A controlled study on the effectiveness of loratadine in combination with flunisolide in the treatment of nonallergic rhinitis with eosinophilia (NARES)

Purello-D'Ambrosio, F; Isola, S.; Ricciardi, L; Gangemi, Sebastiano; Barresi, Luca; Gf, Bagnato

doi:10.1046/j.1365-2222.1999.00598.x

Cited by 30 publications

(19 citation statements)

References 22 publications

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“…However, this effect seems to be present only at low but significant inhibitory doses of MF. To some extent, these findings agree with clinical trials in which it has been demonstrated improvements in the sneezing [27], rhinorrhoea [27], total symptom score [28], nasal itching [28] and total nasal symptom score [29] when combining different corticosteroids and antihistamines in the treatment of allergic and non-allergic rhinitis.…”

Section: Discussionsupporting

confidence: 86%

“…In the same line, it has been reported that loratadine improved the effect of a corticosteroid in the treatment of non-allergic rhinitis with eosinophilia decreasing eosinophil counts in nasal smears [27] and nasal sneezing in seasonal allergic rhinitis [26]. …”

Section: Discussionmentioning

confidence: 99%

“…In fact, some studies with patients suffering from AR demonstrated no additional benefit when MF where used in combination with loratadine [26], while others found significant improvement when using the combination of flunisolide with loratadine [27], fluticasone with cetirizine [28] and MF with DL [29]. However, no study has yet reported the additive anti-inflammatory effect of antihistamines and corticosteriods.…”

Section: Introductionmentioning

confidence: 99%

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Mometasone and desloratadine additive effect on eosinophil survival and cytokine secretion from epithelial cells

et al. 2011

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BackgroundAlthough antihistamines and topical corticosteroids are used in combination to treat allergic rhinitis, their additive effect has not been yet demonstrated. The aim was investigate the antiinflammatory additive effect of mometasone and desloratadine on cytokine and sICAM-1 secretion by epithelial cells, and on eosinophil survival stimulated by human epithelial cells secretions from nasal mucosa and polyps.MethodsEpithelial cells obtained from nasal mucosa or polyps were stimulated with 10% fetal bovine serum in presence of mometasone (10-11M-10-5M) with/without desloratadine (10-5M). Cytokine and sICAM-1 concentrations in supernatants were measured by ELISA. Peripheral blood eosinophils were incubated during 4 days with epithelial cell secretions with (10-11M-10-5M) and/or desloratadine (10-5M) and survival assessed by Trypan blue. Results are expressed as percentage (mean ± SEM) compared to control.ResultsFetal bovine serum stimulated IL-6, IL-8, GM-CSF and sICAM-1 secretion. In mucosa and polyp epithelial cells, mometasone inhibited this induced secretion while desloratadine inhibited IL-6 and IL-8. The combination of 10-5M desloratadine and 10-9M mometasone reduced IL-6 secretion (48 ± 11%, p < 0.05) greater extent than mometasone alone (68 ± 10%) compared to control (100%). Epithelial cell secretions induced eosinophil survival from day 1 to 4, this effect being inhibited by mometasone. At day 4, the combination of mometasone (10-11M) and desloratadine (10-5M) provoked an increased inhibition of eosinophil survival induced by cell secretions (27 ± 5%, p < 0.01) than mometasone (44 ± 7%) or desloratadine (46 ± 7%) alone.ConclusionsThese results suggest that the combination of desloratadine and mometasone furoate have a greater antinflammatory effect in an in vitro model of eosinophil inflammation than those drugs administered alone.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mometasone and desloratadine additive effect on eosinophil survival and cytokine secretion from epithelial cells

et al. 2011

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“…Occasionally, intermittent use of oral glucocorticoid may be required to control symptomology [3••]. Administration of antihistamines in combination with corticosteroids may be clinically effective because of the different mechanism of action of the two drugs [44] Specific evaluations of various treatments for NARES are uncommon, but those controlled trials that have been completed are summarized here.…”

Section: Treatmentmentioning

confidence: 99%

Nonallergic rhinitis with eosinophilia syndrome

Ellis¹,

Keith

2006

Curr Allergy Asthma Rep

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Nonallergic rhinitis with eosinophilia syndrome (NARES) is a clinical syndrome comprising symptoms consistent with allergic rhinitis in which an absence of atopy has been demonstrated by allergen skin testing, and nasal cytology analysis demonstrates more than 20% eosinophils. Anosmia is a prominent feature not shared with allergic rhinitis. The pathophysiology of NARES is poorly understood, but a key component involves a self-perpetuating, chronic eosinophilic nasal inflammation with development of nasal micropolyposis and polyposis. Mast cells likely play an important role as well. NARES is a risk factor for the development of nasal polyposis and aspirin sensitivity, as well as obstructive sleep apnea. Treatment consists mainly of intranasal corticosteroids with or without the addition of second-generation antihistamines and/or leukotriene-receptor antagonists.

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“…5 Also, a single placebocontrolled study comparing flunisolide with a combination of flunisolide and loratadine found that the INS-antihistamine combination was superior to INS alone in reducing both sneezing and rhinorrhea in a group of patients with NARES. 79 Use of first-generation antihistamines might be potentially helpful in reducing rhinorrhea by virtue of their anticholinergic activity.…”

Section: Role Of Oral Antihistamines In the Treatment Of Pnarmentioning

confidence: 99%

Pharmacologic rationale for treating allergic and nonallergic rhinitis

Greiner

Meltzer

2006

Journal of Allergy and Clinical Immunology

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A controlled study on the effectiveness of loratadine in combination with flunisolide in the treatment of nonallergic rhinitis with eosinophilia (NARES)

Abstract: Loratadine improves the effectiveness of flunisolide in treatment of NARES with no change in safety, and with no sedation.

Cited by 30 publications

References 22 publications

Mometasone and desloratadine additive effect on eosinophil survival and cytokine secretion from epithelial cells

Mometasone and desloratadine additive effect on eosinophil survival and cytokine secretion from epithelial cells

Nonallergic rhinitis with eosinophilia syndrome

Pharmacologic rationale for treating allergic and nonallergic rhinitis

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