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Comparison of intranasal azelastine to intranasal fluticasone propionate for symptom control in moderate-to-severe seasonal allergic rhinitis.
Allergy Asthma Proc. 2012 Nov-Dec; 33(6):450-8.AA

Abstract

Intranasal corticosteroids are considered the most effective therapy for moderate-to-severe seasonal allergic rhinitis (SAR) and recommended first line in guidelines. It is uncertain whether intranasal antihistamines have comparable efficacy. This study was designed to compare the efficacy of azelastine (AZE; 137 μg/spray) and fluticasone propionate (FP; 50 μg/spray), both given as 1 spray/nostril bid (i.e., approved dosing regimen in the United States), in SAR via a post hoc analysis of data from a previously published direct-comparison study. Six hundred ten moderate-to-severe SAR patients (≥12 years old) were randomized into a double-blind, placebo-controlled, parallel-group trial. The primary efficacy variable was change from baseline in reflective total nasal symptom score (rTNSS (morning and evening), over 14 days. Reflective total ocular symptom score (rTOSS) was a key secondary variable. Reflective total of seven symptom scores (rT7SS [nasal plus ocular symptoms]) and time to ≥50% reduction from baseline in these key parameters were also analyzed. AZE and FP reduced rTNSS from baseline by a similar degree (-3.25 versus -3.84; p = 0.2014). Patients experienced comparable improvement in rTOSS (-2.62 versus -2.17; p = 0.2371) and rT7SS (-5.83 versus -6.05; p = 0.7820). FP was superior to AZE in alleviating rhinorrhea (-1.15 versus -0.87; p = 0.0433), but AZE showed comparable efficacy for all other nasal and ocular symptoms. There was no clinically or statistically significant difference between AZE (-1.17) and FP (-1.43) for reduction in the overall rhinitis quality of life questionnaire score (although FP, but not AZE, significantly differed from placebo). A similar proportion of patients in the AZE and FP groups achieved a 50% reduction in rTNSS. However, more AZE patients (53.0%) exhibited a 50% reduction in rTOSS by day 14 versus FP (39.6%), and ≤3 days faster (p = 0.028). Intranasal AZE (137 micrograms/spray) and intranasal FP (50 micrograms/spray), both 1 spray/nostril b.i.d., had comparable efficacy in symptom control in moderate-to-severe SAR.

Authors+Show Affiliations

Allergy and Asthma Associates of Southern California, Mission Viejo, CA, USA. wcarr@allergee.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase III
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23127291

Citation

Carr, Warner W., et al. "Comparison of Intranasal Azelastine to Intranasal Fluticasone Propionate for Symptom Control in Moderate-to-severe Seasonal Allergic Rhinitis." Allergy and Asthma Proceedings, vol. 33, no. 6, 2012, pp. 450-8.
Carr WW, Ratner P, Munzel U, et al. Comparison of intranasal azelastine to intranasal fluticasone propionate for symptom control in moderate-to-severe seasonal allergic rhinitis. Allergy Asthma Proc. 2012;33(6):450-8.
Carr, W. W., Ratner, P., Munzel, U., Murray, R., Price, D., Canonica, G. W., Mullol, J., Virchow, J. C., Lieberman, P., Meltzer, E., & Bachert, C. (2012). Comparison of intranasal azelastine to intranasal fluticasone propionate for symptom control in moderate-to-severe seasonal allergic rhinitis. Allergy and Asthma Proceedings, 33(6), 450-8. https://doi.org/10.2500/aap.2012.33.3626
Carr WW, et al. Comparison of Intranasal Azelastine to Intranasal Fluticasone Propionate for Symptom Control in Moderate-to-severe Seasonal Allergic Rhinitis. Allergy Asthma Proc. 2012;33(6):450-8. PubMed PMID: 23127291.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of intranasal azelastine to intranasal fluticasone propionate for symptom control in moderate-to-severe seasonal allergic rhinitis. AU - Carr,Warner W, AU - Ratner,Paul, AU - Munzel,Ullrich, AU - Murray,Ruth, AU - Price,David, AU - Canonica,G Walter, AU - Mullol,Joaquim, AU - Virchow,J Christian, AU - Lieberman,Phil, AU - Meltzer,Eli, AU - Bachert,Claus, Y1 - 2012/11/02/ PY - 2012/11/7/entrez PY - 2012/11/7/pubmed PY - 2013/6/19/medline SP - 450 EP - 8 JF - Allergy and asthma proceedings JO - Allergy Asthma Proc VL - 33 IS - 6 N2 - Intranasal corticosteroids are considered the most effective therapy for moderate-to-severe seasonal allergic rhinitis (SAR) and recommended first line in guidelines. It is uncertain whether intranasal antihistamines have comparable efficacy. This study was designed to compare the efficacy of azelastine (AZE; 137 μg/spray) and fluticasone propionate (FP; 50 μg/spray), both given as 1 spray/nostril bid (i.e., approved dosing regimen in the United States), in SAR via a post hoc analysis of data from a previously published direct-comparison study. Six hundred ten moderate-to-severe SAR patients (≥12 years old) were randomized into a double-blind, placebo-controlled, parallel-group trial. The primary efficacy variable was change from baseline in reflective total nasal symptom score (rTNSS (morning and evening), over 14 days. Reflective total ocular symptom score (rTOSS) was a key secondary variable. Reflective total of seven symptom scores (rT7SS [nasal plus ocular symptoms]) and time to ≥50% reduction from baseline in these key parameters were also analyzed. AZE and FP reduced rTNSS from baseline by a similar degree (-3.25 versus -3.84; p = 0.2014). Patients experienced comparable improvement in rTOSS (-2.62 versus -2.17; p = 0.2371) and rT7SS (-5.83 versus -6.05; p = 0.7820). FP was superior to AZE in alleviating rhinorrhea (-1.15 versus -0.87; p = 0.0433), but AZE showed comparable efficacy for all other nasal and ocular symptoms. There was no clinically or statistically significant difference between AZE (-1.17) and FP (-1.43) for reduction in the overall rhinitis quality of life questionnaire score (although FP, but not AZE, significantly differed from placebo). A similar proportion of patients in the AZE and FP groups achieved a 50% reduction in rTNSS. However, more AZE patients (53.0%) exhibited a 50% reduction in rTOSS by day 14 versus FP (39.6%), and ≤3 days faster (p = 0.028). Intranasal AZE (137 micrograms/spray) and intranasal FP (50 micrograms/spray), both 1 spray/nostril b.i.d., had comparable efficacy in symptom control in moderate-to-severe SAR. SN - 1539-6304 UR - https://www.unboundmedicine.com/medline/citation/23127291/Comparison_of_intranasal_azelastine_to_intranasal_fluticasone_propionate_for_symptom_control_in_moderate_to_severe_seasonal_allergic_rhinitis_ L2 - https://www.ingentaconnect.com/openurl?genre=article&issn=1088-5412&volume=33&issue=6&spage=450&aulast=Carr DB - PRIME DP - Unbound Medicine ER -