Clinical efficacy and safety of fixed-dose intranasal combination of azelastine hydrochloride and fluticasone propionate for treatment of seasonal allergic rhinitis

Allergic rhinitis is a common chronic respiratory disease that affects millions of people worldwide and has a significant impact on their quality of life, productivity, and performance. Achieving control of the symptoms of moderate/severe allergic rhinitis, which often requires the use of several drugs from different pharmacological groups, is particularly challenging. The article considers clinical efficacy and safety of fixed-dose intranasal combination of azelastine hydrochloride and fluticasone propionate for treatment of seasonal allergic rhinitis. The combination of azelastine hydrochloride and fluticasone propionate demonstrates a synergistic effect in improving the symptoms of both early and late allergic reactions and has a pronounced anti-inflammatory effect. Studies show that the use of fixed-dose combination of azelastine hydrochloride and fluticasone propionate significantly improves nasal and ocular symptoms of seasonal allergic rhinitis compared to fluticasone propionate and azelastine hydrochloride monotherapies. The drug acts quickly and provides sustained relief of symptoms which contributes to improved quality of life for the patients. The article provides an overview of the main preclinical, clinical randomized trials and studies in real clinical practice on the efficacy and safety of the fixed-dose intranasal combination, especially in comparison with monotherapies with the drugs included in the combination and placebo. It demonstrates its effectiveness in different populations regardless of race, gender and age, and in long-term use. Azelastine hydrochloride in combination with fluticasone propionate has the most extensive body of evidence of its efficacy, including studies conducted in the Russian patient population. The drug can be used in patients from the age of 12 years with moderate to severe seasonal allergic rhinitis. It is included in all international and Russian guidelines on allergic rhinitis.