title: Early interventional treatment with intranasal corticosteroids compared with postonset treatment in pollinosis.
abstract: BACKGROUND
  The usefulness of early interventional treatment (EIT) with intranasal corticosteroids (INSs) compared with postonset treatment (POT) has not been clarified.
  
  
  OBJECTIVE
  To study the efficacy and safety of EIT with INSs compared with POT and placebo in Japanese cedar/cypress pollinosis.
  
  
  METHODS
  We designed a 3-armed, double-blinded, randomized, placebo-controlled trial. Patients received mometasone furoate nasal spray (EIT group: n = 25), placebo (n = 25), or 4 weeks of placebo followed by 8 weeks of mometasone (POT group: n = 25) for a 12-week period starting on February 1, 2011. The primary end point was the comparison of the total nasal symptom score (TNSS) among the 3 groups. Total ocular symptom score (TOSS), total naso-ocular symptom score (TSS), Allergic Rhinitis and Its Impact (ARIA) on Asthma classification, and safety were the main secondary end points.
  
  
  RESULTS
  The placebo and POT groups, but not the EIT group, had a significant exacerbation of TNSS and TOSS soon after the start of pollen counts being high on consecutive days. The 12-week mean TSS in the EIT group (score, 2.3) was significantly lower than in the placebo (5.0; P < .01) and POT (3.9; P = .03) groups. All patients in the placebo and POT groups were classified as having persistent rhinitis, whereas 80% of the EIT group met the ARIA classification criteria (P = .03). The quality-of-life score and nasal eosinophil cationic protein levels were lower in the EIT and POT groups compared with the placebo group. Daytime sleepiness, smell disturbance, and the mean dose of loratadine taken as the rescue medication were similar. Treatment with mometasone was well tolerated.
  
  
  CONCLUSIONS
  EIT with INSs is superior to POT in controlling pollinosis.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
authors.forename: Takaya
authors.initials: T
authors.lastname: Higaki
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Okano
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Makihara
authors.forename: Tazuko
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Takenori
authors.initials: T
authors.lastname: Haruna
authors.forename: Yohei
authors.initials: Y
authors.lastname: Noda
authors.forename: Shin
authors.initials: S
authors.lastname: Kariya
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nishizaki
mesh_terms: D000281:Administration, Intranasal; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D000328:Adult; D000485:Allergens / Q000009:adverse effects / Q000276:immunology; D018926:Anti-Allergic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D032485:Cryptomeria / Q000009:adverse effects / Q000276:immunology; D029781:Cupressus / Q000009:adverse effects / Q000276:immunology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D011058:Pollen / Q000009:adverse effects / Q000276:immunology; D011244:Pregnadienediols / Q000008:administration & dosage* / Q000009:adverse effects; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy* / Q000276:immunology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000485:Allergens; D018926:Anti-Allergic Agents; D011244:Pregnadienediols; D000068656:Mometasone Furoate