Cetirizine, loratadine, or placebo in subjects with seasonal allergic rhinitis: Effects after controlled ragweed pollen challenge in an environmental exposure unit☆☆☆★★★

Day, James H.; Briscoe, Maureen P.; Widlitz, Michael D.

doi:10.1016/s0091-6749(98)70172-1

Cited by 100 publications

(75 citation statements)

References 26 publications

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“…Pollen exposure in the environmental exposure unit is an effective, reproducible, safe and suitable method for single-center clinical studies (1320)(1321)(1322)(1323). These exposure units are mostly used to assess the efficacy of antiallergic treatments.…”

Section: Environmental Exposure Unitsmentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,867

1,761

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Section: Environmental Exposure Unitsmentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,867

1,761

View full text Add to dashboard Cite

“…Because of the short window when pollen counts are high, it was only possible to assess the effects of 2 wk of each active therapy. However, this has been shown to be an adequate length of time to achieve the majority of response in patients with antileukotrienes, antihistamines, inhaled and intranasal corticosteroids (13)(14)(15)(16).…”

mentioning

confidence: 99%

Antiasthmatic Effects of Mediator Blockade versus Topical Corticosteroids in Allergic Rhinitis and Asthma

Wilson

Orr

Sims

et al. 2000

Am J Respir Crit Care Med

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To compare the antiasthmatic efficacy of inflammatory mediator blockade versus topical corticosteroid therapy in patients with seasonal allergic rhinitis (SAR) and asthma, 14 patients were enrolled into a single-blind, double-dummy, placebo-controlled crossover study comparing 2 wk therapy of ( 1 ) 400 g orally inhaled budesonide plus 200 g intranasal budesonide (BUD) or ( 2 ) 10 mg oral montelukast plus 10 mg oral cetirizine (ML ϩ CZ). Before each treatment period, patients received 7 to 10 d placebo washout. All treatments were given once daily in the morning. Throughout the study, patients recorded the following domiciliary measures: peak expiratory flow (PEF), rescue inhaler requirement, asthma symptoms, and daily activity score. Laboratory measurements were made at trough of adenosine monophosphate (AMP) bronchial challenge and exhaled nitric oxide (NO). Compared with pooled placebo (PL), there were significant (p Ͻ 0.05) improvements in all domiciliary measures with both treatments (mean PEF [L/min] PL: 463; BUD: 478; ML ϩ CZ: 483). For geometric mean AMP PC 20 (mg/ml), there was an improvement (p Ͻ 0.05), compared with PL (47), for ML ϩ CZ (133) but not for BUD (51); whereas for NO (ppb) there was significant suppression with BUD (7.6) but not ML ϩ CZ (11.5) compared with PL (13.6). In conclusion, both combined mediator blockade and combined topical corticosteroids are equally effective antiasthma therapy in patients with asthma and SAR.Asthma and allergic rhinitis are common conditions, occurring with increasing prevalence, and frequently coexisting (1). Both conditions occur in patients with underlying atopy and have a common etiology and pathophysiology. Untreated rhinitis can result in increased lower respiratory tract inflammation (2) due to a variety of possible mechanisms (3). There is good evidence to show that treating the upper airway inflammation in seasonal allergic rhinitis with intranasal corticosteroids alone has beneficial effect on lower airway inflammation in terms of an improvement in bronchial hyperreactivity (4).Topically delivered inhaled and intranasal corticosteroids are widely recognized as effective anti-inflammatory treatment for both conditions (5, 6). They work by altering gene transcription to increase or decrease a plethora of cytokines, inflammatory mediators and enzymes, and adhesion molecules (7). Histamine and cysteinyl leukotrienes are important inflammatory mediators in the pathogenesis of asthma and allergic rhinitis. With the introduction of leukotriene receptor antagonists it is now possible to selectively block the effects of both of these mediators. This may have a theoretical advantage over corticosteroid therapy as a result of a better adverse effect profile as well as the preference for taking tablets rather than inhalers and nasal sprays.The anti-inflammatory properties of leukotriene receptor antagonists have been shown to exhibit beneficial effects on asthma disease control (8). Antihistamines have been considered to be effective in the management of asthma ...

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“…Several well-controlled trials have compared the efficacy of cetirizine with placebo and/or other H 1 antihistamines in adults and children with SAR and PAR/PER [43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80]. The majority of these trials have been conducted as double-blind, randomized, placebo-controlled, parallel-group studies in large groups of patients recruited from a single or multiple centres.…”

Section: Clinical Trials Of Cetirizine In Armentioning

confidence: 99%

“…severe/very severe symptoms). Although most of the studies in SAR patients were generally conducted during specified pollen seasons, some studies investigated the effects of therapy in specially built exposure chambers, which allowed investigation of controlled pollen allergen-induced symptoms in the absence of naturally occurring confounding factors such as variable airborne pollen levels, multiple pollen/non-pollen airborne allergens, air pollutants, and variable geographic/climatic conditions [59,60,61,62,63,64]. …”

Section: Clinical Trials Of Cetirizine In Armentioning

confidence: 99%

“…The efficacy of therapeutic doses of cetirizine has been compared in several studies with that of therapeutic doses of other commonly employed and newer preparations of SGAHs in adolescent/adult patients with SAR [55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72] and adolescent/adult and paediatric patients with PAR/PER [73,74,75,76,77,78,79,80]. The majority of these studies have compared the effects of the various antihistamines directly with that of cetirizine and/or placebo on the reduction of symptom severity scores, using different composites of the individual symptom scores as the main efficacy measure.…”

Section: Clinical Trials Of Cetirizine In Armentioning

confidence: 99%

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The Clinical Use of Cetirizine in the Treatment of Allergic Rhinitis

2013

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Background: Cetirizine is among the first second-generation H₁ antihistamines (SGAHs) developed to provide selective H₁ receptor inhibition without central nervous system depression. Objective: The aim of this review is to summarize the amount of data collected over 25 years of clinical use of cetirizine and compare this with data available for other SGAHs in the management of patients with allergic rhinitis (AR). Methods: A comprehensive literature search for publications relating to cetirizine was performed using the Pubmed database, and relevant papers published in English were selected for detailed review. Results: Compared with the majority of other SGAHs, cetirizine was generally shown to have a more favourable pharmacological profile, to be well tolerated, be at least equally or more efficacious in attenuating/inhibiting nasal and ocular symptoms and to improve the quality of life in AR patients. The majority of clinical trials investigating the effect of SGAHs in AR patients further indicated that cetirizine was often employed as the main comparator active drug. Conclusion: Based on the evidence that cetirizine is a commonly employed active comparator drug in AR, it is tempting to suggest that cetirizine may be a suitable benchmark in the development of novel pharmacotherapies for AR.

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Cetirizine, loratadine, or placebo in subjects with seasonal allergic rhinitis: Effects after controlled ragweed pollen challenge in an environmental exposure unit☆☆☆★★★

Cited by 100 publications

References 26 publications

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Antiasthmatic Effects of Mediator Blockade versus Topical Corticosteroids in Allergic Rhinitis and Asthma

The Clinical Use of Cetirizine in the Treatment of Allergic Rhinitis

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