Ayşe Enise Göker, Elif Aksungur, Cem Çelik, Uğur Uygan, Gülpembe Bozkurt, Ayça Başkadem Yılmazer, Maide Hacer Alagöz
In adults with perennial allergic rhinitis and objectively confirmed hyposmia, intranasal corticosteroid-containing regimens were associated with greater improvement in olfactory function than azelastine monotherapy. These findings suggest that intranasal corticosteroid-containing regimens may be preferable when olfactory dysfunction accompanies perennial allergic rhinitis. However, given the non-randomized and open-label design of the study, the results should be interpreted with caution.
OBJECTIVE: To compare the effects of commonly used intranasal therapies on olfactory dysfunction in adults with perennial allergic rhinitis using objective psychophysical testing.
METHODS: This prospective study included 90 adults with perennial allergic rhinitis and objectively confirmed hyposmia. Patients were allocated into three treatment groups: intranasal azelastine monotherapy, intranasal azelastine plus mometasone furoate combination therapy, and intranasal mometasone furoate monotherapy. Treatments were administered for one month. Olfactory function was assessed before and after treatment using the Sniffin' Sticks test (threshold, discrimination, identification, and composite TDI score). Nasal obstruction was evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) scale. Between-group comparisons of treatment-related change scores and supportive within-group analyses were performed using non-parametric statistical tests.
RESULTS: Ninety patients were included, with 30 patients in each treatment group. The mean ages were 29.43 ± 10.58 years in the azelastine group, 29.13 ± 8.79 years in the azelastine plus mometasone furoate group, and 29.90 ± 6.33 years in the mometasone furoate group. Baseline TDI scores were 29.10 ± 1.45, 28.37 ± 2.83, and 27.70 ± 2.34, respectively. Mean ΔTDI was - 3.33 ± 4.14 in the azelastine group, 9.13 ± 4.35 in the combination group, and 11.90 ± 3.82 in the mometasone furoate group, with a significant between-group difference (p < 0.001).
CONCLUSION: In adults with perennial allergic rhinitis and objectively confirmed hyposmia, intranasal corticosteroid-containing regimens were associated with greater improvement in olfactory function than azelastine monotherapy. These findings suggest that intranasal corticosteroid-containing regimens may be preferable when olfactory dysfunction accompanies perennial allergic rhinitis. However, given the non-randomized and open-label design of the study, the results should be interpreted with caution.