The Effect of Novel Combination Therapy with Azelastine Hydrochloride and Fluticasone Propionate in Allergic Rhinitis

Background: Allergic rhinitis is a prevalent condition in the community and impairs quality of life. Treatment often requires combination of different topical treatment. We wanted to assess the effect of combination steroid and antihistamine nasal spray in patients who have failed primary therapy. Secondary aims were to analyse the multidomain impact of rhinitis, financial costs incurred and impact on quality of life. Method: We analysed fifty-three patients who were referred to the specialist hospital having failed primary care treatment for nasal and sinus disease. The MSNOT-20 is a disease specific validated questionnaire to identify rhinitis and its response to treatment. Patients were re-assessed following one month of treatment use. Skin prick testing and nasal inspiratory peak flow were also used. Results: All subjects had improvement in their symptoms following treatment (31.6 (10.69) vs. 11 (4.18)-mean and standard deviation before and after treatment respectively, p<0.05). There was improvement in each subgroup, statistically significant in all except the emotional subgroup. Common allergens identified in sufferers were grass, house dust mite and tree pollen. The majority of patients were in the working age bracket and 90% had to take time off work due to their symptoms. Conclusion: There is significant impact on quality of life and education/work-based complications of rhinitis. Combination intranasal steroid with intranasal antihistamine is effective at improving symptomatology of allergic rhinitis, this was also demonstrated through patient comments. MSNOT-20 is once again proven as a useful tool in detecting rhinitis, its impact and disease response to treatment.