Comparison of safety, effectiveness and cost-effectiveness of Combination of Levocetirizine and Fexofenadine with Montelukast in Allergic Rhinitis and its effect on quality of life
Background: Allergic Rhinitis (AR) manifest with rhinorrhea, nasal congestion, obstruction, and pruritus. The management of allergic rhinitis consists of: environmental control measures and allergen avoidance, pharmacological management, and immunotherapy. Combination of levocetirizine and fexofenadine with montelukast have shown a significant improvement in patients with allergic rhinitis, so we designed this study to assess the comparison of effectiveness and safety of montelukast-levocetirizine and montelukast-fexofenadine in allergic rhinitis.
Methodology: This open-label, randomized, prospective, and parallel group study was conducted at a teritary care hospital in a period of two months. All patient clinically diagnosed with allergic rhinitis in the age group of 18 to 60 years were included in the study. The patients were divided into two groups by random number table and patients in Group A received a combination of levocetrizine and monetluekast whereas patients n Group B received a combination of fexofenadine with monteluekast once daily for 20 days. The patients were called for two follow-ups first after 10 days of onset of therapy and second visit after 20 dyas of treatment and the patients were assessed clinically.
Results: The baseline characteristic of patients in both groups were comparable at baseline. There was a statistically significant decrease in total nasal symptom scores and total ophthalmic symptom score in both groups at 10 day and 20 days, though there was no statistically significant difference in both groups. There was a statistically significant decrease in quality of life scores in both groups at 10 days and 20 days, though at 20 day patients on levocetirizine had better response. There was a statistically significant higher cost of therapy in Group B.
Conclusion: Both Levocetirizine and Fexofenadine in combination with Monteleukast showed significant improvement as compared to baseline in terms of TNSS and TOSS. Patients in Levocetirizine group had a comparatively better quality of life, lesser side effects and low cost of therapy.
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