Effects of intranasal azelastine on the response to nasal allergen challenge.

Abstract

OBJECTIVES/HYPOTHESIS:

Azelastine, a second-generation H1-receptor antagonist, is available for topical administration. The aim of the study was to evaluate the effects of topical intranasal azelastine on the early-phase and the late-phase allergic responses and on nasal hyper-responsiveness to methacholine.

STUDY DESIGN:

Double-blind, placebo-controlled, two-way crossover study in 20 subjects with seasonal allergic rhinitis, out of their allergy season.

METHODS:

Subjects were randomly assigned to receive either placebo or two puffs of azelastine twice a day (548 microg/d) for 2 weeks followed by nasal challenge with allergen. Twenty-four hours later, while still receiving treatment, subjects underwent a nasal lavage and a nasal challenge with methacholine. End points included symptom scores, levels of mediators and number of eosinophils in nasal lavages, and the weight of secretions after methacholine challenge.

RESULTS:

Compared with placebo, treatment with intranasal azelastine resulted in significant reductions in allergen-induced sneezing, rhinorrhea, itching, nasal congestion, and levels of albumin during the early-phase response (P <.05). Azelastine had no effect on levels of histamine or tryptase during the early-phase response. There was a significant eosinophil influx 24 hours after challenge, which was not inhibited by azelastine. Treatment with azelastine had no effect on the levels of albumin, interleukin-4, interleukin-5, intercellular adhesion molecule-1, tumor necrosis factor-alpha, and eosinophil cationic protein during the late-phase response. However, azelastine did show a significant inhibitory effect on the methacholine response 24 hours after nasal allergen challenge (P <.05).

CONCLUSIONS:

The effects of intranasal azelastine are similar to those of oral second-generation antihistamines.

• Authors: Supinda Saengpanich, Paraya Assanasen, Marcy deTineo, Lauran Haney, Robert M Naclerio, Fuad M Baroody
• Journal: The Laryngoscope (Laryngoscope) Vol. 112 Issue 1 Pg. 47-52 (Jan 2002) ISSN: 0023-852X [Print] United States
• PMID: 11802037 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Inflammation Mediators
• Phthalazines
• Methacholine Chloride
• azelastine

Topics

• Adult
• Cross-Over Studies
• Double-Blind Method
• Female
• Humans
• Inflammation Mediators (metabolism)
• Male
• Methacholine Chloride
• Nasal Lavage Fluid (immunology)
• Nasal Provocation Tests
• Phthalazines (administration & dosage)
• Rhinitis, Allergic, Seasonal (diagnosis, drug therapy, immunology)
• Treatment Outcome