Subjective and objective assessments in patients with seasonal allergic rhinitis: effects of therapy with mometasone furoate nasal spray.
BACKGROUND
Efficacy of topical nasal steroid therapy for allergic rhinitis is usually evaluated by patient and clinician assessments of subjective symptom changes in diaries and at clinical interviews.


OBJECTIVE
We sought to complement the subjective measures with objective measures of nasal cytology, biochemistry, and function.


METHODS
In this double-blind, randomized study patients with seasonal allergic rhinitis (SAR) 12 years of age or older received 200 microg mometasone furoate nasal spray (n = 80) or placebo spray (n = 41) once daily for 2 weeks. Subjective assessments by clinician and patient comprised symptom/sign scores and overall therapeutic response evaluations. Objective measures included nasal cytology, nasal biochemistry, nasal airway resistance (NAR), mucociliary clearance, and olfactory functions.


RESULTS
Mometasone furoate produced a significantly greater decrease than placebo in subjective measures of SAR for total symptom score (-46% vs -30%, p < 0.05), total nasal score (-47% vs -30%, p < 0.024), individual nasal symptom scores, and overall therapeutic response. The objective measures of eosinophil, basophil, and neutrophil counts and mucociliary clearance were significantly better in mometasone furoate- than in placebo-treated patients. Similarly, within-treatment statistically significant improvements were produced by mometasone furoate but not by placebo sprays for levels of eosinophilic cationic protein, tryptase and albumin, NAR, and odor identification. Significant positive correlations were found between NAR and nasal stuffiness and between eosinophils, basophils, and neutrophils and both eosinophilic cationic protein and albumin.


CONCLUSIONS
Subjective measures of SAR were significantly improved in the mometasone furoate group by comparison with placebo-treated patients. Objective assessments supported the subjective findings because within-treatment measures were frequently significantly improved after mometasone furoate treatment but not after placebo treatment.
Allergy & Asthma Medical Group and Research Center, San Diego, Calif, USA.
E O
EO
Meltzer
A A
AA
Jalowayski
H A
HA
Orgel
A G
AG
Harris
D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D000368:Aged; D000418:Albumins / Q000378:metabolism; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D004311:Double-Blind Method; D005938:Glucocorticoids; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D000068656:Mometasone Furoate; D009079:Mucociliary Clearance; D009297:Nasal Mucosa / Q000166:cytology; D015508:Nasal Obstruction; D017063:Outcome Assessment, Health Care; D011244:Pregnadienediols / Q000009:adverse effects / Q000627:therapeutic use*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy* / Q000503:physiopathology; D012903:Smell / Q000502:physiology; D016896:Treatment Outcome
D000418:Albumins; D018926:Anti-Allergic Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011244:Pregnadienediols; D000068656:Mometasone Furoate