Efficacy of nasal saline irrigation in conjunction with intranasal steroids in allergic rhinitis.

Aim: To study the efficacy of nasal saline irrigation combined with intranasal corticosteroids in treating Allergic Rhinitis and compare it with intranasal corticosteroids alone.

Methodology: A prospective, randomized trial conducted at a tertiary care center. Symptomatic individuals diagnosed with Allergic Rhinitis were included. The control group received fluticasone propionate nasal spray (200 mcg/day) and the treatment group received fluticasone propionate nasal spray (200 mcg/day) along with nasal saline irrigation with isotonic normal saline (50 ml/nostril with each irrigation thrice a day). The two groups were followed up for 12 weeks. The outcome was compared using a patient-reported experience measure "Allergic rhinitis scoring system".

Results: A total of 120 patients (60 in each group) were included in the study. Pre-intervention, there were no significant differences between the two groups with the Allergic rhinitis scoring system. Post-Intervention, significant improvements were evident across all assessed symptoms: rhinorrhoea (14.93 ± 4.16 vs. 17.80 ± 3.16, p < 0.0001), sneezing (14.40 ± 3.91 vs. 18.27 ± 3.16, p < 0.0001), nasal blockage (10.47 ± 4.66 vs. 13.80 ± 4.80, p = 0.0002), nasal pruritus (17.93 ± 3.17 vs. 19.13 ± 1.96, p = 0.0140), ocular pruritus (18.60 ± 2.84 vs. 19.13 ± 2.22, p = 0.2537), and total Allergic rhinitis scoring system score (77.00 ± 9.79 vs. 88.13 ± 7.70, p < 0.0001).

Conclusion: Nasal saline irrigation used in conjunction with intranasal corticosteroids more effectively alleviates all symptoms of Allergic rhinitis. However, there was no significant difference in ocular pruritus in both groups.

Trial registration: Trial registered with Clinical trial registry-India, CTRI/2023/01/048641. URL: https://ctri.nic.in/Clinicaltrials/main1.php?EncHid=44058.73881 .