Abstract | BACKGROUND: OBJECTIVE: METHODS: MEDLINE and EMBASE were searched for nasal challenge studies and clinical trials published in English between January 1, 1991, and January 31, 2009, using the following terms, alone or in combination: antihistamines, second-generation antihistamines, allergic rhinitis, intermittent allergic rhinitis, perennial allergic rhinitis, persistent allergic rhinitis, seasonal allergic rhinitis, nasal challenge, nasal blockage, and nasal congestion. Studies that were not active or placebo controlled, that did not evaluate change in nasal congestion scores, or that focused on treatments other than desloratadine, fexofenadine, and levocetirizine for nasal congestion associated with AR were excluded. RESULTS: Twenty-six clinical trials met the criteria for inclusion in the review. In 11 placebo-controlled trials that included objective assessment of nasal congestion, desloratadine, fexofenadine, and levocetirizine were associated with reductions in the severity of nasal congestion through maintenance of nasal airflow. The mean AUC for nasal airflow over 6 hours was significantly greater with desloratadine compared with placebo in 3 studies (P < 0.05); placebo-controlled trials of fexofenadine and levocetirizine had similar results. In 25 placebo- and active-controlled trials that reported subject-rated symptom scores, the 3 newer antihistamines were efficacious in the treatment of nasal congestion associated with AR. In 10 trials that reported objective and/or subjective measures, desloratadine was associated with significant improvements in nasal congestion compared with placebo (P < or = 0.05), beginning as early as the first 2 hours after allergen challenge. Fexofenadine was associated with significantly lower nasal congestion scores compared with placebo in 4 studies (P <- 0.05); nasal congestion scores were significantly reduced with levocetirizine in 3 placebo-controlled trials (P < or = 0.005). CONCLUSIONS:
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Authors | Claus Bachert |
Journal | Clinical therapeutics
(Clin Ther)
Vol. 31
Issue 5
Pg. 921-44
(May 2009)
ISSN: 0149-2918 [Print] United States |
PMID | 19539095
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
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Chemical References |
- Histamine H1 Antagonists, Non-Sedating
- levocetirizine
- Loratadine
- Terfenadine
- fexofenadine
- desloratadine
- Cetirizine
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Cetirizine
(therapeutic use)
- Child
- Clinical Trials as Topic
- Female
- Histamine H1 Antagonists, Non-Sedating
(therapeutic use)
- Humans
- Loratadine
(analogs & derivatives, therapeutic use)
- Male
- Middle Aged
- Nasal Obstruction
(drug therapy, etiology)
- Rhinitis, Allergic, Seasonal
(complications, drug therapy)
- Terfenadine
(analogs & derivatives, therapeutic use)
- Treatment Outcome
- Young Adult
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