Daily versus self-adjusted dosing of topical mometasone furoate nasal spray in patients with allergic rhinitis: randomised, controlled trial.
BACKGROUND
Many patients with allergic rhinitis are reluctant to use daily intranasal steroids for prolonged periods. A self-adjusted regimen which delivers reasonable control of allergic rhinitis may be more acceptable to such patients.


OBJECTIVE
To compare the efficacy of daily use of mometasone furoate nasal spray, versus a self-adjusted regimen, in patients with chronic allergic rhinitis, in terms of symptom control and nasal volume change.


METHODS
Ambulatory visits in an office setting.


METHODS
Sixty patients with chronic allergic rhinitis were randomised: 30 were prescribed mometasone furoate nasal spray once daily for six weeks, while 30 were prescribed the same spray daily for one week, every alternate day for one week and then on a self-adjusted regimen for four weeks. Patients kept a symptom diary documenting sneezing, rhinorrhoea, nasal blockage and nasal itching. Acoustic rhinometry was used to measure the total nasal cavity volume at the first visit and at the end of the treatment period.


RESULTS
The total nasal score on treatment days showed an improvement in both groups, compared with baseline measurements. There was no significant difference in total nasal scores between the two groups, except on days 10 (p = 0.043), 20 (p = 0.008), 23 (p = 0.19), 30 (p = 0.008) and 37 (p = 0.000), when the daily group's total nasal score was significantly lower than the self-adjusted group's total nasal score, and on day 8 (p = 0.004), when the self-adjusted group's total nasal score was significantly lower than the daily group's total nasal score. Total nasal cavity volume significantly increased in both groups (p = 0.0001), with no statistically significant difference between the groups.


CONCLUSIONS
Self-adjusted dosage of mometasone furoate nasal spray gives reasonable control of allergic rhinitis (albeit with some 'breakthrough' symptoms). Patients should learn how to control these symptoms with the least number of steroid doses.
Khan
M A
MA
Department of Otolaryngology, College of Medicine, Qassim University, PO Box 30109, Buraidah 51477, Qassim, Kingdom of Saudi Arabia. asnmkhan@yahoo.com
Abou-Halawa
A S
AS
Al-Robaee
A A
AA
Alzolibani
A A
AA
Al-Shobaili
H A
HA
D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D009296:Nasal Cavity / Q000473:pathology; D011244:Pregnadienediols / Q000008:administration & dosage*; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D012646:Self Administration
D018926:Anti-Allergic Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011244:Pregnadienediols; D000068656:Mometasone Furoate