Vol.99 No.6 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 6 June 2006
The Effect of Prophylactic Treatment with
Fexofenadine on Japanese Cedar Pollinosis
Nobuo Ohta and Masaru Aoyagi
(Yamagata University School of Medicine)
Shinichi Sakurai
(Yamagata Prefectual Hospital)
Hiroshi Yoshitake
(Juntendo University)
Cedar pollinosis is prevalent in Japan with a growing number of patients reporting increasingly severe symptoms each year. This study evaluated the clinical effect of treating patients with fexofenadine early in the cedar pollinosis season. Patients were divided into two treatment groups: early pollen season patients who consulted the clinic before the pollen season (Group 1); full pollen season patients who consulted the clinic after the start of the pollen season (Group 2). Both groups received fexofenadine HCI 60 mg bid from the date of arrival in the clinic until pollen season end. Mean duration of treatment was 55.2 days (Group 1), 19.2 days (Group 2). Clinical efficacy was assessed based on changes in patient-reported symptoms [collected in daily diaries] and concurrent usage of other medications. Other assessments included measurement of eosinophil cationic protein (ECP), vascular endothelial growth factor (VEGF) and eotaxin concentrations in the nasal wash. Forty-nine patients were included in this study (Group 1: N＝26; Group 2: N＝23). Symptom and symptom-medication scores for Group 1 at weeks 2 and 4 (peak pollen season) were significantly lower (p＜0.05) than those of Group 2. While both groups showed elevation of ECP, VEGF and eotaxin in the nasal wash during the peak pollen season, the elevation was lower in Group 1 (p＝NS). This study showed that fexofenadine treatment prior to the pollen season reduced cedar pollinosis symptoms to a greater extent than commencing treatment after the start of the pollen season. This difference in efficacy may be linked to the inhibition of ECP and VEGF by fexofenadine.
Key words : prophylactic treatment, fexofenadine, Japanese cedar pollinosis