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For Hay Fever, Steroid Nasal Sprays Are Best

WebMD Health News

March 6, 2002 -- If you're fighting hay fever with Claritin or Singulair, you may want to switch to Flonase. It's cheaper and seems to be more effective in curbing the sneezing, runny nose, and congestion.

A new study compares these three leading hay fever medications, finding that Flonase (a nasal spray) was more effective at controlling seasonal allergies than a combination of the two popular anti-allergy drugs, Claritin and Singulair.

The results were presented at the recent meeting of the American Academy of Allergy, Asthma, and Immunology.

"Both approaches worked well with minimal side effects," says lead author Robert Naclerio, MD, professor of surgery at the University of Chicago, in a news release. "But in our small study, the symptom scores were slightly better and the measures were significantly better for those taking [Flonase]."

The symptoms of hay fever occur when pollen triggers the body's immune system to release chemicals such as histamine, which irritate and inflame the tissues lining the nose, eyes, and sometimes the lungs.

Drugs like Claritin are antihistamines that work by blocking the action of histamine, thus relieving hay-fever symptoms. Singulair blocks other inflammation-causing substances. Both are tablets that can be taken orally.

Flonase, and other nasal inhalers such as Vancenase and Nasacort, contain a corticosteroid medication that directly blocks the inflammation and swelling of hay fever.

"Because of the effect on inflammation, we prefer [Flonase]," he adds. "But for patients, the choice may come down to cost and whether they would prefer a pill or a spray."

Naclerio's study involved 60 patients with ragweed allergies who were randomly given one of two treatments. One group got Flonase once a day, plus placebo pills. The other group got a placebo nasal spray plus Claritin and Singulair.

Two weeks later, the Flonase group reported a greater reduction of allergy symptoms than the pill group. On a scale of zero (no symptoms) to 12 (severe symptoms), the Flonase group had a median score of 4.5 while the Claritin/Singulair group had a median score of 6.

The Flonase group also had better scores measuring quality-of-life factors such as sleep, emotions, and daily activities. On a scale of zero to seven, overall scores for the Flonase group fell from 2.8 before the study to 1.4 after two weeks. The Claritin/Singulair scores fell from 2.6 before the study to 1.7 after two weeks.

The Flonase group also had better immune response. They had fewer eosinophils -- a type of immune cell associated with allergies -- in their nasal passages at two weeks. They also had lower levels of eosinophil cationic protein, another sign of inflammation.

Patients taking Flonase also had fewer headaches, he reports.

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