Comparison of morning vs. evening intranasal mometasone furoate for SAR

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Created On: 24/07/2026

Seasonal allergic rhinitis (SAR) commonly impairs nasal function, sleep quality, daytime alertness, and overall quality of life.

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Key take away

Morning and evening once-daily intranasal mometasone furoate exhibit comparable efficacy in improving nasal symptoms, sleep quality, daytime sleepiness, and quality of life in patients with moderate-to-severe seasonal allergic rhinitis.

Background

Seasonal allergic rhinitis (SAR) commonly impairs nasal function, sleep quality, daytime alertness, and overall quality of life. Although chronotherapy has been proposed to optimize treatment outcomes, evidence regarding the ideal timing of once-daily intranasal corticosteroid (INCS) administration remains limited. This study evaluated whether morning or evening dosing of intranasal mometasone furoate influences clinical efficacy in SAR.

Method

This prospective, randomized, single-blind study enrolled 120 adults with moderate-to-severe SAR. Participants received intranasal mometasone furoate 200 μg once daily either in the morning or the evening for 15 days. Clinical outcomes were assessed using the Total Nasal Symptom Score (TNSS), Rhinitis Quality of Life Scale (RQLS), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Baseline-adjusted comparisons between treatment groups were performed via analysis of covariance (ANCOVA).

Result

Both morning and evening treatment groups illustrated remarkable improvements from baseline in nasal symptoms, sleep quality, daytime sleepiness, and rhinitis-related quality of life following 15 days of therapy. After adjustment for baseline values using ANCOVA, no vital differences were observed between morning and evening administration for any efficacy outcome (all P > .05). Baseline disease severity was identified as the strongest predictor of post-treatment outcomes, accounting for a substantial proportion of the variability in clinical response, whereas the timing of mometasone furoate administration did not produce any clinically meaningful differences.

Conclusion

Once-daily intranasal mometasone furoate provided equivalent clinical benefits when administered either in the morning or the evening in adults with moderate-to-severe SAR. Flexible morning or evening administration could therefore be adopted according to patient preference while maintaining therapeutic potency.