OBJECTIVES/HYPOTHESIS: The symptoms of allergic rhinitis result from an immunoglobulin E-dependent mast cell activation cascade, marked by the release of inflammatory mediators, including histamine. Patients with perennial allergic rhinitis also have elevated levels of cysteinyl leukotrienes (CysLTs) in nasal lavage fluid. Histamine and CysLTs produce different responses in the pathogenesis of allergic rhinitis, and this study tested the hypothesis that the effects of combined antihistamine and leukotriene antagonist therapy would be more effective than antihistamine alone. STUDY DESIGN: Multicentered, prospective, randomized, placebo-controlled, parallel-group. METHODS:Three groups totaling 275 patients using: 1) fexofenadine alone, 2) fexofenadine with montelukast, or 3) fexofenadine with placebo, participated in a 21-day trial conducted during the spring pollen season. Objective analysis included pre- and poststudy physical examination findings and nasal resistance measurements. Subjective data gathered included a daily patient diary and pre- and poststudy patient satisfaction measurements. RESULTS: The group using both fexofenadine and montelukast showed significantly better control of nasal congestion both subjectively, using patient diary and visual analog scale evaluations, and objectively, using rhinomanometry and physical examination, compared to groups using antihistamine alone or with placebo. CONCLUSIONS: Our data provided both objective and subjective evidence that leukotrienereceptor antagonist-antihistamine combination therapy is more effective than antihistamine alone in the control of allergic rhinitis symptoms.
RCT Entities:
OBJECTIVES/HYPOTHESIS: The symptoms of allergic rhinitis result from an immunoglobulin E-dependent mast cell activation cascade, marked by the release of inflammatory mediators, including histamine. Patients with perennial allergic rhinitis also have elevated levels of cysteinyl leukotrienes (CysLTs) in nasal lavage fluid. Histamine and CysLTs produce different responses in the pathogenesis of allergic rhinitis, and this study tested the hypothesis that the effects of combined antihistamine and leukotriene antagonist therapy would be more effective than antihistamine alone. STUDY DESIGN: Multicentered, prospective, randomized, placebo-controlled, parallel-group. METHODS: Three groups totaling 275 patients using: 1) fexofenadine alone, 2) fexofenadine with montelukast, or 3) fexofenadine with placebo, participated in a 21-day trial conducted during the spring pollen season. Objective analysis included pre- and poststudy physical examination findings and nasal resistance measurements. Subjective data gathered included a daily patient diary and pre- and poststudy patient satisfaction measurements. RESULTS: The group using both fexofenadine and montelukast showed significantly better control of nasal congestion both subjectively, using patient diary and visual analog scale evaluations, and objectively, using rhinomanometry and physical examination, compared to groups using antihistamine alone or with placebo. CONCLUSIONS: Our data provided both objective and subjective evidence that leukotriene receptor antagonist-antihistamine combination therapy is more effective than antihistamine alone in the control of allergic rhinitis symptoms.
Authors: Sarah K Wise; Sandra Y Lin; Elina Toskala; Richard R Orlandi; Cezmi A Akdis; Jeremiah A Alt; Antoine Azar; Fuad M Baroody; Claus Bachert; G Walter Canonica; Thomas Chacko; Cemal Cingi; Giorgio Ciprandi; Jacquelynne Corey; Linda S Cox; Peter Socrates Creticos; Adnan Custovic; Cecelia Damask; Adam DeConde; John M DelGaudio; Charles S Ebert; Jean Anderson Eloy; Carrie E Flanagan; Wytske J Fokkens; Christine Franzese; Jan Gosepath; Ashleigh Halderman; Robert G Hamilton; Hans Jürgen Hoffman; Jens M Hohlfeld; Steven M Houser; Peter H Hwang; Cristoforo Incorvaia; Deborah Jarvis; Ayesha N Khalid; Maritta Kilpeläinen; Todd T Kingdom; Helene Krouse; Desiree Larenas-Linnemann; Adrienne M Laury; Stella E Lee; Joshua M Levy; Amber U Luong; Bradley F Marple; Edward D McCoul; K Christopher McMains; Erik Melén; James W Mims; Gianna Moscato; Joaquim Mullol; Harold S Nelson; Monica Patadia; Ruby Pawankar; Oliver Pfaar; Michael P Platt; William Reisacher; Carmen Rondón; Luke Rudmik; Matthew Ryan; Joaquin Sastre; Rodney J Schlosser; Russell A Settipane; Hemant P Sharma; Aziz Sheikh; Timothy L Smith; Pongsakorn Tantilipikorn; Jody R Tversky; Maria C Veling; De Yun Wang; Marit Westman; Magnus Wickman; Mark Zacharek Journal: Int Forum Allergy Rhinol Date: 2018-02 Impact factor: 3.858
Authors: Abdel Naser Zaid; Murad N Abualhasan; David G Watson; Ayman Mousa; Nadia Ghazal; Rana Bustami Journal: Drug Des Devel Ther Date: 2015-09-23 Impact factor: 4.162