Selecting an optimal pharmacotherapy for allergic rhinitis from the standpoint of guidelines and observation in real-life clinical practice

Introduction . Allergic rhinitis (AR) is a common condition that has considerable impact on patients’ quality of life. Moreover, it is the risk factor for asthma development. Therefore, achieving control of AR remains crucial. Aim. To analyze comparative efficacy of fixed-dose combination of olopatadine hydrochloride – mometasone furoate versus combination of intranasal corticosteroids with second generation oral antihistamines. Materials and methods . Seventy-five patients (ages 19–59) mainly with moderate severity of AR enrolled the study. Group 1 (29 patients) was given a fixed-dose combination of olopatadine hydrochloride – mometasone furoate (Ryaltris) in 2 sprays (25/600 mcg) in each nostril twice daily, whereas group 2 (46 patients) – intranasal corticosteroids with second generation oral antihistamines for 14 days. The efficacy was evaluated using validated questionnaires and scales (TNSS, TOSS, VAS, SNOT-22) before, during and after the treatment is complete. Results and discussion. We revealed AR and allergic conjunctivitis symptoms improvement as well as quality of life parameters. Nevertheless, disease control was achieved earlier (on day 2 of treatment) in group 1, while in group 2 – only on day 4. Conclusions. Our study showed comparable efficacy of fixed-dose combination of olopatadine hydrochloride – mometasone furoate (Ryaltris) and combination of intranasal corticosteroids with second generation oral antihistamines. However, fixed-dose combination topical therapy is associated with lower risk of adverse reactions and leads to early control of AR and allergic conjunctivitis symptoms. Besides, fixed combination use adjusts adherence to treatment.