Allergic rhinitis is an under diagnosed global health problem which affects up to 25% of the
population worldwide. It has been reported as being one of the 10 most common causes for
attendance to primary care clinics. It is clinically defined as a symptomatic disorder of the
nose induced by an IgE mediated inflammation following allergen exposure of the membranes
lining the nose and is characterized by varying combinations of nasal symptoms including
sneezing, nasal blockage, rhinorrhoea and itching. Intra nasal corticosteroids form the
cornerstone of anti-inflammatory therapy in allergic rhinitis and there is increasing
interest in the role of intranasal beta 2 agonists in the management of allergic rhinitis.
The question therefore arises as to whether salmeterol exhibits such synergistic activity in
the nose in terms of potentiating the steroid response of fluticasone.