title: Efficacy, cost-effectiveness, and tolerability of mometasone furoate, levocabastine, and disodium cromoglycate nasal sprays in the treatment of seasonal allergic rhinitis.
abstract: BACKGROUND
  Current guidelines recommend intranasal glucocorticosteroids as first-line therapy for seasonal allergic rhinitis.
  
  
  OBJECTIVE
  To compare the efficacy, cost-effectiveness, and tolerability of the topical glucocorticosteroid mometasone furoate, the topical antihistamine levocabastine hydrochloride, and the cromone disodium cromoglycate in seasonal allergic rhinitis.
  
  
  METHODS
  This study was performed during the 2003 grass pollen season as an open, randomized, parallel-group, single-center study of 123 patients assigned to receive mometasone furoate (200 microg once daily), levocabastine hydrochloride (200 microg twice daily), or disodium cromoglycate (5.6 mg 4 times daily). Symptom scores and nasal inspiratory peak flow measurements were recorded in a patient diary. The global efficacy of the study medication was evaluated by patients after treatment. Eosinophil cationic protein concentrations were measured in nasal secretions before and after treatment. Cost-effectiveness was evaluated as medication cost per treatment success.
  
  
  RESULTS
  Mometasone furoate therapy was significantly superior to the use of levocabastine or disodium cromoglycate with respect to all nasal symptoms, the global evaluation of efficacy, and eosinophil cationic protein concentration. Furthermore, mometasone furoate therapy was significantly superior to disodium cromoglycate therapy with respect to nasal inspiratory peak flow. Medication cost per treatment success was lowest with mometasone furoate use and highest with levocabastine use.
  
  
  CONCLUSIONS
  This is the first study to compare mometasone furoate nasal spray with nonsteroidal topical treatments for seasonal allergic rhinitis. Mometasone furoate nasal spray was confirmed as a first-choice topical treatment option for seasonal allergic rhinitis.
authors.affiliation: Institut für Atemwegsforschung GmbH, Düsseldorf, Germany. dnreblange@aol.com
authors.forename: Bernd
authors.initials: B
authors.lastname: Lange
authors.forename: Karl-Friedrich
authors.initials: KF
authors.lastname: Lukat
authors.forename: Klaus
authors.initials: K
authors.lastname: Rettig
authors.forename: Gabriele
authors.initials: G
authors.lastname: Holtappels
authors.forename: Claus
authors.initials: C
authors.lastname: Bachert
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D004205:Cromolyn Sodium / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D047150:Eosinophil Cationic Protein / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D011244:Pregnadienediols / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D012129:Respiratory Function Tests; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents; D010880:Piperidines; D011244:Pregnadienediols; D000068656:Mometasone Furoate; D047150:Eosinophil Cationic Protein; C047340:levocabastine; D004205:Cromolyn Sodium