Seasonal rhinitis and azelastine: long- or short-term treatment?

Abstract

BACKGROUND:

Azelastine is a topical antihistamine, clinically demonstrated to be effective in allergic rhinitis.

OBJECTIVE:

We evaluated the clinical efficacy and the antiallergic activity of azelastine nasal spray, administered 0.56 mg per day, 0.28 mg per day, or on demand over a 3-month period during natural allergen exposure, in a double-blind, placebo-controlled fashion.

METHODS:

Thirty patients, sensitized to grass or Parietaria pollen, were allocated to three treatment groups: those receiving the standard dosage (0.14 mg/nostril two times a day), half the dosage (0.07 mg/nostril two times a day), or placebo daily for 3 months. All patients were allowed to take additional doses of azelastine when needed. Evaluation parameters were as follows: clinical symptoms recorded on a diary card, number of additional, on-demand azelastine puffs, nasal inflammatory cell count, intercellular adhesion molecule-1 expression on nasal epithelial cells, and pollen count.

RESULTS:

This study showed the following: (1) the half dose (0.28 mg/day) and the standard dose (0.56 mg/day) were equally effective in reducing clinical symptoms (p = NS), although the standard dosage required fewer additional puffs during times of peak pollen counts (p < 0.05); (2) both dosages were able to reduce the allergic inflammation (p < 0.05 vs placebo); and (3) on-demand use achieved acceptable clinical control but did not significantly reduce allergic inflammation.

CONCLUSION:

Continuous treatment was more effective than on-demand use as assessed by both clinical evaluation and antiinflammatory action.

• Authors: G Ciprandi, V Ricca, G Passalacqua, T Truffelli, C Bertolini, N Fiorino, A M Riccio, M Bagnasco, G W Canonica
• Journal: The Journal of allergy and clinical immunology (J Allergy Clin Immunol) Vol. 99 Issue 3 Pg. 301-7 (Mar 1997) ISSN: 0091-6749 [Print] United States
• PMID: 9058684 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Histamine H1 Antagonists
• Phthalazines
• Intercellular Adhesion Molecule-1
• azelastine

Topics

• Administration, Intranasal
• Adolescent
• Adult
• Double-Blind Method
• Epithelial Cells
• Epithelium (immunology)
• Female
• Histamine H1 Antagonists (administration & dosage, adverse effects, therapeutic use)
• Humans
• Immunohistochemistry
• Intercellular Adhesion Molecule-1 (analysis)
• Leukocyte Count
• Male
• Medical Records
• Middle Aged
• Nasal Mucosa (cytology, drug effects, immunology)
• Neutrophils (drug effects, immunology)
• Phthalazines (administration & dosage, adverse effects, therapeutic use)
• Pollen (immunology)
• Radioallergosorbent Test
• Rhinitis, Allergic, Seasonal (drug therapy)
• Skin Tests