EFFICACY OF ORAL BILASTINE MONOTHERAPY VERSUS ORAL PROBIOTICS IN PATIENTS WITH ALLERGIC RHINITIS: AN OBSERVATIONAL COMPARATIVE STUDY

Abstract

 Introduction: Allergic rhinitis (AR) is among the most common chronic disorders encountered in otorhinolaryngology practice, and pharmacotherapy with second-generation oral antihistamines remains the mainstay of symptomatic treatment. Study aimed to compare the efficacy of oral bilastine monotherapy versus oral probiotics in patients with allergic rhinitis over 4 weeks of treatment, with change in Total Nasal Symptom Score (TNSS) from baseline as the primary endpoint and change in Absolute Eosinophil Count (AEC) from baseline as the secondary endpoint. Methods: This prospective, observational, comparative study was conducted at a tertiary care center in South India in 2025. 100 patients aged 18–60 years diagnosed with allergic rhinitis with a TNSS >6 were included and allocated into two groups of 50 each. Group Bilastine received oral bilastine 20 mg, and Group Probiotics received oral probiotics once daily for four weeks. Patients were followed up at 4 weeks with TNSS and AEC. Data were analyzed using independent t-test and paired t-test, and chi-square test as appropriate, with p<0.05 considered significant. Results: Both groups showed statistically significant within-group reductions in TNSS and AEC from baseline to 4 weeks. However, the bilastine group achieved significantly greater reductions than the probiotic group after 4 weeks, both in TNSS (50.8% vs 35%) and AEC (52.2% vs 40.7%). Conclusion: Oral bilastine monotherapy produced significantly greater short-term improvement in nasal symptom scores and peripheral eosinophil counts than oral probiotic monotherapy in patients with allergic rhinitis. Probiotics produced a modest but statistically significant improvement and may hold value as adjunctive rather than stand-alone therapy.