A method for evaluating therapy for hay fever. A comparison of four treatments

Abstract

An attempt was made to develop a method for comparing the value of different forms of treatment for hay fever. A cross-over trial was carried out in 61 patients, comparing 4 treatments: topical corticosteroids [beclomethasone dipropionate, betamethasone sodium phosphate], topical cromoglycates [Lomusol, Opticrom] placebo tablets and oxatomide (a new oral treatment with antihistamine and cromoglycate-like properties). Three methods were used to compare these treatments: post-treatment symptom questionnaires; daily analog line scores of symptoms; nasal FEV1 [forced expiratory volume in 1s]. Daily analog line diary scores, with an analysis which took into account variation in pollen count, were the most sensitive. By employing this diary method, it was shown that all 3 active treatments were significantly better than placebo and that topical corticosteroids were significantly better than topical cromoglycates. The activity of oxatomide was not significantly different from that of steroids or cromoglycate, but it was associated with more frequent side-effects. Daily diaries, combining symptom relief and freedom from side effects into a single score of usefulness adjusted for pollen count, may be suitable means for comparing treatments for hay fever.