ALLERGIC RHINITIS treatment with a combination of mometasone furoate and azelastine (MF-Az) nasal spray improved nasal and non-nasal symptoms in a large real-world study of patients in India. Allergic rhinitis is an IgE-mediated inflammatory condition affecting the nose that can impair quality of life, productivity and healthcare utilisation. The retrospective analysis also found the treatment was well tolerated, with no hospitalisations, serious adverse events or treatment discontinuations linked to adverse events.
The findings aligned with the Allergic Rhinitis and Its Impact on Asthma (ARIA) 2025 guideline, which recommends a combination of an intranasal corticosteroid and an intranasal antihistamine as first-line therapy for moderate-to-severe allergic rhinitis because of superior symptom control.
Allergic rhinitis is said to affect more than 600 million people worldwide. Intranasal corticosteroids have remained the cornerstone of pharmacological management because of their broad anti-inflammatory effects. However, symptom control may be insufficient with corticosteroid monotherapy, particularly in patients with moderate-to-severe disease.
The multicentre retrospective study reviewed medical records from 4,500 patients, of whom 4,213 met the inclusion criteria, treated across 424 ENT clinics in India. Investigators examined medical history, symptoms, clinical findings and adverse events, using changes in total nasal symptom scores (TNSS) and total non-nasal symptom scores (TNNSS) from baseline to evaluate effectiveness.
Mean TNSS improved by 1.97 points after seven days and by 3.62 points after 14 days. Mean TNNSS decreased by 1.55 points at Day 7 and by 2.70 points at Day 14. All improvements reached statistical significance (p<0.0001). The investigators did not report outcomes separately for men and women.
No hospitalisations, serious adverse events or treatment discontinuations due to adverse events were identified during the study.
The investigators concluded that the MF-Az combination significantly reduced both nasal and non-nasal symptoms while demonstrating good tolerability in routine clinical practice.
As a retrospective observational study without a comparator arm, the findings reflected routine clinical practice but could not establish causality. The 14-day follow-up assessed only short-term outcomes, while reliance on routine medical records and variable symptom scoring across centres may have influenced the results. The investigators also acknowledged that potential confounders were not controlled and that adverse events may have been under-recorded because safety data were based on routine documentation. The study was funded by Glenmark Pharmaceuticals, which markets the evaluated nasal spray, and five authors were company employees, although the paper stated that the funder had no role in the study design, analysis, interpretation or publication decisions.
Reference
Monga AK et al. A retrospective study on the effectiveness and safety of the combination of intranasal corticosteroid and intranasal antihistamine in the management of patients with allergic rhinitis. Front Allergy. 2026;DOI:10.3389/falgy.2026.1863171.
Featured image: onephoto on Adobe Stock
Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.
