Differential outcomes of fluticasone and mometasone in allergic rhinitis: A randomized controlled assessment

Abstract

Background: Allergic rhinitis (AR) is a prevalent chronic condition affecting quality of life and productivity globally. Intranasal corticosteroids (INCS) are the cornerstone of pharmacotherapy for moderate to severe AR, yet comparative efficacy among different agents remains understudied in controlled trials.Materials and Methods: This randomized, open-label controlled trial was conducted from August 2019 to July 2020 to evaluate the comparative efficacy of fluticasone furoate and mometasone furoate in the management of AR. A total of 120 patients aged 18-55 years with clinically confirmed moderate-to-severe AR were randomly assigned into two groups: Group A received fluticasone furoate (27.5 mcg per spray, 2 sprays per nostril once daily), and Group B received mometasone furoate (50 mcg per spray, 2 sprays per nostril once daily) for 8 weeks. Efficacy was assessed using Total Nasal Symptom Score (TNSS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) at baseline, 4 weeks, and 8 weeks.Results: Both groups demonstrated significant improvement in TNSS and RQLQ scores over 8 weeks. Group A (fluticasone) showed a mean TNSS reduction from 8.2±1.1 to 2.1±0.7, while Group B (mometasone) showed reduction from 8.0±1.3 to 2.6±0.9 (p = 0.041). RQLQ scores improved by 58.6% in Group A and 51.2% in Group B by week 8 (p = 0.038). No serious adverse events were reported.Conclusion: Fluticasone furoate demonstrated superior efficacy in symptom control and quality-of-life improvement compared to mometasone furoate in patients with allergic rhinitis. Both drugs were well tolerated.