BACKGROUND:
Allergic rhinitis involves
inflammation of the
nasal passages. The use of nasal
steroids is generally very effective in providing significant
symptom relief. However, compliance for their use is sometimes poor. METHODS: To examine the efficacy of early intervention (before pollen dispersal) with oral
cysteinyl leukotriene receptor antagonists (LTRA) on
pollinosis in patients with
allergy to cedar and Japanese cypress pollens, groups of subjects were treated with LTRA or a
placebo for 4 weeks at the beginning of the cedar pollen dispersal season. Subsequently, all patients received nasal
steroid therapy
concomitantly with LTRA throughout the remaining period of the pollen dispersal season. The effects of such early treatment with LTRA on
pollinosis were investigated using
symptom scores from an
allergy diary and quality of life (QOL) scores. RESULTS: Sneezing and
nasal congestion scores were significantly lower in the LTRA-pretreated subjects than observed in the placebo-pretreated patients between weeks 4 and 6 and weeks 3 and 5, respectively. QOL scores improved significantly in all domains after
concomitant therapy with nasal
steroids. The percent improvement in the
nasal congestion score after the
concomitant therapy was significantly higher in the LTRA group (69%) than in the
placebo group (41%). CONCLUSION: Significant differences observed in
symptoms and in QOL effects between LTRA- and placebo-pretreated patients and the absence of major
adverse effects noted in these studies suggest that early intervention with LTRA is beneficial and safe and should be considered in the management of pollinosis-associated
allergic rhinitis.
