Does Combined Treatment with Topical Steroids and Oral Antihistamines Make Sense?

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According to the treatment choice for pollinosis in Practical Guideline for the Management of Allergic Rhinitis in Japan, combined treatment with intranasal corticosteroids (NS) and oral non-sedative antihistamines (AH) is recommended for moderate, severe, and most severe cases of pollinosis. NS have been proved to be superior to other drugs for alleviation of any nasal symptom and are regarded as the mainstay of treatment in Western countries. Furthermore, combined treatment with NS and AH has shown to be equivalent in efficacy to NS alone. However, some say combination therapy is required for cedar pollinosis in our country, because it is associated with more severe symptoms. In order to verify this hypothesis the add-on effect of AH to NS was examined. Twenty-six patients with cedar pollinosis were enrolled in this study. They were divided into 2 groups. Group 1 received only intranasal mometasone furoate (MF), and group 2 received intranasal MF and oral epinastine hydrochloride. Almost all patients were treated in the early stages of the disease and all received medication during the entire season. Control of the total nasal score and each nasal score was excellent in both groups in any stage. There were no significant differences in any items compared. Usage of NS alone suffices as an early stage treatment option for Japanese cedar pollinosis. A controlled study with the combined use of NS and AH and single use of NS after massive pollen dispersion is the next step.

Does Combined Treatment with Topical Steroids and Oral Antihistamines Make Sense?

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