Among the most frequently used drugs in the treatment of
allergic rhinitis we have to mention topical nasal
corticosteroids and H1
antihistamines used both systemically and topically. The present study focused the effectiveness and tolerability of
cetirizine and
fluticasone propionate in
seasonal allergic rhinitis. 54 patients, divided into three homogeneous groups, underwent the following different treatments: Group 1: Placebo of
fluticasone (2 puff per nostril once daily by
aerosol) +
cetirizine (10 mg/die per os) for 60 days. Group 2:
Fluticasone (100 mg per nostril once daily by
aerosol) + placebo of
cetirizine (per os) for 60 days. Group 3:
Cetirizine (10 mg/die per os) for 60 days +
fluticasone (100 mg per nostril once daily by
aerosol) for 20 days. The patients reported nasal symptoms (
sneezing, obstruction,
itching, rhinorrea) on a clinical diary. ECP levels in nasal secretions were investigated in all patients to determine the anti-inflammatory activity of both treatments.
Cetirizine resulted very effective in the treatment of
sneezing,
itching and acqueous rhinorrea whereas not much effective on
nasal obstruction. On the contrary,
fluticasone, which acted effectively on
nasal obstruction, resulted inefficacious on the other symptoms. The third group of patients achieved the best results on all four symptoms, including obstruction, which continued even after interrupting the treatment with
fluticasone. The ECP levels were significantly reduced by both treatments. The side effects in all 3 groups were rare and not serious. From these results we can assert that the synergic action of the two drugs, achieves the best effectiveness, that the
fluticasone treatment can be limited to 20 days cycles and finally that both molecules are well tolerated.