The authors of this randomised trial aim to answer an important question – which is better: daily versus on demand use of intranasal steroids (fluticasone probionate) or antihistamines (levocetirizine dihydrochloride) for symptomatic control of allergic rhinoconjunctivitis secondary to pollen? The authors performed a well-designed randomised trial with comprehensive inclusion and exclusion criteria and computer-generated randomisation. It also has clear and clinically relevant primary and secondary outcome measures. The authors also accounted for pollen load fluctuation when assessing the results. It is underpowered, not double-blinded and the authors included patients with as low as 25% of daily report of symptoms. Moreover, data about eczema was not collected. Patients who used intranasal steroids daily were considered the control group. No comparison was made between intranasal steroids on demand and antihistamine on demand. Authors concluded that intranasal steroid on demand offers the best symptoms control for both eye and nose symptoms with a significant difference in controlling symptoms like eye itchiness and sneezing. The results were explained by a possible larger placebo effect and by down regulation of corticosteroid receptors when intranasal steroids are used daily. Overall, this is a well-designed study with impact on clinical practice in favour of use of on-demand intranasal steroids for intermittent allergic rhinoconjunctivitis.
Medical control of allergic rhinitis in children
Top Of Page
Accreditations
Pinpoint Scotland Ltd (Registered in Scotland No. SC068684) | © 2024 - Website by Gecko Agency