The Use of Azelastine Hydrochloride/Fluticasone Propionate in the Management of Allergic Rhinitis in Asia: A Review

Pongsakorn Tantilipikorn,1 Virat Kirtsreesakul,2 Chaweewan Bunnag,3 Mukda Vangveeravong,4 Sanguansak Thanaviratananich,5 Supinda Chusakul6 1Center of Research Excellence in Allergy & Immunology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand; 2Department of Otolaryngology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand; 3Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 4Queen Sirikit National Institute of Child Health, Bangkok, Thailand; 5Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khonkaen, Thailand; 6Department of Otolaryngology, Chulalongkorn University, Bangkok, ThailandCorrespondence: Virat Kirtsreesakul, Division of Allergy and Rhinology, Department of Otolaryngology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand, Tel/Fax +6674 429-620, Email kvirat2002@hotmail.comAbstract: The incidence of allergic rhinitis (AR) in Asia and the world is steadily rising. Patients experience incomplete symptom relief despite existing treatment options, which warrants the need for new therapeutic regimes. Azelastine hydrochloride/fluticasone propionate (MP-AzeFlu), a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate has been indicated in the treatment of AR. The current review discusses the effects of MP-AzeFlu versus conventional therapies in achieving superior clinical improvement with a very rapid onset of action (5 minutes). The superiority of MP-AzeFlu in offering complete symptom control with sustained relief in patients with AR compared to the existing therapeutic options is also discussed. MP-AzeFlu has been shown to improve the quality of life for patients with AR, thereby enhancing patient adherence to therapy and establishing its preference for the treatment of AR. Currently, the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines recommend the use of a combination of intranasal corticosteroids and intranasal antihistamines as first-line treatment in patients with persistent AR with visual analog scores ≥ 5 or when prior treatment with single agents has been ineffective. Widely published data on the efficacy and safety of its prolonged use in adults and children have validated that effective treatment of AR can be achieved with MP-AzeFlu.Keywords: fixed-dose combination, intranasal, MP-AzeFlu, corticosteroids, antihistamines