Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-23T03:48:00.087Z Has data issue: false hasContentIssue false
  • English
  • Français

Daily versus self-adjusted dosing of topical mometasone furoate nasal spray in patients with allergic rhinitis: randomised, controlled trial

Published online by Cambridge University Press:  25 November 2009

M A Khan ,
A S Abou-Halawa ,
A A Al-Robaee ,
A A Alzolibani  and
H A Al-Shobaili
M A Khan*
Affiliation:
Department of Otolaryngology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
A S Abou-Halawa
Affiliation:
Department of Otolaryngology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
A A Al-Robaee
Affiliation:
Department of Otolaryngology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
A A Alzolibani
Affiliation:
Department of Dermatology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
H A Al-Shobaili
Affiliation:
Department of Dermatology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
*
Address for correspondence: Professor Masood Ahmad Khan, Professor of Otorhinolaryngology, College of Medicine, Qassim University, Saudi Arabia, PO Box 30109, Buraidah 51477, Qassim, Saudi Arabia. Fax: +966 6 3801228 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Many patients with allergic rhinitis are reluctant to use daily intranasal steroids for prolonged periods. A self-adjusted regimen which delivers reasonable control of allergic rhinitis may be more acceptable to such patients.

Objectives:

To compare the efficacy of daily use of mometasone furoate nasal spray, versus a self-adjusted regimen, in patients with chronic allergic rhinitis, in terms of symptom control and nasal volume change.

Setting:

Ambulatory visits in an office setting.

Patients and methods:

Sixty patients with chronic allergic rhinitis were randomised: 30 were prescribed mometasone furoate nasal spray once daily for six weeks, while 30 were prescribed the same spray daily for one week, every alternate day for one week and then on a self-adjusted regimen for four weeks. Patients kept a symptom diary documenting sneezing, rhinorrhoea, nasal blockage and nasal itching. Acoustic rhinometry was used to measure the total nasal cavity volume at the first visit and at the end of the treatment period.

Results:

The total nasal score on treatment days showed an improvement in both groups, compared with baseline measurements. There was no significant difference in total nasal scores between the two groups, except on days 10 (p = 0.043), 20 (p = 0.008), 23 (p = 0.19), 30 (p = 0.008) and 37 (p = 0.000), when the daily group's total nasal score was significantly lower than the self-adjusted group's total nasal score, and on day 8 (p = 0.004), when the self-adjusted group's total nasal score was significantly lower than the daily group's total nasal score. Total nasal cavity volume significantly increased in both groups (p = 0.0001), with no statistically significant difference between the groups.

Conclusions:

Self-adjusted dosage of mometasone furoate nasal spray gives reasonable control of allergic rhinitis (albeit with some ‘breakthrough’ symptoms). Patients should learn how to control these symptoms with the least number of steroid doses.

Keywords

Allergic RhinitisMometasone FuroateCorticosteroidsNasal Cavity
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 4 , April 2010 , pp. 397 - 401
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Stewart, MG. Identification and management of undiagnosed and undertreated allergic rhinitis in adults and children. Clin Exp Allergy 2008;38:751–60CrossRefGoogle ScholarPubMed
2 Mucha, SM, deTineo, M, Naclerio, RM, Baroody, FM. Comparison of montelukast and pseudoephedrine in the treatment of allergic rhinitis. Arch Otolaryngol Head Neck Surg 2006;132:164–72CrossRefGoogle ScholarPubMed
3 Trangsrud, AJ, Whitaker, AL, Small, RE. Intranasal corticosteroids for allergic rhinitis. Pharmacotherapy 2002;22:1458–67CrossRefGoogle ScholarPubMed
4 Baena-Cagnani, CE. Safety and tolerability of treatments for allergic rhinitis in children. Drug Saf 2004;27:883–98CrossRefGoogle ScholarPubMed
5 Minshall, E, Ghaffar, O, Cameron, L, O'Brien, F, Quinn, H, Rowe-Jones, J et al. Assessment by nasal biopsy of long-term use of mometasone furoate aqueous nasal spray (Nasonex) in the treatment of perennial rhinitis. Otolaryngol Head Neck Surg 1998;118:648–54Google ScholarPubMed
6 Herman, H. Once-daily administration of intranasal corticosteroids for allergic rhinitis: a comparative review of efficacy, safety, patient preference, and cost. Am J Rhinol 2007;21:70–9CrossRefGoogle ScholarPubMed
7 Schermer, TR, Thoonen, BP, van den Boom, G, Akkermans, RP, Grol, RP, Folgering, HT et al. Randomized controlled economic evaluation of asthma self-management in primary health care. Am J Respir Crit Care Med 2002;166:1062–72CrossRefGoogle ScholarPubMed
8 Small, CB, Stryszak, P, Danzig, M, Damiano, A. Onset of symptomatic effect of mometasone furoate nasal spray in the treatment of nasal polyposis. J Allergy Clin Immunol 2008;121:928–32CrossRefGoogle ScholarPubMed
9 Onrust, SV, Lamb, HM. Mometasone furoate. A review of its intranasal use in allergic rhinitis. Drugs 1998;56:725–45CrossRefGoogle ScholarPubMed
10 Berkowitz, RB, Bernstein, DI, LaForce, C, Pedinoff, AJ, Rooklin, AR, Damaraju, CR et al. Onset of action of mometasone furoate nasal spray (NASONEX) in seasonal allergic rhinitis. Allergy 1999;54:64–9CrossRefGoogle ScholarPubMed
11 Davies, RJ, Nelson, HS. Once-daily mometasone furoate nasal spray: efficacy and safety of a new intranasal glucocorticoid for allergic rhinitis. Clin Ther 1997;19:27–38CrossRefGoogle ScholarPubMed
12 Mygind, N, Nielsen, LP, Hoffmann, HJ, Shukla, A, Blumberga, G, Dahl, R et al. Mode of action of intranasal corticosteroids. J Allergy Clin Immunol 2001;108 (suppl 1):16–25SCrossRefGoogle ScholarPubMed
13 Zitt, M, Kosoglou, T, Hubbell, J. Mometasone furoate nasal spray: a review of safety and systemic effects. Drug Saf 2007;30:317–26CrossRefGoogle ScholarPubMed
14 Kirtsreesakul, V, Chansaksung, P, Ruttanaphol, S. Dose-related effect of intranasal corticosteroids on treatment outcome of persistent allergic rhinitis. Otolaryngol Head Neck Surg 2008;139:565–9CrossRefGoogle ScholarPubMed
15 Veien, NK, Olholm Larsen, P, Thestrup-Pedersen, K, Schou, G. Long-term, intermittent treatment of chronic hand eczema with mometasone furoate. Br J Dermatol 1999;140:882–6CrossRefGoogle ScholarPubMed
16 Lam, HC, Tong, MC, Van Hasselt, CA. Rhinitis symptoms and quality of life in patients with chronic perennial rhinitis treated with desloratadine. J Laryngol Otol 2007;121:1151–5CrossRefGoogle ScholarPubMed
17 Gani, F, Pozzi, E, Crivellaro, MA, Senna, G, Landi, M, Lombardi, C et al. The role of patient training in the management of seasonal rhinitis and asthma: clinical implications. Allergy 2001;56:65–8CrossRefGoogle ScholarPubMed