Supplementary Files
How to Cite
Abstract
Objective: This study aimed to compare the efficacy of nasal glucocorticoid combined with antileukotriene therapy versus a combination of antileukotriene and antihistamine therapy in managing symptoms of seasonal allergic rhinitis.
Methods: A randomised clinical trial was conducted from January 2024 to July 2024, involving 200 patients diagnosed with seasonal allergic rhinitis. Participants were randomly assigned to two groups of 100 each. Group A received a combination of nasal glucocorticoid and antileukotriene, while Group B received a combination of antileukotriene and antihistamine. Patients with significant respiratory comorbidities, ongoing systemic corticosteroid use, or hypersensitivity to the study medications were excluded. Symptom severity was assessed at four-week intervals using a pre-designed proforma, and statistical analysis was conducted to evaluate differences in symptom control between the two groups.
Results: Group A demonstrated superior symptom control compared to Group B across all variables. Nasal obstruction was significantly less frequent in Group A (12.0%) compared to Group B (40.0%, p=0.0001). Similarly, rhinorrhea was observed in 46.0% of Group A compared to 69.0% of Group B (p=0.001). Itching and sneezing were also significantly better managed in Group A, with rates of 40.0% and 68.0% compared to 76.0% and 91.0% in Group B, respectively (p=0.0001). These findings highlight the enhanced efficacy of glucocorticoid-antileukotriene therapy in managing seasonal allergic rhinitis.
Conclusion: Nasal glucocorticoid combined with antileukotriene therapy provides significantly better symptom relief for seasonal allergic rhinitis compared to the combination of antileukotriene and antihistamine. This regimen effectively addresses inflammatory pathways, ensuring comprehensive symptom control and improved patient outcomes.
References
Bernstein JA, Bernstein JS, Makol R, Ward S. Allergic rhinitis: a review. JAMA. 2024;331(10):866-77. https://doi.org/10.1038/s41572-020-00227-0
Bousquet J, Anto JM, Bachert C, Baiardini I, Bosnic-Anticevich S, Walter Canonica G, et al. Allergic rhinitis. Nat Rev Dis. 2020;6(1):95-9. https://doi.org/10.1038/s41572-020-00227-0.
Hill DA, Grundmeier RW, Ram G, Spergel JM. The epidemiologic characteristics of healthcare provider-diagnosed eczema, asthma, allergic rhinitis, and food allergy in children: a retrospective cohort study. Pediatrics. 2016;16(1):1-8. https://doi.org/10.1186/s12887-016-0673-z
Gómez RM, Croce VH, Zernotti ME, Muiño JC. The active smoking effect in allergic rhinitis. World Allergy Organ J. 2021;14(2):100504. https://doi.org/10.1016/j.waojou.2020.100504
Wolf JS, Papadimitriou JC, Morales RE, Califano III JA, Kline NL, Bhatnagar K, et al. The association of active and passive tobacco smoke exposure with chronic rhinosinusitis symptom severity: A cross‐sectional study. Int Forum Allergy Rhinol 2022;12(3):278-85. https://doi.org/10.1002/alr.22887
Chung SJ, Kim BK, Oh JH, Shim JS, Chang YS, Cho SH, et al. Novel tobacco products including electronic cigarette and heated tobacco products increase risk of allergic rhinitis and asthma in adolescents: Analysis of Korean youth survey. Allergy. 2020;75(7):1640-8. https://doi.org/10.1111/all.14212
Wang H, Zuo Y, Li J, Wang W. Effects of glucocorticoid therapy on nasal conditions and inflammatory factors in patients with allergic rhinitis. Int J Clin Exp Med. 2020;13(4):2154-62.
Sokolowska M, Rovati GE, Diamant Z, Untersmayr E, Schwarze J, Lukasik Z, et al. Effects of non‐steroidal anti‐inflammatory drugs and other eicosanoid pathway modifiers on antiviral and allergic responses: EAACI task force on eicosanoids consensus report in times of COVID‐19. Allergy. 2022 ;77(8):2337-54. https://doi.org/10.1111/all.15258
De Corso E, Anzivino R, Galli J, Baroni S, Di Nardo W, De Vita C, et al. Antileukotrienes improve naso‐ocular symptoms and biomarkers in patients with NARES and asthma. Laryngoscope. 2019;129(3):551-7. https://doi.org/10.1002/lary.27576
Kawauchi H, Yanai K, Wang DY, Itahashi K, Okubo K. Antihistamines for allergic rhinitis treatment from the viewpoint of nonsedative properties. Int J Mol Sci. 2019;20(1):213-7. https://doi.org/10.3390/ijms20010213
Deka B, Bhattacharjee B, Ahmed A, Newar A, Sonowal B, Dey N, Barman D, Ikbal AM, Rajkhowa A, Bharali A. Clinical management of allergic rhinitis: A comprehensive review. Res J Pharmacol Pharmacod. 2021;13(1):9-16. https://doi.org/10.5958/2321-5836.2021.00003.3
Linton S, Hossenbaccus L, Ellis AK. Evidence-based use of antihistamines for treatment of allergic conditions. Ann Allergy Asthma Immunol. 2023;131(4):412-20. https://doi.org/10.1016/j.anai.2023.07.019
Pullerits T, Praks L, Ristioja V, Lötvall J. Comparison of a nasal glucocorticoid, antileukotriene, and a combination of antileukotriene and antihistamine in the treatment of seasonal allergic rhinitis. J Allergy Clin Immunol. 2002;109(6):949-955. https://doi.org/10.1067/mai.2002.124467
Rodrigo GJ, Yañez A. The role of antileukotriene therapy in seasonal allergic rhinitis: A systematic review of randomized trials. Ann Allergy Asthma Immunol. 2006;96:779-786. https://doi.org/10.1016/S1081-1206(10)61339-7
Nathan RA. Pharmacotherapy for allergic rhinitis: A critical review of leukotriene receptor antagonists compared with other treatments. Ann Allergy Asthma Immunol. 2003;90:182-191. https://doi.org/10.1016/S1081-1206(10)62138-2
Baççıoğlu A, Yorgancıoğlu A, Cingi C, Çuhadaroğlu Ç. Role of leukotriene antagonists and antihistamines in treatment of allergic rhinitis and asthma comorbidity. J Med Updates. 2013;3(1):34-39. https://doi.org/10.2399/jmu.2013001008.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) 2025 Adia Bushra Piracha, Sadia Chaudhry, Ashar Alamgir, Amna Kousar, Nimra Imtiaz, Saba Sahar