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Daily versus self-adjusted dosing of topical mometasone furoate nasal spray in patients with allergic rhinitis: randomised, controlled trial

Published online by Cambridge University Press:  25 November 2009

M A Khan ,
A S Abou-Halawa ,
A A Al-Robaee ,
A A Alzolibani  and
H A Al-Shobaili
M A Khan*
Affiliation:
Department of Otolaryngology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
A S Abou-Halawa
Affiliation:
Department of Otolaryngology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
A A Al-Robaee
Affiliation:
Department of Otolaryngology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
A A Alzolibani
Affiliation:
Department of Dermatology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
H A Al-Shobaili
Affiliation:
Department of Dermatology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
*
Address for correspondence: Professor Masood Ahmad Khan, Professor of Otorhinolaryngology, College of Medicine, Qassim University, Saudi Arabia, PO Box 30109, Buraidah 51477, Qassim, Saudi Arabia. Fax: +966 6 3801228 E-mail: asnmkhan@yahoo.com
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Abstract

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.

Objectives:

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.

Setting:

Ambulatory visits in an office setting.

Patients and 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.

Keywords

Allergic RhinitisMometasone FuroateCorticosteroidsNasal Cavity
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 4 , April 2010 , pp. 397 - 401
Copyright
Copyright © JLO (1984) Limited 2009

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