TOPICAL TREATMENT USING ANTIHISTAMINIC, STEROID AND A COMBINATION OF BOTH IN ALLERGIC RHINITIS-A DOUBLE-BLIND RANDOMIZED CONTROLLED TRIAL

This study evaluates the effectiveness of corticosteroid fluticasone propionate, antihistaminic azelastine, and a combination of both as well as to find out the prognostic significance of absolute eosinophil count (AEC) in the topical treatment of allergic rhinitis. All cases presenting with symptoms of nasal allergy were included maintaining double-blind status. A total of 225 participants of groups I, II and III were treated with topical azelastine, fluticasone propionate and combination of both. The individual symptom score was recorded before and after treatment at the end of four weeks with the help of symptom evaluation scale. The effectiveness of group-specific drugs was evaluated by comparing individual and total symptom scores. AEC was repeated at the end of four weeks in all cases. After intervention the reduction of total symptom score (TSS) and AEC was 9.26 +/- 0.01, 11.73 +/- 0.54. 11.08 +/- 1.61 and 205.59 +/- 81.18, 176.05 +/- 38.23, 195.75 + 29.22 in group I, II and III respectively. Similarly for sneezing it was 0.21 +/- 0.41. 0.24 +/- 0.43 and 0.13 +/- 0.38, for nasal obstruction 0.4 +/- 0.57. 0.08 +/- 0.13 and 0.33 +/- 0.6, for nasal discharge 0.72 +/- 0.83. 0.04 +/- 0.20 and 0.21 +/- 0.41 and for nasal itching 0.11 +/- 0.39. 0.04 +/- 0.20 and 0.25 +/- 0.44 in group I, II and III respectively. Fluticasone propionate (interventional agent of group II) was found to be the most efficacious in reducing TSS (95.52%). AEC (79.82%). and all individual symptom scores except in case of a symptom of sneezing. the combination of azelastine and fluticasone propionate (interventional agent of group III) was most efficacious and statistically significant.