European Journal of Cardiovascular Medicine

Background: Allergic rhinitis (AR) is a recurrent, chronic condition with a substantial impact on health and quality of life. The debate persists on whether antihistamines or intranasal corticosteroids constitute the first-line treatment for AR. This study aims to compare the efficacy of fluticasone + azelastine nasal spray and levocetirizine tablets in AR treatment. Objectives: The study clinically evaluates the effectiveness of the two regimens in relieving symptoms and compares their overall efficacy in treating allergic rhinitis. Materials and Methods: Patients at a tertiary care hospital were included, with 100 individuals aged 12 to 65 randomized into two groups receiving either fluticasone + azelastine nasal spray or oral levocetirizine for four weeks. Symptom assessment, clinical examination, and laboratory investigations were conducted, with patients maintaining a daily symptom journal. Results: The fluticasone + azelastine group showed a significant reduction in individual symptom severity compared to the levocetirizine group (p<0.01). Symptom scores in the fluticasone + azelastine group decreased by 99-100%, exceeding the 90-91% reduction observed in the levocetirizine group. Except for nasal itching, other symptoms were significantly reduced in the fluticasone + azelastine group. Levocetirizine demonstrated a faster onset of effect compared to fluticasone + azelastine. Conclusion: Fluticasone + azelastine nasal spray is more effective than oral levocetirizine in treating AR. This finding supports the consideration of intranasal corticosteroids as a primary therapeutic approach for allergic rhinitis.