AZELASTINE/FLUTICASONE (AZE/FLU) Nasal Spray on Symptom Control, Nasal Mediators and Nasal Hyperresponsiveness in Allergic Rhinitis (AR)

Inclusion Criteria: 1. Patients with an ARIA-based diagnosis of persistent moderate/severe AR (≥ 2 nasal symptoms suggestive of allergic rhinitis and positive skin prick tests to house dust mite (HDM) (HAL Allergy, Leiden, The Netherlands) at screening. Patients with additional seasonal pollen allergies may be included providing that they are included outside their individual pollen season, and with VAS score for total nasal symptoms of more than 5 2. VAS for TNS of more than 5, and rT5SS of more than 8 at both screening and randomization 3. Age \> 18 and \< 60 years 4. Eosinophilia of more than 5% in nasal secretions at screening 5. Nasal hyperreactivity (drop of PNIF \>20 %) at randomization 6. Possibility to give reliable information and written informed consent Exclusion Criteria: 1. Any evidence of clinically relevant acute or chronic cardiovascular, pulmonary, hepatic, renal, gastrointestinal, haematological, endocrine, metabolic, mental, neurological, or other disease at screening 2. History of allergic reaction to fluticasone propionate, azelastine hydrochloride or one of the excipients (e.g. benzalkonium chloride, phenylethyl alcohol, microcrystalline cellulose) 3. Patients with a change in vision or with a history of increased ocular pressure, glaucoma and/or cataracts 4. Patients with tuberculosis, any type of untreated infection, or recent surgical operation or injury to the nose or mouth 5. Patients on prolonged use of decongestive nose sprays, suffering from so-called rhinitis medicamentosa 6. Patients using other nasal or oral medication affecting nasal function, like nasal corticosteroids, anticholinergics, cromoglycates, leukotriene antagonists, ACE inhibitors during the study or within the last 14 days before randomization; patients using oral corticosteroids during the last 30 days 7. Patients using cytochrome P450 inhibitors (e.g. ritonavir) 8. Nasal endoscopic evidence of rhinosinusitis with or without nasal polyposis (NP) or structural abnormalities such as clinically relevant septal deviation (septum reaching concha inferior or lateral nasal wall) or septal perforation at screening 9. Patients on immunotherapy (IT) for HDM or with history of IT for HDM 10. Patients with a psychiatric, addictive, or any disorder of which the investigators feel that this may compromise the ability to give truly informed consent for participation in this study or provide reliable information on the questionnaire 11. Patients being enrolled in other clinical trials within the last 3 months 12. Pregnancy or breastfeeding 13. Malignancies or severe comorbidity 14. Smoking 15. Use of anticoagulation medication