Effect of topical levocabastine on allergic and non‐allergic perennial rhinitis

Abstract

Forty-four patients, with symptoms of nasal obstruction, sneezing, itching and/or rhinorrhea, were entered into a placebo-controlled, double-blind study to evaluate the clinical efficacy of a topical antihistamine drug, levocabastine, applied 4 times a day for 14 days. At the end of the treatment the placebo patients were treated with levocabastine and the levocabastine patients were treated with beclomethasone dipropionate in a single-blind design for another 14 days. This study showed that levocabastine is significantly more active than placebo with reference to nasal discharge and sneezing. Placebo application improved the symptom score. Levocabastine could not be proved to be more effective against nasal obstruction than placebo in the double-blind trial. In the single-blind set-up, levocabastine resulted in an additional improvement in the score for obstruction, after the placebo period. Although the allergic group tended to respond better, no statistically significant difference could be detected between allergic and non-allergic patients. After treatment with levocabastine, beclomethasone dipropionate administration could not improve the results for nasal discharge and sneezing. For nasal congestion, beclomethasone dipropionate proved to be superior to levocabastine.

The Role of Antihistamines in the Treatment of Vasomotor Rhinitis

“…Levocabastine was found to be superior to placebo for symptoms of nasal discharge and sneezing but not for congestion in the VMR group [25]. …”

“…These effects could clearly have a salutary effect on nasal symptoms. It has been shown that at least some patients with VMR demonstrate inflammatory infiltrates in the nasal mucosa [22-25]. Therefore, it would not be unreasonable to assume that inhibition of the inflammatory activity resulting in these infiltrates could be responsible for the improvement in VMR symptoms shown in at least one double-blind placebo-controlled study [2].…”

The Role of Levocabastine in the Treatment of Allergic Rhinoconjunctivitis

“…Consequently, treatment with an intranasal steroid or a topical or oral decongestant may be indicated in addition to antihistamine therapy if nasal congestion becomes severe. Indeed, addition of intranasal steroid has been shown to provide significantly greater relief from nasal congestion in patients already receiving levocabastine nasal spray 39 …”

“…Patients' mean symptom scores (0=absent to 7=severe) at baseline and after treatment with levocabastine nasal spray for 2 weeks followed by beclomethasone dipropionate nasal spray for 2 weeks ( * = P <0.05; ** = P <0.001 vs baseline 39 )…”

“…The efficacy of treatment with an intranasal steroid as add‐on therapy in patients already receiving levocabastine nasal spray was evaluated in a double‐blind trial in a total of 44 patients with allergic rhinitis 39 . Addition of intranasal beclomethasone dipropionate to the topical antihistamine resulted in a significant improvement in the severity of nasal congestion but produced no additional effect on the severity of sneezing and rhinorrhoea compared with treatment with levocabastine nasal spray alone (Figure 3).…”