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Open AccessArticle

Determining an Appropriate Time to Start Prophylactic Treatment with Intranasal Corticosteroids in Japanese Cedar Pollinosis

1
Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
2
Department Otorhinolaryngology, Himeji Red Cross Hospital, Himeji 670-8540, Japan
3
Department Otorhinolaryngology, Kagawa Rosai Hospital, Marugame 763-8502, Japan
4
Department Otorhinolaryngology, Kagawa Prefectural Central Hospital, Takamatsu 760-0017, Japan
5
Department Otorhinolaryngology, International University of Health and Welfare School of Medicine, 4-3 Kozunomori, Narita 286-8686, Japan
*
Author to whom correspondence should be addressed.
Med. Sci. 2019, 7(1), 11; https://doi.org/10.3390/medsci7010011
Received: 30 September 2018 / Revised: 10 December 2018 / Accepted: 13 December 2018 / Published: 15 January 2019
(This article belongs to the Special Issue Allergic Rhinitis: Epidemiology, Prevention and Management)
Prophylactic treatment with intranasal corticosteroids is effective for pollen-induced seasonal allergic rhinitis. However, the appropriate time to start this treatment remains unclear. We performed a double-blinded, randomized, placebo-controlled trial. Starting on 1 February 2014, patients with Japanese cedar pollinosis received either fluticasone furoate nasal spray (FFNS) for 8 weeks (Group A: n = 24), placebo nasal spray for 2 weeks followed by FFNS for 6 weeks (Group B: n = 23), or placebo for 4 weeks followed by FFNS for 4 weeks (Group C: n = 23). The primary endpoint was comparison of the total naso-ocular symptom score (TSS). Secondary endpoints including the increment cost effective ratio (ICER) were also determined. Continuous pollen dispersion began on the 24th of February. Therefore, Group A and Group B received 3-weeks and 1-week of prophylactic treatment, respectively, whereas Group C received post-onset treatment. During the peak pollen-dispersal period, significant differences in TSS were seen between the groups, particularly between Group A and C. The ICER of Group B vs. Group C was lower than that of Group A vs. Group C. These results suggest that long-term prophylactic treatment with FFNS is clinically the most potent treatment, whereas short-term prophylactic treatment is cost effective for pollen-induced allergic rhinitis. View Full-Text
Keywords: allergic rhinitis; double-blinded randomized placebo-controlled trial; fluticasone furoate nasal spray; increment cost effective ratio; intranasal corticosteroids; Japanese cedar pollinosis; post-onset treatment; prophylactic treatment; total naso-ocular symptom score allergic rhinitis; double-blinded randomized placebo-controlled trial; fluticasone furoate nasal spray; increment cost effective ratio; intranasal corticosteroids; Japanese cedar pollinosis; post-onset treatment; prophylactic treatment; total naso-ocular symptom score
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MDPI and ACS Style

Haruna, T.; Kariya, S.; Higaki, T.; Makihara, S.-I.; Kanai, K.; Komatsubara, Y.; Oka, A.; Nishizaki, K.; Okano, M. Determining an Appropriate Time to Start Prophylactic Treatment with Intranasal Corticosteroids in Japanese Cedar Pollinosis. Med. Sci. 2019, 7, 11.

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