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. PATIENTS AND 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. CONCLUSION: These results suggest that FP and Cetirizine may be used alternatively in case of an adverse reaction to any of them.

The comparision of the efficacy of fluticasone propinate with cetirizine in perenneal allergic rhinitis

Background: allergic rhinitis is an IgE mediated hypersensitivity reaction of the nasal mucosa characterised by nasal discharg, obstruction, and pruritus. Patients and 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, wich is suposed 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 mg/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. Conclusion: these results suggest that FP and Cetirizine may be used alternatively in case of an adverse reaction to any of them (AU)

Fundamento: la rinitis alérgica es una reacción de hipersensibilidad de la mucosa nasal, mediada por IgE, y caracterizada por secreción, obstrucción y prurito nasal.Pacientes y métodos: en este estudio se incluyeron 43 pacientes con rinitis alérgica perenne con el objetivo de comparar la eficacia de propionato de fluticasona (PF), un corticoide administrado en nebulización nasal, con cetiricina, un antihistamínico sistémico administrado por vía oral, que supuestamente carece de actividad antiinflamatoria no esteroide. A 22 pacientes se les administró cetirizina (10 mg/día en una sola dosis) durante 45 días. A los 21 pacientes restantes se aplicó PF (400 g/día) 2 veces al día en cada ventana nasal durante 45 días.Antes del tratamiento se efectuaron pruebas cutáneas a todos los pacientes. Antes y después del tratamiento se hicieron: recuentos de eosinófilos en sangre y frotis nasal; en suero y secreción nasal se determinaron PGE2 y la relación LTC4/LTD4, y además se realizó estudio electrorrinomanométrico.Además, antes y después del tratamiento, se evaluaron el porcentaje de eosinófilos y el recuento de mastocitos en las biopsias obtenidas a partir del borde anterior del cornete medio.Resultados: cuando comparamos el recuento de eosinófilos en el frotis nasal, porcentaje de eosinófilos y recuento total de eosinófilos entre ambos grupos, se puso de manifiesto que PF fue más eficaz que cetiricina. Por otra parte, cuando comparamos el cociente LTC4:LTD4 en suero y frotis nasal, valores de PGE2 y recuento de mastocitos y la resistencia de las vías respiratorias nasales determinadas mediante ERM, no se detectaron diferencias estadísticamente significativas entre ambos grupos.Conclusión: los resultados del presente estudio demuestran que ambos fármacos pueden utilizarse alternativamente en caso de reacciones adversas a cualquiera de ellos (AU)