Evaluation of treatment response in patients with seasonal allergic rhinitis using domiciliary nasal peak inspiratory flow.
BACKGROUND
Measurement of domiciliary nasal peak inspiratory flow rate (PIFR) may have a role in the objective assessment of treatment response in seasonal allergic rhinitis (SAR).


OBJECTIVE
We wished to evaluate the relationship between domiciliary measurement of nasal PIFR and a variety of symptoms associated with rhinitis.


METHODS
Thirty-eight nonasthmatic patients, mean age (SEM) 30 years (1.4), with symptomatic SAR were evaluated in a placebo-controlled, single-blind, double-dummy, three way parallel group study. Patients received oral cetirizine 10 mg once daily and were randomized to receive, in addition, either: (i) intranasal mometasone furoate 200 microgram (n = 14); (ii) oral montelukast 10 mg (n = 11); or (iii) placebo (n = 13). All treatments were given once daily for 4 weeks and were preceded by a 1 week placebo period. Domiciliary diary cards were used to record morning (am) and evening (pm) domiciliary nasal PIFR and symptom (nasal, eye, throat) scores and impact on daily activity. A total daily symptom score was then calculated from the sum of these separate symptom scores.


RESULTS
Baseline values for symptom scores and PIFR after placebo run-in were not significantly different when comparing the three groups. After 4 weeks of active treatment, there were significant (P < 0.05) improvements in nasal symptoms, total daily symptoms and PIFR with all treatments, with there being no significant confounding effect of pollen count, when analysed as a covariate. There were significant (P < 0.01) correlations for nasal symptom scores vs PIFRam (r = - 0.51) and PIFRpm (r = - 0.56), and similarly for daily activity vs PIFRam (r = - 0.42) and PIFRpm (r = - 0.48).


CONCLUSIONS
These results suggest that domiciliary measurements of nasal peak flow correlate significantly with symptoms of seasonal allergic rhinitis and may therefore be a potentially useful objective short-term marker of treatment response.
Wilson
A
A
Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Scotland.
Dempsey
O J
OJ
Sims
E J
EJ
Coutie
W J
WJ
Paterson
M C
MC
Lipworth
B J
BJ
D000085:Acetates / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D017332:Cetirizine / Q000627:therapeutic use*; D003521:Cyclopropanes; D004359:Drug Therapy, Combination; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D007320:Inspiratory Capacity; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D008875:Middle Aged; D000068656:Mometasone Furoate; D011058:Pollen; D011244:Pregnadienediols / Q000627:therapeutic use; D011804:Quinolines / Q000627:therapeutic use; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy* / Q000503:physiopathology*; D012646:Self Administration; D016037:Single-Blind Method; D013440:Sulfides; D016896:Treatment Outcome
D000085:Acetates; D018926:Anti-Allergic Agents; D003521:Cyclopropanes; D006634:Histamine H1 Antagonists; D020024:Leukotriene Antagonists; D011244:Pregnadienediols; D011804:Quinolines; D013440:Sulfides; D000068656:Mometasone Furoate; C093875:montelukast; D017332:Cetirizine