A comparison of the clinical efficacy and safety of intranasal fluticasonepropionate and antihistamines in the treatment of rhinitis

Adequate management of allergic rhinitis is needed to avoid its considerabl e adverse social, clinical, and economic impact. Both topical intranasal st eroids and oral or topical antihistamines are recognised as effective treat ments for this condition. In comparative studies, however, intranasal stero ids and, in particular, fluticasone propionate aqueous nasal spray (FPANS), have afforded consistently better symptomatic relief and have a greater be neficial effect on quality of life. Furthermore, the addition of an antihis tamine to FPANS therapy has generally produced little further benefit. Intr anasal administration is associated with a low systemic absorption of fluti casone propionate and, following regular use of FPANS, placebo, or an oral antihistamine, no significant differences were seen between treatment group s in plasma or urinary cortisol. Overall, therefore, the data indicate that FPANS is superior to second-generation antihistamines in the management of allergic rhinitis.