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Wise et al.

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Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE IX.B.10.b. Evidence for the use of combination oral antihistamine and intranasal corticosteroids in the treatment of allergic rhinitis Study Year LOE Study design Study groups Clinical endpoint Conclusion Pinar et al. 1473 2008 1b RCT (n = 95): 1 Mometasone furoate INCS; 2 Mometasone furoate INCS + desloratadine; 3 Mometasone furoate INCS + montelukast; 4 Placebo TNSS, rhinoconjunctivitis Scores, nPIF Combination therapy resulted in better nasal symptom scores at week 2 and better QOL scores than INCS monotherapy. Barnes et al. 1470 2006 1b DBRCT, crossover (n = 27): 1 Fluticasone + oral cetirizine; 2 Fluticasone + oral placebo TNSS, mini-RQLQ, nPIF, nasal nitric oxide Nasal symptom scores are equivalent with combination therapy compared to INCS. Di Lorenzo et al. 1472 2004 1b DBRCT, double dummy SAR, (n = 100): 1 Fluticasone INCS + cetirizine; 2 Fluticasone INCS; 3 Cetirizine + montelukast; 4 Placebo DNSS, nasal lavage eosinophil count and ECP level Combination therapy was equivocal to monotherapy INCS in reducing nasal symptoms in SAR. Wilson et al. 1469 2000 1b SBRCT SAR, (n = 38): 1 Mometasone INCS + cetirizine; 2 Cetirizine; 3 Cetirizine and montelukast nPIF, symptom diary card Combination of oral cetirizine and mometasone INCS was not significantly better than cetirizine alone for SAR. Ratner 1471 1998 1b DBRCT, double dummy SAR, (n = 600): 1 Fluticasone INCS + loratadine; 2 Loratadine; 3 Fluticasone INCS Symptoms Combination therapy, although significantly better than an oral antihistamine alone, offered no significant advantage over INCS alone.

DBRCT = double-blind randomized controlled trial; DNSS = Daily Nasal Symptom Score; ECP = eosinophil cationic protein; INCS = intranasal corticosteroid; LOE = level of evidence; mini-RQLQ = mini-Rhinoconjunctivitis Quality of Life Questionnaire; nPIF = nasal peak inspiratory flow; QOL = quality of life; RCT = randomized controlled trial; SAR = seasonal allergic rhinitis; SBRCT = single blind randomized controlled trial; TNSS = Total Nasal Symptom Score.

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.