical Practice Guidelines and HEDIS Measures of Asthma and Depression Therapy Management

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

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