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| |  AAAAI: Phototherapy May Improve Symptom Management in Allergic Rhinitis By Bonnie Darves SAN FRANCISCO, CA -- March 23, 2004 -- For patients who do not respond to conventional treatments for allergic rhinitis or who choose to refrain from taking medication during pregnancy, phototherapy may prove an effective alternative, according to new research presented here at the American Academy of Allergy, Asthma & Immunology Annual Meeting. Long used in the treatment of atopic dermatitis, phototherapy has been little used or studied in allergic rhinitis, but it may emerge as a new avenue, said lead investigator A.I. Koreck, MD, University of Szeged, Szeged, Hungary. "There are some groups of patients in whom complete [symptom] resolution cannot be obtained with standard therapies, and special subsets for whom the use of antihistamines is controversial, so there is still a place and need for new treatment options for allergic rhinitis -- and we suggest that phototherapy may be an effective treatment for these patients," Dr. Koreck said. The randomised, double blind, placebo-controlled study enrolled 49 patients, all of whom had a 2-year or longer history of moderate to severe allergic rhinitis that was not well controlled by conventional drugs. Subjects received 3 treatments weekly over a 3-week period of ultraviolet (UV) B, UVA, combination UVB/UVA or placebo (natural light). Patients were symptomatic at the start of the study. Phototherapy treatment was delivered intranasally in gradually increasing doses as tolerated, for periods ranging from 3 to 7 minutes. The starting dose was 16.7 J, which was lower than doses used in treatment of dermatological conditions, Dr. Koreck said. An independent investigator evaluated patients for symptom reduction, nasal tissue changes and eosinophil cell count changes. Patients also kept daily symptom diaries. At the end of the treatment period, 66% of patients who received either UVB or UVA phototherapy reported more than 30% decrease in sneezing (P = .033), rhinorrhoea (P = .017) and nasal itching (P = .011). In the placebo group, more than 60% reported either no improvement or slight improvement. Total nasal scores were significantly improved for the UVB- and UVA-treated patients, but nasal obstruction did not decrease significantly, Dr. Koreck noted. Nasal lavage samples showed a significant decrease in eosinophil cell counts (P = .009) and only a few patients experienced side effects, primarily nasal dryness, which resolved after treatment with emollients. Interleukin (IL) 4 levels were not affected by phototherapy, but there was a decrease in IL5 levels (P = .04), she added. The researchers have not completed data analysis to determine how long the treatment benefits persist after discontinuation of phototherapy, Dr. Koreck said.
[Study title: Phototherapy for Hay Fever - A New Therapeutic Tool for the Management of Allergic Rhinitis. Poster 601]
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