Investigation of the effect of two different treatment methods on the quality of life in patients with allergic rhinoconjunctivitis

This study aimed to assess the impact of allergic rhinitis on the health-related quality of life and to identify significant quality-of-life challenges faced by allergic rhinitis patients. Additionally, it aimed to evaluate the effects of intranasal steroids and combinations of intranasal antihistamines with steroids on AR symptoms. Adult patients who tested positive for allergic rhinitis via a skin prick test and sought treatment at our clinic between December 2022 and October 2023 were included in this prospective study conducted at the Pamukkale University Hospital ENT clinic. The patients' age, gender, medications, comorbid diseases, and allergic rhinitis symptoms were assessed. Allergic rhinitis scores were determined using the ARS (Score For Allergic Rhinitis) form, with those scoring 7 or higher being eligible for the study. Patients underwent evaluation using the RQLQ and VAS (Visual Analog Scale) before treatment and at 1st week, 1st month, and 2nd month post-treatment. They were randomly assigned to receive one of two different topical sprays indicated for allergic rhinitis treatment. The average onset time of the drugs used was 4.38 days in the Aze-Flu combined group and 4.50 days in the fluticasone group. There was no significant difference between the two groups (p<0.050). However, on the 7th day, there was a notable discrepancy in symptom improvement related to sleep, eyes, and emotions favoring the Aze-Flu group (p<0.050). On day 7, higher scores were found in the VAS and permanent taste disturbance VAS scales in the Aze-Flu group (p<0.050). There was no significant difference between the groups in RQLQ symptoms at 1 month (p>0.050). At 1 month, higher scores were found in the temporary taste disturbance (VAS), permanent taste disturbance VAS and permanent smell disturbance VAS scales in the Aze-Flu group (p<0.050). In the fluticasone group, there was a clinically significant decrease of more than 50% in RQLQ scores compared to baseline in general problems, nasal symptoms, and eye symptoms at the 7th day follow-up. Similarly, in the Aze-Flu group, there was a clinically significant decrease of more than 50% in RQLQ scores compared to baseline in general problems, nasal symptoms, eye symptoms, and emotional symptoms at the 7th day follow-up. Notably, among these, the improvement in eye and emotional symptoms significantly differed compared to the fluticasone group (p<0.050). When examining the RQLQ scale scoring, which typically starts with an average initial score of 3-4 (indicating moderate to severe distress), it was found to be within the range of 0-2 when assessing symptoms in the 1st-month follow-up. In patients' statements, scores were frequently recorded as 1 (indicating distress not counted) and 0 (indicating no distress experienced). This pattern was consistently observed throughout the study. According to the VAS and RQLQ scales, we observed that both drugs suppressed AR symptoms, with the combination being more effective in the early period according to the RQLQ scale, while there was no significant difference between them in the long term. Considering factors such as cost and potential side effects, both medications can be safely prescribed to patients diagnosed with AR.