Managing both nasal and ocular symptoms in patients


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Managing both nasal and ocular symptoms in patients

  1. 1. Managing both nasal and ocular symptoms in patients with moderate to severe seasonal allergic rhinitis (SAR)<br />“When we think about allergic rhinitis, we forget that the eyes come along.”<br /><br />OBJECTIVE:<br />
  2. 2. that about 75% of the most severe SAR patients complain of itchy eyes and about two thirds of them complain of watery eyes<br />there's been a lot of interest in looking at combinations of nasal antihistamines and nasal corticosteroids, with previous studies showing that the combination is more effective statistically than the single entities<br /><br />Basis of Research<br />
  3. 3. Paul Ratner, MD, allergist/immunologist and founder and director of Sylvana Research, of San Antonio, Texas, a research facility for investigational medications.<br /><br />Lead Reasearcher<br />
  4. 4. the ocular effects from treatment with this combination.<br /><br />Aim of study“Treat the Eyes and the Nose” <br />
  5. 5. His investigational team enrolled 610 patients with ocular symptoms from SAR during the 2007/08 Texas Mountain Cedar season. <br />The patients were randomized to 1 of 4 groups receiving 1 spray per nostril twice daily: azelastine alone, fluticasone alone, azelastine plus fluticasone, and placebo.<br /><br />Procedure<br />
  6. 6. The primary end point was efficacy, defined as a change from baseline in the total nasal symptom score (TNSS) for nasal congestion, sneezing, itchy nose, and runny nose.<br />The secondary end point was the effect of azelastine plus fluticasone on the total ocular symptom score (TOSS) for itchy eyes, watery eyes, and redness<br /><br />Set objectives to investigate<br />
  7. 7. Results were presented at the American College of Allergy, Asthma & Immunology (ACAAI) 2009 Annual Scientific Meeting in a podium session<br /><br />Results<br />
  8. 8. Nasal and Ocular Symptoms Improved <br />improvements on TNSS were statistically significant for the patients treated with the combination spray compared with single drug<br /><br />1. TNSS<br />
  9. 9. There was also a statistically significant improvement in TOSS for those treated with the combination spray<br /><br />2. TOSS<br />
  10. 10. The only adverse events reported by more than 2% of those treated with the combination spray were<br />bitter taste (7.2%), <br />epistaxis(3.9%), <br />and headache (2.6%).<br /><br />adverse effects<br />
  11. 11. The first is that the combination therapy with nasal antihistamines and nasal steroids is definitely panning out to be more effective than treatment with the individual components<br />Second, in addition to treating the nasal symptoms that you would expect, you're also getting the added benefit of having relief of the ocular symptoms."<br /><br />Conclusion<br />
  12. 12. allergists are now using both drugs in combination in 30% to 40% of their patients.<br />So what this study reinforces is that polypharmacy, using an antihistamine blocker as well as a nasal steroid, may be a more effective modality in treating this ocular complaint and the nasal symptoms<br /><br />
  13. 13. This study was funded by Meda pharmaceuticals<br />November 13, 2009 (San Diego, California)<br />Presented in ENT class (Ml410)<br /> by Dr. Karl <br /><br /><br />THE END<br />