TOPLINE

Patients with allergic rhinitis who used medication as needed — defined as up to 4 days per week — during pollen season achieved symptom control and treatment satisfaction no worse than those who used medications on a daily basis; for some medication classes, as-needed use was even better than daily use.

METHODOLOGY

• Researchers analyzed patient-reported data collected through a mobile app to compare weeks during pollen season when patients with allergic rhinitis used medication on an as-needed vs a regular basis, evaluating differences in treatment satisfaction and symptom control.
• The analysis included 1042 European users with self-reported allergic rhinitis (mean age, 39.1 years; 47% female), covering 2690 weeks of data collected between May 2015 and December 2025.
• Regular use was defined as reporting the use of the same single medication class on all 7 days of the week; as-needed use was defined as using the same single class on at most 4 days per week.
• Medication classes assessed were oral antihistamines (OAH), intranasal corticosteroids (INCS), fixed intranasal antihistamine + corticosteroid combinations (INAH+INCS), and INCS+OAH (defined as use of both on the same day).
• Symptom control was assessed via visual analog scales (VASs), with higher scores indicating worse control. Treatment satisfaction was assessed via a separate VAS, with higher scores indicating higher satisfaction.

TAKEAWAY

• Overall, a total of 1792 weeks (66.6%) involved the use of medication on a regular basis. Treatment satisfaction did not differ significantly between as-needed and regular use for the INCS and INAH plus INCS classes.
• Treatment satisfaction, when assessed by maximum VAS scores, favored the as-needed approach for both OAH (adjusted coefficient, 7.34) and INCS plus OAH (adjusted coefficient, 11.36; P < .05 for both).
• Symptom control showed either no significant differences between the two approaches or results favoring as-needed medication use; for OAH, the median global VAS score was lower with the as-needed approach (adjusted coefficient, -5.70; P < .001).
• These findings were consistent in sensitivity analyses — one restricting the definition of as-needed use to at most 2 days per week and another comparing treatment days with the nontreatment days preceding them.

IN PRACTICE

"[T]his study suggests that most patients are capable of self-managing their disease: in most cases where patients feel that as-needed medication is appropriate, they do not achieve a worse level of disease control compared to a regular approach," the researchers wrote.

SOURCE

Jean Bousquet, with the Allergic Rhinitis and Its Impact on Asthma (ARIA) in Montpellier, France, was the corresponding author of the study, which was published online on September 9 in Allergy.

LIMITATIONS

For some analyses, only a small number of weeks met the eligibility criteria, limiting the precision of those estimates. The findings may not generalize to the proportion of weeks in which medication was used on a regular or an as-needed basis in the general population. Residual confounding could not be ruled out.

DISCLOSURES

The study was supported by multiple organizations, including Breathing Together Onlus Association in Italy, the Clinical Research Support Program of the Japanese Society of Allergology, and several European foundations and universities. Several authors disclosed financial relationships with numerous pharmaceutical companies, including consulting fees, research support, and honoraria.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.