Azelastine + fluticasone nasal spray as prophylactic treatment for Artemisia pollinosis

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Created On: 13/01/2026

Artemisia pollinosis contributes substantially to seasonal allergic rhinitis (SAR), where inadequate management during high-pollen periods increases susceptibility to asthma attacks.

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Key take away

Early use of azelastine–fluticasone combination nasal spray before pollen season improves symptom control in Artemisia pollinosis and may help prevent asthma attacks.

Background

Artemisia pollinosis contributes substantially to seasonal allergic rhinitis (SAR), where inadequate management during high-pollen periods increases susceptibility to asthma attacks. Despite the proven efficacy of nasal corticosteroids and antihistamines, data on their pre-season preventive application are limited. Hence, this study aimed to assess whether prophylactic administration of an azelastine hydrochloride–fluticasone propionate combination nasal spray could mitigate nasal symptoms and reduce asthma exacerbations ahead of the pollen season.

Method

This randomized controlled trial enrolled 120 Artemisia pollinosis-affected people and divided them into prophylactic treatment group and a control group. Participants in the intervention arm initiated a combined azelastine–fluticasone nasal spray approximately two weeks before the start of the pollen season and continued therapy throughout the exposure period. Nasal symptoms were measured using the total nasal symptom score (TNSS), and asthma attacks were systematically recorded. Clinical outcomes were compared between groups across both the pollen season and the treatment period.

Result

A total of 107 patients were included in the final dataset after exclusions for noncompliance and incomplete information. Baseline demographics and allergy-related histories were similar between the prophylactic and control groups. Pollen levels increased, fluctuating substantially and surging after storm events. Control patients showed early symptom escalation.

Across both analysis periods:

Prophylactic treatment resulted in markedly lower TNSS scores (5.97 and 5.94) versus the control group (7.86 and 7.80).
Additionally, the need for supplemental medications—such as antihistamines or antileukotrienes—to manage breakthrough nasal symptoms was marginally lower among those receiving prophylactic treatment; however, this reduction did not reach statistical significance.
Asthma attacks were reported in 41 patients (38.3%), with a nonsignificant trend toward fewer events among those receiving prophylactic therapy.

Conclusion

Pre-season prophylaxis with azelastine–fluticasone nasal spray substantially reduced nasal symptoms in patients with Artemisia pollinosis. Although the effect on asthma attacks was not statistically significant, these findings underscore its potential to lessen the overall seasonal burden of allergic disease.

Source:

Frontiers in Allergy

Link:

https://pubmed.ncbi.nlm.nih.gov/40276330/

Article:

A randomized controlled trial evaluating prophylactic treatment of Artemisia pollinosis using azelastine hydrochloride and fluticasone propionate nasal spray