Efficacy and Adherence of Combined Fluticasone Propionate and Azelastine Nasal Spray Versus Fluticasone Propionate Alone in Pediatric Allergic Rhinitis.
Figen Çelebi Çelik, Özlem Sancaklı, Özgen Soyöz, İdil Akay Hacı, Mehmet Şirin Kaya, Ayça Demir, Canan Ş Karkıner, Demet Can
{"title":"Efficacy and Adherence of Combined Fluticasone Propionate and Azelastine Nasal Spray Versus Fluticasone Propionate Alone in Pediatric Allergic Rhinitis.","authors":"Figen Çelebi Çelik, Özlem Sancaklı, Özgen Soyöz, İdil Akay Hacı, Mehmet Şirin Kaya, Ayça Demir, Canan Ş Karkıner, Demet Can","doi":"10.4168/aair.2026.18.3.417","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Intranasal corticosteroids (INCS) and their combination with intranasal antihistamines (INCS/INAH) are treatment options for patients with allergic rhinitis (AR). Therefore, we aimed to prospectively compare these two different intranasal therapies regarding symptom scores, quality of life (QoL), and treatment adherence in adolescents.</p><p><strong>Methods: </strong>The study included pediatric patients aged 12-18 years, diagnosed with moderate-to-severe AR. Patients' symptom severity at baseline and at the one- and two-month follow-ups was assessed using the Total Nasal Symptoms Score (TNSS); additionally, QoL and treatment adherence were measured via the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and Medication Adherence Reporting Scale (MARS), respectively. These scores were compared between treatment groups.</p><p><strong>Results: </strong>The study included 79 patients with moderate-to-severe AR. Thirty-five patients (44.3%) had concomitant allergic diseases, and 28 (35.4%) had asthma. INCS (fluticasone propionate) therapy was started in 41 patients (51.9%), and combination therapy (azelastine hydrochloride + fluticasone propionate [AzeFlu]) was started in 38 patients (48.1%). Treatment adherence (MARS) was higher in the AzeFlu group (<i>P</i> = 0.002; odds ratio, 5.111; 95% confidence interval, 1.776-14.711). A positive correlation was found between treatment adherence and parental education levels (<i>P</i> = 0.002, <i>r</i> = 0.373 for mothers; <i>P</i> = 0.004, <i>r</i> = 0.351 for fathers). TNSS and PRQLQ scores were improved in treatment adherence patients (<i>P</i> = 0.001, <i>P</i> = 0.047). There were no significantly differences in TNSS and PRQLQ scores between the treatment groups.</p><p><strong>Conclusions: </strong>AzeFlu therapy may be preferred in patients with persistent symptoms and unresponsive to other treatments. Especially in adolescent children with persistent AR, AzeFlu should be considered as first-line treatment to increase treatment adherence.</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"18 3","pages":"417-427"},"PeriodicalIF":4.3000,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226864/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Allergy, Asthma & Immunology Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4168/aair.2026.18.3.417","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Intranasal corticosteroids (INCS) and their combination with intranasal antihistamines (INCS/INAH) are treatment options for patients with allergic rhinitis (AR). Therefore, we aimed to prospectively compare these two different intranasal therapies regarding symptom scores, quality of life (QoL), and treatment adherence in adolescents.
Methods: The study included pediatric patients aged 12-18 years, diagnosed with moderate-to-severe AR. Patients' symptom severity at baseline and at the one- and two-month follow-ups was assessed using the Total Nasal Symptoms Score (TNSS); additionally, QoL and treatment adherence were measured via the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and Medication Adherence Reporting Scale (MARS), respectively. These scores were compared between treatment groups.
Results: The study included 79 patients with moderate-to-severe AR. Thirty-five patients (44.3%) had concomitant allergic diseases, and 28 (35.4%) had asthma. INCS (fluticasone propionate) therapy was started in 41 patients (51.9%), and combination therapy (azelastine hydrochloride + fluticasone propionate [AzeFlu]) was started in 38 patients (48.1%). Treatment adherence (MARS) was higher in the AzeFlu group (P = 0.002; odds ratio, 5.111; 95% confidence interval, 1.776-14.711). A positive correlation was found between treatment adherence and parental education levels (P = 0.002, r = 0.373 for mothers; P = 0.004, r = 0.351 for fathers). TNSS and PRQLQ scores were improved in treatment adherence patients (P = 0.001, P = 0.047). There were no significantly differences in TNSS and PRQLQ scores between the treatment groups.
Conclusions: AzeFlu therapy may be preferred in patients with persistent symptoms and unresponsive to other treatments. Especially in adolescent children with persistent AR, AzeFlu should be considered as first-line treatment to increase treatment adherence.
期刊介绍：
The journal features cutting-edge original research, brief communications, and state-of-the-art reviews in the specialties of allergy, asthma, and immunology, including clinical and experimental studies and instructive case reports. Contemporary reviews summarize information on topics for researchers and physicians in the fields of allergy and immunology. As of January 2017, AAIR do not accept case reports. However, if it is a clinically important case, authors can submit it in the form of letter to the Editor. Editorials and letters to the Editor explore controversial issues and encourage further discussion among physicians dealing with allergy, immunology, pediatric respirology, and related medical fields. AAIR also features topics in practice and management and recent advances in equipment and techniques for clinicians concerned with clinical manifestations of allergies and pediatric respiratory diseases.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
