Efficacy of Proactive Topical Antihistamine Use in Patients with Seasonal Allergic Conjunctivitis

Introduction Topical antihistamines are often instilled symptomatically to control patients’ eye allergy symptoms. The purpose of this study was to evaluate the effectiveness of proactive and as-needed use of antihistamine eye drops in controlling symptoms and to examine whether proactive use may improve quality of life (QOL). Methods This was a prospective, multicenter, cohort study in Japan. We classified 418 patients who had developed certain symptoms and used antihistamine eye drops for 2 weeks into two groups: those who used the drops at the required frequency at a fixed time (proactive use) and those who used them as-needed. The Japanese Allergic and Conjunctival Diseases Quality of Life Questionnaire (JACQLQ) and Ten-Item Personality Inventory were used to evaluate QOL and personality. Participants’ QOL was evaluated using JACQLQ scores after matching of baseline characteristics using propensity score analysis. Results After propensity score matching, 115 “proactive” and 115 “as-needed” patients were analyzed. After treatment, in “as-needed” patients, the overall QOL scale was 1.66 (95% CI 1.55–1.78); in “proactive” patients, the overall QOL scale was 1.34 (95% CI 1.23–1.46) and was significantly improved compared with the “as-needed” patients (analysis of covariance, P = 0.002). Furthermore, proactive use significantly alleviated depression ( P = 0.03). This improvement of QOL was independent of improvement of the clinical sign scores. Conclusion Proactive use of topical antihistamine may serve as an effective means for improving QOL of patients with seasonal allergic conjunctivitis. Trial Registration University Hospital Medical Information Network (UMIN) 000039554.