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

This study was undertaken in order to develop a method for comparing the value of different forms of treatment for hay fever. A cross-over trial was carried out in sixty-one patients, comparing four treatments: topical corticosteroids, topical cromoglycates, placebo tablets and oxatomide (a new oral treatment with antihistamine and cromoglycate-like properties). Three methods were used to compare these treatments: (1) post-treatment symptom questionnaires; (2) daily analogue line scores of symptoms; and (3) nasal FEV1. Of these, daily analogue line diary scores, with an analysis which took into account variation in pollen count, proved to be the most sensitive. By employing this diary method, it was shown that all three active treatments were significantly better than placebo and that topical corticosteroids were significantly better than topical cromoglycates. The activity of oxatomide was found to be not significantly different from that of steroids or cromoglycate, but it was associated with more frequent side-effects. It is suggested that daily diaries, combining symptom relief and freedom from side effects into a single score of 'usefulness' adjusted for pollen count, are suitable means for comparing treatments for hay fever.