Treatment outcomes in allergic rhinitis: nasal obstruction symptom evaluation scale-based analysis

Abstract

Objective: This study aimed to assess the impact of oral antihistamines (OAH), intranasal corticosteroids (INC), and their combination on Nasal Obstruction Symptom Evaluation (NOSE) scores in individuals diagnosed with mild persistent allergic rhinitis. Materials and Methods: This retrospective study analyzed medical records of 86 patients with mild persistent allergic rhinitis. Patients had been treated with OAH, INC, or combination of both, and symptom severity was assessed using the NOSE scale - an instrument specifically measuring nasal obstruction - before treatment and at one month post-treatment. Results: A total of 86 patients were included, with similar distributions of age (33 [18-79]) and gender (48% female) among the treatment groups. Patients treated with INC exhibited a more pronounced reduction in nasal obstruction symptoms. Multiple linear regression analysis indicated that the baseline NOSE score was the only significant predictor of post-treatment outcomes (beta=0.434, p<0.0001), whereas age, gender, and treatment type did not demonstrate statistical significance. Conclusion: These findings indicate that adding OAHs to INC therapy does not enhance the relief of nasal obstruction in patients with mild persistent allergic rhinitis. Given their proven efficacy and safety, INCs alone may be sufficient and should be considered the firstline treatment for managing nasal obstruction in this patient cohort. However, given the multisystemic symptoms of allergic rhinitis, and the limits of NOSE scale to evaluate symptoms other than nasal airway obstruction, the results of this study should be interpreted carefully. Future studies utilizing multisystem scoring systems are required to capture the broader clinical effects of treatment.