Combination of leukotriene receptor antagonists and antihistamines in management of allergic rhinitis - knowledge, attitude, and practice survey amongst healthcare professionals from India (COMB-AR)

Aim: To evaluate the perceived prevalence and common symptoms of allergic rhinitis (AR) in Indian adults, along with the role of the combination of leukotriene receptor antagonists and antihistamines in the management of AR symptoms. Methods: A digital questionnaire-based survey was conducted among physicians treating patients with AR in India from August 2023 to February 2024. The questionnaire included 13 questions focusing on the use, perceived efficacy, and safety of the montelukast–fexofenadine combination in AR. Data from all completed questionnaires were retrieved and analyzed. Results: A total of 344 clinicians, including chest physicians ( n  = 70), ENTs ( n  = 134), and consulting physicians ( n  = 140), completed the survey. Most physicians (41.6%) reported that the prevalence of AR among their patients was 21–30%, with house dust mites (66.9%) being the most common allergen. History and physical examination of patients were the preferred diagnostic approach among 83.4% of physicians. Similarly, 83.4% preferred fexofenadine with montelukast for AR management due to its minimal/no sedation and cardiac safety. Physicians (65.4%) recommended this combination for patients with nasal congestion, mild-to-moderate AR with asthma, and moderate-to-severe AR not controlled by intranasal corticosteroids. The ideal duration of this combination in the management of AR was 3–4 weeks (47.4%). Physicians expressed satisfaction with the combination, with 53.8% satisfied and 35.2% very satisfied with its efficacy, while 53.5% and 37.5% reported similar satisfaction with its safety. Conclusion: The survey demonstrated that most participating physicians preferred the montelukast–fexofenadine combination and perceived it to be effective and safe for selected patients with AR.