FLUTICASONE PROPIONATE AQUEOUS NASAL SPRAY COMPARED WITH TERFENADINE TABLETS IN THE TREATMENT OF SEASONAL ALLERGIC RHINITIS

Background: Comparative studies with topical corticosteroids and antih istamines for treatment of allergic rhinitis have not always demonstra ted clear distinctions between the two on the basis of therapeutic eff icacy. Objective: This study was designed to compare the efficacy and tolerability of fluticasone propionate aqueous nasal spray with those of terfenadine in the treatment of seasonal allergic rhinitis. Methods : Three hundred forty-eight patients with allergic rhinitis were given fluticasone propionate aqueous nasal spray (200 mu g once daily), ter fenadine tablets (60 mg twice daily), or placebo for 4 weeks in a mult icenter, randomized, double-blind, double-dummy, parallel-group study. Results: Clinician-rated total nasal symptom scores after 1, 2, 3, an d 4 weeks of therapy and patient-rated total nasal symptom scores thro ughout treatment were significantly (p < 0.05) lower in the fluticason e propionate group compared with the terfenadine group or the placebo group. Terfenadine was not statistically different from placebo on the basis of clinician-rated nasal symptom scores, except for sneezing. T otal nasal airflow, measured by rhinomanometry, significantly (p < 0.0 5) improved in the fluticasone propionate group compared with the terf enadine group or the placebo group. More fluticasone propionate-treate d patients compared with the place-treated patients has reduced nasal mucosal eosinophil counts after 4 weeks of therapy (p < 0.05). No seri ous or unusual drug-related adverse events were reported. Morning plas ma cortisol concentrations after 4 weeks of therapy did not differ amo ng groups. Conclusion: Fluticasone propionate aqueous nasal spray is m ore effective than terfenadine tablets for treatment of seasonal aller gic rhinitis.