Three injectable corticosteroids, betamethasone dipropionate, beta-methasone disodium phosphate and betamethasone acetate, and methylprednisolone acetate, were compared for onset and duration of action in patients with severe seasonal allergic rhinoconjunctivitis. The sixty patients who were entered into the trial had been well-studied in our allergy clinic. They were assigned, on the basis of a random number code, to treatment with one of the corticosteroids. Following a single intramuscular injection with one of the preparations, plasma cortisol and blood glucose concentrations also were compared at days 1, 2--3, 5--7 and 14. All three preparations improved the nasal symptoms. There were no individual differences with respect to onset or to duration of action. However, there were some differences in the effects on endogenous cortisol production and on blood glucose levels. Two of the preparations, betamethasone dipropionate and methylprednisolone acetate, suppressed endogenous cortisol for more than 14 days, while betamethasone phosphate/acetate did not suppress cortisol beyond 12 days. Beta-methasone dipropionate produced a moderate increase in blood glucose concentrations for the first two days after administration; betamethasone phosphate/acetate caused an increase for one day and methylprednisolone acetate had no effect.

The efficacy and tolerability of diclofenac suppositories given pre and/or post-operatively were investigated in a randomized double-blind study on 99 patients undergoing tonsillectomy. In one group, 50 mg diclofenac was given 1 h preoperatively, followed by 50 mg directly after the operation. In another group, diclofenac 100 mg was given only immediately post-operatively. A significantly lower consumption of rescue analgesics (paracetamol and/or pethidine) was found in the group treated preoperatively with diclofenac and the average time until first demand of rescue analgesics was significantly longer compared to the group given diclofenac post-operatively only. The tolerance was good and no serious bleeding complications occurred in either group. In the treatment of post-operative pain after tonsillectomy, the combination of pre and post-operative administration of diclofenac suppositories resulted in significantly lower consumption of rescue analgesics and is thus preferable to administration solely post-operatively.

This multicentre, double-blind, randomized parallel-group study compared 3 weeks' treatment with either loratadine (Clarityn) 10 mg once daily, or clemastine (Tavegyl) 1 mg twice daily, and placebo in outpatients with active perennial allergic rhinitis. 155 patients were evaluated for efficacy and safety. Grading of four nasal and three non-nasal symptoms, rhinoscopy signs, and therapeutic response was performed on treatment days 6, 13, and 20. Patients recorded daily symptoms and possible adverse experiences in a diary, also indicating when symptoms of active rhinitis were relieved. Loratadine and clemastine were statistically significantly superior to placebo throughout the study (P less than 0.05), based on assessment of patients' nasal and eye symptoms, patients' diary scores, rhinoscopy signs of symptoms, and onset of relief. The loratadine group showed a statistically significantly (P less than 0.05) faster onset of relief of symptoms compared with the group treated with clemastine. Concerning nasal stuffiness, loratadine was significantly (P less than 0.05) superior to clemastine after 1 week's treatment. Reports of adverse reactions showed that significantly (P less than 0.05) more patients complained of sedation in the clemastine than in the loratadine group. Regarding other adverse experiences and laboratory tests, the three treatment groups were statistically comparable (P less than 0.05). The study showed that compared with placebo both loratadine and clemastine were effective in relieving nasal and eye symptoms in patients with perennial allergic rhinitis. Loratadine was safe and well tolerated and was significantly less sedative than clemastine; loratadine may therefore possess an advantage in clinical use in the treatment of perennial allergic rhinitis.

The efficacy and safety of loratadine, a new orally active specific H1-receptor blocking antihistamine with poor penetration into the CNS, was evaluated in a double blind comparative study. One hundred and seven hay fever patients, sensitive to birch pollen, were randomized into three parallel groups receiving loratadine 40 mg once daily, clemastine 1 mg twice daily, or placebo during the birch pollen season. Both active treatments showed reduction of symptoms in comparison with placebo, but the results were more pronounced with loratadine treatment, which significantly reduced the overall allergic condition as well as all separate allergic rhino-conjunctivitis symptoms except nasal stuffiness. Compared with placebo the sedation rate was significantly higher with clemastine treatment (P less than 0.05) but not with loratadine. Loratadine was thus concluded to be efficacious in hay fever treatment with a sedation rate not differing from placebo.

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