Loteprednol etabonate nasal spray, at a dose of 400 micrograms daily, is more effective than placebo in controlling the symptoms of hay fever, or seasonal allergic rhinitis, according to a report in the March issue of Allergy.

Loteprednol, sold under the trade name Lotemax or Alrex, is one of the first members of a drug class called “soft steroids,” modified versions of traditional steroids. The soft steroids are designed to improve the risk/benefit ratio seen with the older steroids.

Dr. Norbert Krug, from Fraunhofer Institute of Toxicology and Experimental Medicine in Hannover, Germany, and colleagues measured seasonal allergic rhinitis symptoms in 165 patients who were randomly assigned to receive loteprednol nasal spray, at 100, 200, or 400 microgram daily doses, or placebo for 14 days. Allergy testing with grass pollen was performed several times during the study.

The 400-microgram dose of loteprednol significantly reduced the total nasal symptom score compared with placebo, whereas the lower doses of the drug did not, the investigators found.

In terms of specific symptoms, loteprednol 400 micrograms outperformed placebo in reducing runny nose, nasal congestion and itching, and improving nasal flow.

Loteprednol was well tolerated at all of the doses tested and the side effects were similar to that seen with placebo, the investigators note.

Based on these findings, the authors conclude that 400 micrograms appears to be the best loteprednol dose for treating seasonal allergic rhinitis in future clinical trials.

SOURCE: Allergy, March 2005.