Step-Down Therapy Can Reduce Medication Use

When treating patients with seasonal allergic rhinitis caused by pollens, pharmacists can maintain the same dosage or use a step-down therapy approach as pollen levels fall.

This decision should be based on the severity of the patient’s symptoms and their specific needs, according to results of a study published in the Journal of ClinicalOtorhinolaryngology: Head and Neck Surgery.

Investigators conducted a randomized, open-label, parallel control study to compare the efficacy of step-down pharmacotherapy guided by pollen count with maintaining therapy.

A total of 135 patients were recruited and divided into 2 groups. The medicine and rhinitis symptom scores of the 2 groups were recorded and compared.

The rhinitis symptom score of the step-down group showed no significant difference when compared with the symptom score of the maintaining group, according to the findings.

However, the medicine score of the step-down group was lower than the score of the maintaining group (3.67 and 4.78, respectively). Notably, the compliance of the step-down group was also better than the maintaining group (80.6% versus 60.3%, respectively).

In the subgroup of patients with severe symptoms, the investigators found that symptoms were more severe in the group receiving step-down therapy.

Based on these findings, the investigators concluded that later in the season, when pollen count is relatively low, step-down pharmacotherapy could reduce medication use and increase compliance of patients while controlling their symptoms.

However, this approach may be more suitable for patients with milder symptoms. than those with severe rhinitis symptoms, according to the investigators.

REFERENCE

Li LS, Guan K, Wang ZX, et al. The comparison of step-down pharmacotherapy and maintaining dose therapy for seasonal allergic rhinitis. Europe PMC; December 31, 2019. https://europepmc.org/article/med/32086889. Accessed July 14, 2020.