Quality of life indices may be predictive of placebo and medication response to treatment for allergic rhinitis.
BACKGROUND
Quality of life (QOL) is known to be an important clinical endpoint in determining medication efficacy; however, the predictive value of QOL indices for response to medication or placebo has not been tested.


OBJECTIVE
To determine whether a correlation between measures of QOL and response to medication/placebo exists in an evaluation of budesonide for allergic rhinitis.


METHODS
Two hundred nine participants completed the 36-item short-form health QOL survey at screening for entry into a study examining the onset of action of budesonide in an allergen challenge system. During the treatment phase, symptom assessments were recorded hourly after dosing of double-blind medication. Participants were determined to be responders or nonresponders to study medication. A responder was defined as a participant who rated medication effectiveness as fair to excellent with regard to symptom relief, for three consecutive hourly assessments during the study day or one whose total symptom score decreased by > or =25% for three consecutive hourly assessments. Baseline QOL scores were compared between responders and nonresponders.


RESULTS
Differences were noted among responders and nonresponders on the basis of whether budesonide or placebo was received. Ratings of general health perception, pain, physical function, and role limitation due to physical health were significantly lower among participants who responded to placebo, compared with placebo nonresponders. In addition, the overall physical health and 36-item short-form health survey averages were significantly lower. Differences between responders and nonresponders to budesonide did not reach statistical significance.


CONCLUSIONS
Lower baseline QOL scores were associated with a clinically significant response to placebo in a trial of treatment for allergic rhinitis. QOL may be a factor in participant response to medication in clinical studies and, hence, a predictor of outcome.
Ellis
A K
AK
Internal Medicine, Queen's University, Kingston, Ontario, Canada.
Rafeiro
E
E
Day
J H
JH
D019819:Budesonide / Q000627:therapeutic use*; D004311:Double-Blind Method; D005544:Forecasting; D006801:Humans; D010919:Placebos; D011788:Quality of Life; D006255:Rhinitis, Allergic, Seasonal / Q000517:prevention & control*; D016896:Treatment Outcome
D010919:Placebos; D019819:Budesonide