A comparison of intranasal corticosteroid, leukotriene receptor antagonist, and
topical antihistamine in reducing symptoms of perennial allergic rhinitis as
assessed through the Rhinitis Severity Score.
Author(s): Sardana N, Santos C, Lehman E, Craig T.
Affiliation(s): College of Medicine, Penn State University, Hershey Medical Center, 500
University Drive, Hershey, PA 17033, USA.
Publication date & source: 2010, Allergy Asthma Proc. , 31(1):5-9
Rhinitis symptom complex consists of rhinorrhea, congestion, itchy mucosa, itchy
eyes, and sneezing. Available medications vary in their benefit for each of these
symptoms. It was the purpose of this article to compare symptom reduction with
three different classes of medications. Montelukast, azelastine, and budesonide
were compared to determine the effect on individual, as well as total, symptom
scores using the Rhinitis Severity Score (RSS). All three medications were
compared with placebo and showed efficacy in prior studies using Balaam's
crossover design. The inclusion and exclusion criteria and all procedures were
identical for all three studies. In analyzing the data from the RSS
questionnaire, we used the procedure PROC MIXED in SAS specific for Balaam's
crossover design (SAS Institute, Inc., Cary, NC). Although all three medications
were effective compared with placebo, montelukast had the greatest effect of the
three medications on reduction of ocular itching and throat and palate itching.
Azelastine's effect was greater than budesonide and montelukast for reduction of
rhinorrhea. Systemic medication, montelukast, as expected, provided better relief
for symptoms distant from the nasal cavity, and the antihistamine, azelastine,
reduced rhinorrhea, more than either montelukast or budesonide.
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