A perception-based survey to understand the role of a combination of bilastine and montelukast in the management of allergic rhinitis

Aim: To understand the clinical perceptions and role of a combination of bilastine and montelukast in the management of allergic rhinitis (AR). Methods: A cross-sectional, observational survey was conducted through a digital questionnaire among 445 healthcare practitioners (HCPs) in India from May to October 2024. The questionnaire consisted of 15 questions that asked physicians to share their insights on the prevalence, diagnosis, and management of AR, as well as their perception of efficacy, safety, and recommended patient profile for bilastine-montelukast combination. Data were collected and analyzed using descriptive statistics, expressed as frequencies and percentages. Results: Among 445 HCPs (ear, nose, throat, chest, and consulting physicians), the majority (40%) reported an AR prevalence of 21-30% in their practice. Sneezing was the most reported AR symptom (67.19%). For managing mild intermittent/persistent AR, 45.39% preferred antihistamines, while 53.71% favored a combination of antihistamines and leukotriene receptor antagonists for moderate intermittent/persistent AR. Approximately 87% of HCPs preferred the bilastine-montelukast combination for AR management, citing its nonsedative properties, superior nasal congestion control, cardiac safety, and compatibility with renal or hepatic impairments. Around 61% supported its use for various AR patient profiles, including those with asthma, mild-to-moderate AR with any cardiac or renal dysfunction, moderate-to-severe AR not controlled with intranasal corticosteroids, mild-to-moderate intermittent AR, and persistent AR. The ideal duration of this combination was reported to be 3–4 weeks by 44% of HCPs. Most HCPs expressed satisfaction with this combination’s efficacy (88.8%) and safety (92.3%). The most reported adverse events were gastrointestinal disturbances and fatigue (30%), followed by neuropsychiatric events (7%). Conclusion: A combination of bilastine-montelukast was preferred by most HCPs in the management of AR across diverse patient profiles and was found to be effective and well-tolerated. Clinical significance: The study emphasizes a strong preference for the combination of bilastine and montelukast in managing AR. It highlights their nonsedative properties, superior control of nasal congestion, cardiac safety, and compatibility for patients with renal or hepatic impairments. Additionally, there is a high level of physician satisfaction regarding the efficacy and safety of this treatment, reinforcing its importance as an option for managing AR.