Summary This study was undertaken in order to develop a method for comparing the value of different forms of treatment for hay fever. A cross‐over trial was carried out in sixty‐one patients, comparing four treatments: topical corticosteroids, topical cromoglycales, placebo tablets and oxatomide (a new oral treatment with antihistamine and cromoglycate‐like properties). Three methods were used to compare these treatments: (1) post‐treatment symptom questionnaires; (2) daily analogue line scores of symptoms; and (3) nasal FEV1. Of these, daily analogue line diary scores, with an analysis which took into account variation in pollen count, proved to be the most sensitive. By employing this diary method, it was shown that all three active treatments were significantly better than placebo and that topical corticosteroids were significantly better than topical cromoglycates. The activity of oxatomide was found to be not significantly different from that of steroids or cromoglycate, but it was associated with more frequent side‐effects. It is suggested that daily diaries, combining symptom relief and freedom from side effects into a single score of ‘usefulness’ adjusted for pollen count, are suitable means for comparing treatments for hay fever.

The antivasoconstrictor activity of the drugs cinnarizine and flunarizine is considered in relation to their inhibitory action on calcium ion flux mechanisms. Their clinical efficacy in peripheral vascular disease is reviewed, and the possible mode of action of the two drugs is discussed in relation to their described pharmacologic effects.

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1 Cinnarizine, an inhibitor of calcium ion transport across smooth muscle cell membrane, has been shown to exert an anti‐asthmatic effect in patients with chronic asthma. 2 It is postulated that antagonism to calcium ion transport across the mast cell membrane may cause the compound to have a pharmacological effect similar to sodium cromoglycate. 3 Cinnarizine is orally active and its therapeutic effect is demonstrated in a double‐blind, cross‐over, placebo controlled study. 4 Patient benefit was shown by a significant improvement in peak flow rate. A non‐significant trend towards a reduction in symptomatic bronchodilator usage and a decrease in asthma symptom score was also shown. 5 It is concluded that cinnarizine could well prove to be the first of a new family of anti‐asthmatic drugs offering a protective effect when taken systemically.

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