We studied the efficacy and side effects of the H1-antihistamine
astemizole in perennial
rhinitis. We also defined subgroups of responders and examined the added effect of a
steroid spray. Fifty-five adults completed
a 10- to 14-week controlled trial.
Astemizole reduced the number of sneezes to 41% (p less than 0.001) and the number of nose blowings to 55% (p less than 0.001) of the placebo values. The added use of
beclomethasone dipropionate caused a further reduction to 14% (p less than 0.001) and 37% (p less than 0.05), respectively.
Nasal blockage was only marginally affected by the
antihistamine, but it was reduced to 64% by the
steroid spray (p less than 0.001). "Sneezers" responded better to the
antihistamine than "blockers," with "nose blowers" in an intermediate position. The effect was equal in allergic and nonallergic patients.
Astemizole was completely nonsedative but increased appetite and
body weight. An open 1-year study of 17 patients demonstrated that
astemizole maintained its efficacy and that further
weight gain did not occur. It is concluded that
astemizole is a highly effective nonsedative H1-antihistamine suitable for continuous
therapy of perennial
rhinitis.