Therapy of acute rhinosinusitis in patients with allergic rhinitis: possibilities for implementing advanced control of inflammation

Abstract

Introduction. Allergic rhinitis (AR) in conjunction with acute infectious rhinosinusitis (ARS) can lead to increased inflammation and contributes to a more severe course of ARS.Aim. To study the effect of some non-sedating H1-antihistamines on the severity of clinical presentations in adult patients with ARS and underlying AR as part of routine medical practice.Materials and methods. Group 1 (75 patients) and Group 2 (85 patients) were generated through simple randomization from the patient population with ARS and underlying AR, who were prescribed benzhydryl-piperazinyl-butylmethylxanthine succinate (Teoritin® MF, 4 mg/day) or desloratadine (INN, 5 mg/day), respectively. The course of therapy was 14 days. The estimated parameters included changes in indices of nasal symptoms, rhinoscopic and non-nasal symptoms during follow-up visits, time to reach zero indices, the proportions of patients, whose symptoms reduced after 3 and 7 days of treatment, the need for the use of nasal decongestants and changes in quality of life measures.Results and discussion. During the first 3 days of treatment, nasal breathing improved in 91% (95% CI 81–96%) of patients in Group 1 vs 56% (95% CI 45–67%) in Group 2, p < 0.001; rhinorrhea was relieved in 76% (95% CI 65–85%) and 62% (95% CI 51–72%) in Groups 1 and 2, respectively. By Day 7 of treatment, complete restoration of nasal breathing was observed in 71% of patients in Group 1 (95% CI 59–80%), and in 41% (95% CI 31–52%) in Group 2 (p = 0.014); rhinorrhea was relieved in 61%(95% CI 49–72%) of patients in Group 1 and 37% (95% CI 27–48%) in Group 2, p = 0.001. Decongestants were used by 20%(95% CI 12–31%) of patients in Group 1, and by 35% (95% CI 25–47%) of patients in Group 2, p = 0.031. The between-group difference was significant in terms of duration and frequency of adjuvant therapy, p < 0.05.Conclusion. In comparison with desloratadine, it provided a more pronounced reduction of nasal and non-nasal symptoms, as well as relief of rhinoscopic signs of inflammation in a shorter time. The use of Teoritin® MF contributed to the reduction in the need (duration and frequency) for nasal decongestants.