The comparison of the efficacy of fluticasone propionate with cetirizine in perennial allergic rhinitis.
BACKGROUND
Allergic rhinitis is an IgE mediated hypersensitivity reaction of the nasal mucosa characterised by nasal discharge, obstruction, and pruritus.


METHODS
In this study, 43 patients with perenneal allergic rhinitis were enrolled in order to compare the efficacy of Fluticasone Propionate (FP), a corticosteroid nasal spray, with Cetirizine, a systemic oral antihistaminic preparation, which is supposed to have nonsteroidal antiinflammatory activity. Cetirizine (10 mg daily as a single dose) was administered to 22 patient for 45 days. On the other hand, FP (400 micrograms/day) was administered into each nostril twice a day in the remaining 21 patients for 45 days. Skin test was obtained from each patient before therapy. Total eosinophil count, eosinophil count in nasal smear, electrorhinomanometric investigation, PGE2 and ratio of LTC4 to LTD4 both in the serum and in the nasal secretions were determined before and after therapy. In addition, percentage of eosinophils, and mast cells count in the biopsy specimens taken from anterior edge of middle choncha were evaluated before and after therapy, and than the results were graded for each patients.


RESULTS
When we compared the eosinophil count in nasal smear, eosinophil percentage and total eosinophil parameters between two groups, it was shown that FP was more effective than Cetirizine. On the other hand, when we compared the ratio of LTC4 to LTD4 in serum and nasal smear, level of PGE2 and mast cell and nasal airway resistance measured by ERM, there were non statistical difference between two groups.


CONCLUSIONS
These results suggest that FP and Cetirizine may be used alternatively in case of an adverse reaction to any of them.
Karaman
O
O
Departments of Allergy, Otorhinolaringology, Microbiology an Pathology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey.
Günbay
A
A
Uzuner
N
N
Günbay
U
U
Gülay
Z
Z
Sarioğlu
S
S
Yuluğ
N
N
D000281:Administration, Intranasal; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000730:Androstadienes / Q000008:administration & dosage / Q000627:therapeutic use*; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers; D017332:Cetirizine / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D015232:Dinoprostone / Q000032:analysis; D004804:Eosinophils; D005260:Female; D000068298:Fluticasone; D006801:Humans; D007958:Leukocyte Count; D017997:Leukotriene C4 / Q000032:analysis; D017998:Leukotriene D4 / Q000032:analysis; D008297:Male; D008365:Manometry; D008407:Mast Cells; D008875:Middle Aged; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D012882:Skin Tests; D016896:Treatment Outcome
D000730:Androstadienes; D018926:Anti-Allergic Agents; D015415:Biomarkers; D017997:Leukotriene C4; D017998:Leukotriene D4; D000068298:Fluticasone; D015232:Dinoprostone; D017332:Cetirizine