Early interventional treatment with intranasal corticosteroids is superior to post‐onset treatment in Japanese cedar/cypress pollinosis

Abstract

Background The usefulness of early interventional treatment (EIT) with intranasal corticosteroids (INS) as compared to post-onset treatment (POT) has not been clarified. We sought to determine the efficacy and safety of EIT with INS compared with POT and placebo in Japanese cedar/cypress pollinosis. Method Results The placebo and POT groups, but not the EIT group, showed a significant exacerbation of TNSS and TOSS soon after the start of pollen counts being high on conse- cutive days. The 12-week average TSS in the EIT group (score, 2.3) was significantly lower than in the placebo (5.0; P<0.01) and POT (3.9; P=0.03) groups. All subjects in the placebo and POT groups were classified as having persistent rhinitis, while 80% of the EIT group met the ARIA classification criteria (P=0.03). QOL score and nasal ECP levels were lower in the EIT and POT groups as compared with the placebo group. Daytime sleepiness, smell disturbance and the average dose of loratadine taken as the rescue medication were similar. Treatment with mometasone was well tolerated. Conclusion