Treatment of hay fever in relation to asthma, in children.

Therapeutic intervention for mild or intermittent AR includes antihistamines or intranasal corticosteroids (INCS). Both types of drug have certain benefits and it is unclear which of the two are more effective and preferred by younger patients (children aged 6 to 18 years old). Besides, the patients tend to use INCS when they have complaints instead of continuously during the hay fever season, as prescribed by the GP. This could also influence the effectiveness of INCS.
Allergic rhinitis (AR) and asthma are considered manifestations of the same origin affecting different parts of the respiratory tract. It has been suggested that adequate treatment of AR might be beneficial for the lower airways. Whereas INCS and perhaps antihistamines may be a promising additive treatment to reduce asthma symptoms in patients with rhinitis and mild asthma, more research is needed.
In this randomized controlled singleblind trail we will select children (6-18 years old) with seasonal AR (hay fever) under treatment by the general practitioner. During the hay fever season children will get either antihistamines on demand, INCS on demand or INCS continuously. We will compare the percentage of (nose and eye) symptom free days during the pollen season and the effect of treatment on asthma symptoms and control.

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Patients have to fill in an online diary on a daily basis for 3 months. During these 3 months several questionnaires will be conducted. The measure points will be at the start, halfway ( 6 weeks) and at the end of the study.

Children will receive medication for a period of 3 months during the hay fever season. This medication can be taken in three different schedules:

1. Levocetrizine, 5mg, if necessary;

2. Fluticason, 50mcg, 1 or 2 sprays a day in each nostril, when necessary;

3. Fluticason, 50mcg, 1 or 2 sprays in each nostril, daily.