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Background: This study intended to assess the severity of Japanese cedar pollinosis using the Practical Guideline for the Management of Allergic Rhinitis in Japan (PG-MARJ) and the Allergic Rhinitis and its Impact on Asthma (ARIA) Guideline. Methods: An Internet questionnaire survey of patients with pollinosis was conducted in mid-May 2011 and responses were obtained from 3382 individuals who had potential symptoms of Japanese cedar pollinosis from February to early May 2011 and who had experienced such symptoms for at least two pollen seasons. Results: According to PG-MARJ, 23.5% of the respondents had severest rhinitis, 29.4% severe rhinitis, 31.3% moderate rhinitis, 13.8% mild rhinitis and 2.0% asymptomatic rhinitis. According to ARIA, 67.2% of them had moderate/severe persistent rhinitis, 23.8% moderate/severe intermittent rhinitis, 4.4% mild persistent rhinitis and 4.6% mild intermittent rhinitis. Conclusions: Moderate to severe rhinitis was diagnosed in more than 80% of the respondents according to PG-MARJ, while moderate/severe rhinitis was diagnosed in more than 90% of the respondents according to ARIA. Most of the respondents suffered relatively severe pollinosis. More than 80% of the respondents had all the three major symptoms (i.e., sneezing, rhinorrhea and nasal blockage). Disagreement in the severity assessment between the two guidelines was noted in approximately 20% of the respondents. [ABSTRACT FROM AUTHOR]

Background: It is known that the symptoms of allergic rhinitis can significantly reduce the quality of life of the patient. One of such typical symptoms of allergic rhinitis is nasal obstruction. Nasal obstruction is currently thought to be closely related to the presence and abundance of lipid mediators, such as leukotriene and thromboxane (TX) A[SUB2]. The novel drug ramatroban, a TXA[SUB2] receptor antagonist, which has been developed by Bayer Yakuhin Ltd. (Osaka, Japan), has been demonstrated, in clinical trials, to improve nasal obstruction in the treatment of patients with allergic rhinitis and it has recently become commercially available. Methods: In the present study, ramatroban was administered for 28 days to 10 patients who were diagnosed with perennial allergic rhinitis but were untreated. Changes in self-reported symptom scores and in vivo allergic reaction parameters were assessed during three observational periods. Results: From baseline scores, all three symptom scores after 28 days treatment with ramatroban declined clearly in all patients, except for one patient who suffered a cold during the study period and had aggravated rhinorrhea and nasal obstruction as a result. The concentrations of histamine and TXB[SUB2] (a metabolite of TXA[SUB2]) in the nasal fluid induced by antigen challenge after the 28 day treatment period also decreased in most subjects compared with concentrations during the pretreatment period. The symptom scores for nasal obstruction during the pretreatment period were correlated with the concentration of TXB[SUB2] in antigen-induced nasal fluid. Conclusions: The present study reconfirmed the clinical efficacy of a post-marketed drug, namely ramatroban, in the treatment of allergic rhinitis. In addition, the results suggest that ramatroban suppressed the secretion of chemical mediators in nasal that are thought to be involved in the allergic reaction in patients with perennial allergic rhinitis. [ABSTRACT FROM AUTHOR]

Background: Statistically significant results of medical intervention trials are not always clinically meaningful. We sought to estimate the minimal clinically important difference (MCID) (the smallest change in a given end-point that is meaningful to a patient) during seasonal alteration of Japanese cedar/cypress pollinosis (JCCP). Methods: Results of a double-blinded, placebo-controlled trial of JCCP patients conducted between 2008 and 2010 were analyzed using an anchor-based method in which a face scale for Japanese rhinoconjunctivitis quality-of-life questionnaire (JRQLQ) was set as an anchor. MICDs were calculated as changes of average scores, including those for naso-ocular symptoms with 5 items in diary cards (T5SS), naso-ocular symptoms with 6 items (T6SS) and QOL with 17 items on the JRQLQ when face scale scores either improved or deteriorated by one point. Results: In 2009 and 2010, 3,698 and 374, respectively, grains/cm² of pollens were dispersed. The MCIDs for T5SS in 2009 and 2010 were 1.426 (0.285 per item) and 1.441 (0.288), respectively. The MCIDs for T6SS were 4.115 (0.686) and 3.183 (0.531) in 2009 and 2010, respectively. The MCIDs for QOL were 10.469 (0.616) and 6.026 (0.354) in 2009 and 2010, respectively. Conclusions: For T5SS in the diary, T6SS and QOL in JRQLQ, unit differences of 1.5 (0.3 per item), 3.6 (0.6) and 8.2 (0.5), respectively, were considered clinically meaningful by JCCP patients. The MCID for symptoms recorded in the diary was stable irrespective of the dispersed pollen level. [ABSTRACT FROM AUTHOR]