Monotherapy with intranasal corticosteroids results in some improvement of the nasal congestion in patients with allergic rhinitis. However, the improvement after oral administration of the combination tablet of fexofenadine hydrochloride/pseudoephedrine hydrochloride (FH/PH) is more rapid. In this study, we evaluated the possibility of expediting the induction effect of monotherapy with intranasal corticosteroids by using these combination tablets at the start of therapy.
For this evaluation, 29 patients presenting with the chief complaints of nasal allergy and nasal congestion were divided into two groups: one group (n=17) was treated with the FH/PH tablets in combination with intranasal corticosteroids (combination group), while the other (n=12) was treated with an intranasal corticosteroid spray alone (intranasal corticosteroid monotherapy group).
The combination group was treated with the FH/PH tablets for two weeks. One week after the start of treatment, concurrent administration of an intranasal corticosteroid spray (mometasone furoate hydrate) was started to initiate the shift toward intranasal corticosteroid therapy. Two weeks after the first dose, the treatment was switched to intranasal corticosteroid monotherapy, which was then used as the sole regimen for the subsequent two weeks. The overall treatment efficacy was evaluated four weeks after the first dose.
One, two and four weeks after the first dose, the Visual Analogue Scale (VAS) for symptoms showed significant improvement in both groups. The degree of swelling of the inferior nasal turbinate mucosa showed steady improvement each week after the start of treatment in the combination group; on the other hand, no significant improvement of the mucosal swelling was observed at one week after the start of treatment in the intranasal corticosteroid monotherapy group.
Our findings suggest that improvement of nasal congestion with FH/PH is more rapid than that with intranasal corticosteroids, and it is advantageous to administer FH/PH prior to the start of intranasal corticosteroid monotherapy.
Our study further suggests that fast-acting FH/PH may perform a key role as an effective induction agent at the start of monotherapy with intranasal corticosteroids in patients with allergic rhinitis presenting with nasal congestion.
