Comparison of Fluticasone Furoate and Cetirizine Versus Fluticasone Furoate and Montelukast in Allergic Rhinitis

Bobby Pardomuan Sitompul, Rus Suheryanto, Hendradi Surjotomo

Abstract


Background: The complexity of treatment in allergic rhinitis remains to be a global challenge. The medical treatment option for moderate-severe persistent allergic rhinitis is the combination of intranasal corticosteroid (INCS) and oral antihistamine or leukotriene receptor antagonist (LTRA). The combination INCS with LTRA is selected based on the presence of asthma. Purpose: To determine the effect of fluticasone furoate plus cetirizine administration compared to fluticasone furoate plus montelukast on nasal eosinophils count and clinical improvement in patients with moderate-severe persistent allergic rhinitis. Method: This study was an experimental research with double blind randomized clinical trial (RCT) design, and pre and post test control. Patient were divided into two group. Group-1 received intranasal fluticasone furoate 110 μg in the morning and oral cetirizine 10 mg in the evening, and group-2 received intranasal fluticasone furoate 110 μg and montelukast 10mg. The treatment efficacy was assessed from nasal eosinophil count and total five symptoms score (T5SS) based on visual analogue scale (VAS) before and 4 weeks after treatment. Result: Both groups showed a decrease in the nasal eosinophil count and T5SS score based on VAS before and after treatment (p< 0.05). Group-2 showed a statistically significant improvement in nasal obstruction and rhinorrhea compared to group-1 (p <0.05). The decrease in nasal eosinophil count and T5SS was higher in group-2 than group-1, however it is not statistically significant. Conclusion: The combination of fluticasone furoate and montelukast was found to be more effective in reducing nasal obstruction and rhinorrhea than the combination of fluticasone furoate and cetirizine

ABSTRAK

Latar belakang: Rinitis alergi masih merupakan masalah besar secara global dengan tatalaksana yang kompleks. Terapi medikamentosa rinitis alergi persisten sedang berat (RAPSB) berdasarkan guideline yaitu pemberian kortikosteroid intranasal (INCS) dikombinasikan dengan antihistamin oral atau leukotriene receptor antagonist (LTRA). Saat ini, terapi menggunakan kombinasi LTRA masih berdasarkan ada atau tidaknya komorbiditas asma pada pasien RAPSB. Tujuan: Mengetahui pengaruh pemberian fluticasone furoate bersama cetirizine dibandingkan dengan fluticasone furoate bersama montelukast terhadap eosinofil mukosa hidung dan perbaikan klinis pada penderita RAPSB. Metode: Penelitian eksperimental murni dengan rancangan uji klinik secara acak, tersamar ganda, serta kontrol pra dan pasca perlakuan. Penderita dibagi menjadi 2 kelompok. Kelompok 1 mendapat terapi fluticasone furoate intranasal 110 μg/hari dengan cetirizine 10mg/hari dan kelompok 2 fluticasone furoate intranasal 110 μg/hari dengan montelukast 10mg/hari. Penilaian efektivitas terapi dengan menilai jumlah eosinofil mukosa hidung dan total five symptoms score (T5SS) berdasarkan visual analogue scale (VAS) pada awal penelitian dan 4 minggu setelah perlakuan. Hasil: Kedua kelompok memperlihatkan penurunan jumlah eosinofil mukosa hidung dan penurunan T5SS berdasarkan VAS antara sebelum dan setelah perlakuan (p< 0.05). Kelompok 2 lebih baik secara bermakna menurunkan keluhan hidung tersumbat dan pilek encer dibandingkan kelompok 1 (p <0.05). Jumlah eosinofil dan T5SS berdasarkan VAS kelompok 2 lebih menurun dibandingkan kelompok 1, akan tetapi secara statistik tidak terdapat perbedaan yang bermakna. Kesimpulan: Pemberian fluticasone furoate serta montelukast lebih baik secara bermakna menurunkan keluhan hidung tersumbat dan pilek encer dibandingkan pemberian fluticasone furoate serta cetirizine.

Kata kunci: rinitis alergi, cetirizine, kortikosteroid intranasal, montelukast


Keywords


allergic rhinitis, cetirizine, intranasal corticosteroid, montelukast

Full Text:

PDF


DOI: https://doi.org/10.32637/orli.v51i1.409

Refbacks

  • There are currently no refbacks.


All articles and issues in Journal Oto Rhinolaryngologica Indonesiana have unique DOI number registered in Crossref.

Web
Analytics Made Easy - StatCounter View ORLI Stats