Pollen-Blocking Cream May Reduce Symptoms of Allergic Rhinitis

Yael Waknine

August 16, 2004

Aug. 16, 2004 — A pollen-blocking cream reduces symptoms of allergic rhinitis by nearly 60% without causing adverse effects, according to the results of a double-blind, randomized, placebo-controlled, cross-over study published in the August issue of the Archives of Otolaryngology - Head and Neck Surgery.

"The methods for treatment of inhalation allergies vary and may include mechanical measures for pollen reduction and/or different pharmacological agents," writes Swetlana Schwetz, MD, and colleagues, from the Institute of Immunology at the Federal Scientific Research Center in Moscow, Russia. "Medications can lead to various adverse effects, and therefore physicians and patients alike are always seeing safer alternative remedies."

The researchers investigated Dr. Theiss Alergol pollen-blocker cream (Phyt-Immun GmbH; Homburg, Germany) as an alternative treatment for symptoms of allergic rhinitis. The pollen-blocker cream is a petrolatum-based ointment that serves as a mechanical barrier to allergens when applied to the lower nose region.

The study involved 91 patients aged 18 to 55 years, with a minimum two-year history of seasonal or perennial allergic rhinitis as confirmed by history and positive skin test results. Patients were randomly assigned to receive pollen-blocker cream (n = 43) or carboxymethylcellulose in gel as placebo (n = 48), to be applied sparingly to the lower internal nose region four times daily for nine days.

On the first day, a nasal provocation test was used to determine the concentration of allergen extract needed to cause a positive result (baseline), defined as a decrease in nasal airflow of 40% or greater or a symptom score of 3 or higher (scale, 1-6).

On days 2 and 5, usual application of pollen-blocking cream or placebo was followed by a nasal provocation test using baseline allergen concentrations. Changes in nasal airflow were measured by anterior rhinomanometry and nasal symptom severity scores were recorded.

A one-day wash-out period ensued, after which patients were issued the test product not previously used and the testing cycle was repeated under identical conditions.

The pollen-blocker cream was significantly more effective than placebo ( P < .001) in reducing allergy symptoms. The median symptom score decreased to a more significant degree with application of the pollen-blocker cream (4 to 1, 75% difference; P < .001) compared with use of the placebo ointment (4 to 3, 25% difference).

Airflow rates increased significantly (compared with day 1) in response to treatment with both pollen-blocker cream (20%) and placebo (10%), but the pollen-blocker cream was significantly more effective than placebo ( P < .001). "The pollen blocker cream was...able to prevent two thirds of the airflow decrease observed after unprotected allergen provocation," the authors comment.

Overall response to the pollen-blocker cream was good: 50% of patients were classified as good responders, 25% were responders, and another 25% were nonresponders. No adverse events were reported.

Limitations of the study include lack of true placebo (carboxymethylcellulose in gel captured small quantities of pollen) and a priming effect after provocations that lead to a decrease in the symptom score over time with use of each product.

"[The pollen-blocker cream] reduced the airflow decrease after allergen exposure by 66%," the authors point out. "The effect of the placebo ointment was only half as large."

The authors conclude, "[T]his objective assessment clearly demonstrated that...pollen blocker cream is a safe and effective alternative to the drugs normally prescribed for allergic rhinitis in conventional medicine."

Phyt-Immun GmbH, the maker of Dr. Theiss Alergol pollen-blocker cream, funded this study.

Arch Otolaryngol Head Neck Surg. 2004;130:979-984

Reviewed by Gary D. Vogin, MD

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