title: Comparison of Oral Montelukast and Intranasal Fluticasone in Patients with Asthma and Allergic Rhinitis.
abstract: BACKGROUND
  Even though the links between upper and lower airway had been of interest to clinicians since long back, it has not attracted the attention of the researchers till recent past. But the evidence is still far from conclusive, due to limited number of randomized controlled trials available on subjects with concomitant allergic rhinitis and asthma. This gap in the knowledge is even more conspicuous in Indian population.
  
  
  OBJECTIVE
  The current study is conducted with an objective of comparing the efficacy and tolerability of intranasal Fluticasone and oral Montelukast in treatment of allergic rhinitis and bronchial asthma.
  
  
  METHODS
  The study was a prospective randomized, single blinded, comparative, parallel group study, with two intervention groups conducted in a tertiary teaching hospital in Chennai, Southern India. One hundred and twenty patients diagnosed with concomitant diagnosis of allergic rhinitis and bronchial asthma was randomly allocated to either Fluticasone propionate aqueous nasal spray or oral Montelukast group.
  
  
  RESULTS
  Out of total 120 subjects recruited, 108 subjects were included in the final analysis. The mean reduction in asthma and rhinitis symptom scores and improvement in PEFR was higher for Group A, compared to Group B during all the follow-up periods. No statistically significant difference was observed in proportion of subjects reporting exacerbations in the current study. Both the treatments were well tolerated.
  
  
  CONCLUSIONS
  Addition of intranasal Fluticasone propionate to Salmeterol plus Fluticasone is beneficial in improving asthma control, allergic rhinitis control and lung functions as compared to oral Montelukast. Thereby the use of intranasal Fluticasone Propionate in comparison to oral Montelukast in control of Allergic Rhinitis is justified as per the significant improvement in outcome measures.
authors.affiliation: Junior Consultant, Respiratory Critical Care and Sleep Medicine, VIMHANS Primamed Hospital , Nehru Nagar, Delhi, India .
authors.forename: Apar
authors.initials: A
authors.lastname: Jindal
authors.affiliation: Associate Professor, Department of Respiratory Medicine, Chettinad Hospital and Research Institute , Kelambakkam, Chennai, Tamilnadu, India .
authors.forename: Subramanian
authors.initials: S
authors.lastname: Suriyan
authors.affiliation: Post Graduate Student, Department of Respiratory Medicine, Chettinad Hospital and Research Institute , Kelambakkam, Chennai, Tamilnadu, India .
authors.forename: Suresh
authors.initials: S
authors.lastname: Sagadevan
authors.affiliation: Professor and Head of Department, Department of Respiratory Medicine, Chettinad Hospital and Research Institute , Kelambakkam, Chennai, Tamilnadu, India .
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Narasimhan
authors.affiliation: Professor, Department of Respiratory Medicine, Chettinad Hospital and Research Institute , Kelambakkam, Chennai, Tamilnadu, India .
authors.forename: Aruna
authors.initials: A
authors.lastname: Shanmuganathan
authors.affiliation: Assistant Professor, Department of Respiratory Medicine, Chettinad Hospital and Research Institute , Kelambakkam, Chennai, Tamilnadu, India .
authors.forename: Viswambhar
authors.initials: V
authors.lastname: Vallabhaneni
authors.affiliation: Assistant Professor, Department of Respiratory Medicine, Chettinad Hospital and Research Institute , Kelambakkam, Chennai, Tamilnadu, India .
authors.forename: Ragulan
authors.initials: R
authors.lastname: Rajalingam
keywords: Intra nasal steroids; Leukotriene antagonists; Nasobronchial allergy