The goal of this clinical trial is to determine the best combination of drugs and drug delivery routes to treat surgically naive chronic rhinitis patients. The main question it aims to answer is:
Do high volume, high pressure delivery mechanisms in nasal irrigation improve the efficacy of azelastine combined with nasal steroid mometasone as compared to the standard low pressure, low volume delivery mechanisms in nasal sprays?
Subjects will complete six months of one of three medication regimens:
1. Saline irrigation followed by azelastine spray and mometasone spray 2. Mometasone saline irrigation 3. Azelastine saline irrigation combined with mometasone saline irrigation.
Adults 18 years and older seeking treatment for chronic rhinitis and willing to undergo six months of topical therapy.
Diagnosis of Chronic Rhinitis.
The patient has diagnosis(es) other than chronic rhinitis that can account for his/her symptoms (septal deviation, nasal valve collapse, chronic sinusitis).
Use of oral antihistamines or oral steroids, unless patient undergoes a 4 week washout period.
Smokers (tobacco, marijuana, vaping, etc.).
Known or suspected pregnancy, or lactation.
Parallel
Azelastine (137 mcg/spray) Nasal Spray and Mometasone (50 mcg/spray) Nasal Spray
DrugParticipants will follow this medication regimen for 6 months.
Mometasone Nasal Irrigation (1 mg capsule)
DrugParticipants will follow this medication regimen for 6 months.
Mometasone (1 mg) and Azelastine (1 mg) Nasal Irrigation
DrugParticipants will follow this medication regimen for 6 months.
Improvement seen in the Sino-Nasal Outcome Test (SNOT)-22 score
Sino-Nasal Outcome Test (SNOT-22) scores will be measured at baseline, 1 month, 3 months, and 6 months. Scores will be compared between three arms. The Sino-Nasal Outcome Test is a self-administered questionnaire that is used to assess nasal symptoms using a 0-5 point scale with 0=no problem, 1=very mild problem, 2=mild or slight problem, 3=moderate problem, 4=severe problem, 5=problem as bad as it can be. The SNOT-22 consists of 22 questions, rated from 0 to 5 for a minimum score of 0 to maximum score of 110, with higher scores indicating worse symptoms.
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