Comparative Efficacy of Mometasone Nasal Spray Combined with different Doses of Desloratadine, and Montelukast in Childhood Allergic Rhinitis:  A Randomized Clinical Trial

Niloufar Ghanbari; Kambiz Eftekhari; Mohammadreza  Samadzadeh-Mamaghani; Mohsen  Sedighiyan; Diana Noemi Diaz; Alireza Shafiei

doi:10.18502/ijaai.v23i4.16211

Niloufar Ghanbari Department of Pediatric Emergency, Bahrami Children's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Kambiz Eftekhari Division of Gastroenterology, Department of Pediatric, Pediatric Gastroenterology and Hepatology Research Center, Bahrami Children's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mohammadreza Samadzadeh-Mamaghani Department of Pharmacology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
Mohsen Sedighiyan Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Diana Noemi Diaz Department of Pediatric Surgery, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
Alireza Shafiei Division of Allergy and Clinical Immunology, Department of Pediatrics, Bahrami Children's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijaai.v23i4.16211

Keywords: Allergic rhinitis; Children; Desloratadine; Mometasone furoate; Montelukast

Abstract

Allergic rhinitis is a common childhood disease. Although various drugs have been used to treat allergic rhinitis, including nasal corticosteroids, antileukotrienes, and antihistamines, there is still controversy about the optimal dose and the best combination with the highest efficacy. Higher doses of antihistamines are recommended for better control of urticaria, but there is insufficient evidence regarding the efficacy of increased doses of antihistamines in allergic rhinitis. The aim of the study was to evaluate the effectiveness of different drug combinations in the treatment of children with allergic rhinitis.

Sixty-four children with persistent moderate to severe allergic rhinitis were enrolled and randomly divided into 4 groups. All children received mometasone furoate nasal spray once daily. In addition to mometasone, each group received one of the following drugs or drug combinations: daily desloratadine, twice daily desloratadine, montelukast, or a combination of desloratadine and montelukast. The severity of symptoms before and after the intervention was evaluated based on the total nasal symptoms score, including sneezing, nasal congestion, nasal itching, and rhinorrhea.

Sixty patients completed the study. The reduction of nasal congestion score and total nasal symptoms score in the groups receiving desloratadine twice a day and desloratadine plus montelukast was superior to the daily desloratadine group and daily montelukast groups

According to this work, the treatment of allergic rhinitis with mometasone nasal spray with desloratadine twice a day or with the combination of desloratadine and montelukast was more effective than other treatment regimens.