Corticosteroid-sparing effect of azelastine in the management of bronchial asthma.

Busse, William W.; Middleton, Elliott; Storms, William W.; Dockhorn, Robert J.; Chu, Theodore J.; Grossman, Jay; Weiler, John M.; Bronsky, Edwin A.; Mansfield, Lyndon E.; Bell, Thomas D.; Hemsworth, George R.; Perhach, James L.; D'eletto, T. A.; Dam, Anup

doi:10.1164/ajrccm.153.1.8542104

Cited by 46 publications

(22 citation statements)

References 18 publications

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“…Information on major study characteristics of the 19 studies retrieved for our meta-analysis is presented in table 2. All degrees of asthma severity were present, from pollen-induced asthma [21,31,36] to steroid-sparing studies (oral corticosteroids [27]; inhaled corticosteroids [23]). Asthma was usually defined by a history of reversible airflow obstruction, with impaired lung function that improved considerably after use of inhaled bronchodilators.…”

Section: Resultsmentioning

confidence: 99%

Effects of antihistamines in adult asthma: a meta-analysis of clinical trials

Ganse¹,

Kaufman²,

Derde³

et al. 1997

Eur Respir J

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A meta-analysis of clinical trials of antihistamines was performed to assess the risk-benefit ratio of this therapeutic class in asthma. Double-blind randomized placebo-controlled trials assessing lung function changes under repeated use of antihistamine in adult asthma were selected, and the quality of studies was scored. Morning peak expiratory flow rate (PEFR) was the primary outcome: an effect size was computed for each study, with a 95% confidence interval (95% CI), and a mean effect size was computed, combining all studies. Effect sizes were also determined for secondary outcomes: evening PEFR, forced expiratory volume in one second (FEV1) and daily use of inhaled β-agonists.Nineteen studies were included in the meta-analysis. Mean quality score of studies was 59.4%; asthma was generally uncontrolled at study inclusion. Altogether, 582 antihistamine-treated and 557 placebo-treated asthma patients were evaluable. Antihistamines had little effect on airway calibre (mean increase in morning PEFR: 13 L·min -1 ; 95 CI: 8-18 L·min -1 ) and on use of inhaled β-agonists (mean reduction in daily use: 0.4 doses; 95% CI: 0-0.8 doses). Sedation occurred more often with antihistamines than with placebo (p<0.001); additional side-effects were mentioned, including weight gain, altered taste, headache and dry mouth.Respiratory and systemic effects observed after repeated use of antihistamines do not support the use of these medications in the treatment of asthma; better designed studies could affect this appraisal.

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Section: Resultsmentioning

confidence: 99%

Effects of antihistamines in adult asthma: a meta-analysis of clinical trials

Ganse¹,

Kaufman²,

Derde³

et al. 1997

Eur Respir J

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“…Likewise, H 1 R blocker azelastine reduced the frequency of administration of inhaled corticosteroids without loss of pulmonary function in a clinical trial with patients with chronic asthma (Busse et al, 1996).…”

Section: Histaminergic Regulation Of the Signaling Of Other Receptorsmentioning

confidence: 98%

Current Knowledge and Perspectives on Histamine H₁and H₂Receptor Pharmacology: Functional Selectivity, Receptor Crosstalk, and Repositioning of Classic Histaminergic Ligands

Monczor

Fernández

2016

Mol Pharmacol

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H 1 and H 2 histamine receptor antagonists, although developed many decades ago, are still effective for the treatment of allergic and gastric acid-related conditions. This article focuses on novel aspects of the pharmacology and molecular mechanisms of histamine receptors that should be contemplated for optimizing current therapies, repositioning histaminergic ligands for new therapeutic uses, or even including agonists of the histaminergic system in the treatment of different pathologies such as leukemia or neurodegenerative disorders. In recent years, new signaling phenomena related to H 1 and H 2 receptors have been described that make them suitable for novel therapeutic approaches. Crosstalk between histamine receptors and other membrane or nuclear receptors can be envisaged as a way to modulate other signaling pathways and to potentiate the efficacy of drugs acting on different receptors. Likewise, biased signaling at histamine receptors seems to be a pharmacological feature that can be exploited to investigate nontraditional therapeutic uses for H 1 and H 2 biased agonists in malignancies such as acute myeloid leukemia and to avoid undesired side effects when used in standard treatments. It is hoped that the molecular mechanisms discussed in this review contribute to a better understanding of the different aspects involved in histamine receptor pharmacology, which in turn will contribute to increased drug efficacy, avoidance of adverse effects, or repositioning of histaminergic ligands.

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“…Drugs administered by the oral route may have an effect on both nasal and bronchial symptoms (2027). Oral H 1 -antihistamines represent the first-line treatment of allergic rhinitis but although studies have found some effect on asthma symptoms (1942,(2028)(2029)(2030), many negative studies are unpublished and pulmonary function tests are unchanged. These drugs are not recommended for the treatment of asthma (2031,2032).…”

Section: Therapeutic Consequencesmentioning

confidence: 99%