title: 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.
abstract: 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.
authors.affiliation: College of Medicine, Penn State University, Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.
authors.forename: Niti
authors.initials: N
authors.lastname: Sardana
authors.forename: Carah
authors.initials: C
authors.lastname: Santos
authors.forename: Erik
authors.initials: E
authors.lastname: Lehman
authors.forename: Timothy
authors.initials: T
authors.lastname: Craig
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D000281:Administration, Intranasal; D000287:Administration, Topical; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D019819:Budesonide / Q000627:therapeutic use; D003521:Cyclopropanes; D004311:Double-Blind Method; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use*; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D008875:Middle Aged; D010793:Phthalazines / Q000627:therapeutic use; D011804:Quinolines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D013440:Sulfides; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000085:Acetates; D000305:Adrenal Cortex Hormones; D003521:Cyclopropanes; D039563:Histamine H1 Antagonists, Non-Sedating; D020024:Leukotriene Antagonists; D010793:Phthalazines; D011804:Quinolines; D013440:Sulfides; D019819:Budesonide; C093875:montelukast; C020976:azelastine