Hay fever treatments--which should be tried first?

Area of Science:

• Allergy and Immunology
• Pharmacology
• General Practice Medicine

Background:

• Hay fever (allergic rhinitis) significantly impacts quality of life.
• Numerous treatment regimens exist, necessitating comparative efficacy studies.
• General practice settings are crucial for evaluating real-world treatment utility.

Purpose of the Study:

• To compare the overall usefulness of nine distinct hay fever treatment regimens.
• To assess patient-reported outcomes including symptom severity, side effects, and ease of use.
• To identify the most effective and practical hay fever treatments in a general practice setting.

Main Methods:

• A multi-center comparative trial involving 140 general practitioners and 640 hay fever patients.
• Data collection over three pollen seasons (1981-1983) using daily patient diaries.
• Patient-reported 'usefulness' scored on a linear analogue scale, integrating symptom control, side effects, and usability.

Main Results:

• Beclomethasone diproprionate with sodium cromoglycate eye drops (Beconase/Opticrom) achieved the highest overall usefulness score.
• Beconase/Opticrom demonstrated significantly better performance than several other regimens, including mequitazine and sodium cromoglycate nasal insufflation.
• While not statistically superior to some other top-tier treatments like astemizole, Beconase/Opticrom ranked first for both mild and severe hay fever cases.

Conclusions:

• Beconase/Opticrom is a highly effective and practical treatment option for hay fever.
• The study provides valuable real-world evidence for optimizing hay fever management in primary care.
• Dimethothiazine (Banistyl), though effective, is no longer available by prescription.