title: Comparing the effects of Botulinum Toxin-A and cetirizine on the treatment of allergic rhinitis.
abstract: BACKGROUND
  There are few reports on the effects of intranasal Botulinum Toxin-A (BTX-A) as a treatment of allergic rhinitis (AR). In this study, we compared the efficacy of intranasal BTX-A to cetirizine in the treatment of AR.
  
  
  METHODS
  Fifty AR patients at the age of 26.2 ± 9.1 years (64% females), were recruited to the trial according to the Allergic Rhinitis and its Impact on Asthma (ARIA) criteria. Participants randomly received either intranasal injection of BTX-A (75IU Dysport®) or cetirizine (10mg/day). Symptoms (based on the ARIA) and side effects were assessed every two weeks for two months. Quality of life was evaluated before and after the study using the Rhinasthma questionnaire.
  
  
  RESULTS
  Total symptom severity score of patients significantly decreased (P < 0.001) and quality of life significantly improved (P < 0.001) at the same level in both groups. Side effects included nasal dryness (4%) and epistaxis (4%) in the BTX-A group. In the cetirizine group 44% sleepiness and 4% blurred vision was reported.
  
  
  CONCLUSIONS
  Nasal injection of BTX-A shows the same therapeutic effects as cetirizine in the management of AR. Since BTX is expensive, we do not suggest it in the first line of treatment for AR. However, BTX-A is a potential treatment for patients who are resistant or not compliant to the routine medications of AR. Further studies are required to investigate implications and limitations of BTX-A in the treatment of AR.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Sayyed Mostafa
authors.initials: SM
authors.lastname: Hashemi
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Okhovat
authors.forename: Saghi
authors.initials: S
authors.lastname: Amini
authors.forename: Mahdi
authors.initials: M
authors.lastname: Pourghasemian
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D017332:Cetirizine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011788:Quality of Life; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D039563:Histamine H1 Antagonists, Non-Sedating; D019274:Botulinum Toxins, Type A; D017332:Cetirizine