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Steroid nasal spray more effective against hay fever

Researchers from the University of Chicago have found that the corticosteroid nasal spray fluticasone propionate (Flonase) is slightly more effective at controlling seasonal allergies than a combination of two popular anti-allergy drugs: loratidine (Claritin) and montelukast (Singulair).

The study was presented March 4 at the 58th annual meeting of the American Academy of Allergy, Asthma and Immunology.

"Both approaches worked well with minimal side effects," said Robert Naclerio, M.D., professor of surgery at the University of Chicago and director of the study, "but in our small study the symptom scores were slightly better and the measures of inflammation were significantly better for those taking fluticasone.

"Because of the effect on inflammation, we prefer fluticasone," he added, "but for patients, the choice may come down to cost and whether they would prefer a pill or a spray."

Since one out of five people in the United States suffers from seasonal allergies, such preferences have financial implications. Antihistamines are prescribed three times as often, even though intranasal corticosteroids are less expensive than the non-sedating antihistamines. Combining loratidine with montelukast increases the cost difference.

A daily dose of Claritin, the leading antihistamine, costs $2.92 at the University of Chicago Hospitals pharmacy. Singulair, which works by blocking leukotrienes -- substances that trigger inflammation -- costs $4 per day. Flonase, the leading prescription nasal spray, costs $2.21 per day.

Since loratidine and montelukast are effective alone and act through different mechanisms, the makers of these drugs joined forces to combine them. The only published previous study found the two drugs together were somewhat more effective than either drug used alone. This study compared this combination against the popular nasal spray.

The researchers enrolled 60 patients with ragweed allergies i
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Contact: John Easton
jeaston@uchospitals.edu
773-702-6241
University of Chicago Medical Center
4-Mar-2002


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