Comparative efficacy, safety, and effect on quality of life of triamcinolone acetonide and fluticasone propionate aqueous nasal sprays in patients with fall seasonal allergic rhinitis

Gross, Gary N.; Jacobs, Robert L.; Woodworth, Thomas H.; Georges, George; Lim, Janet

doi:10.1016/s1081-1206(10)61911-4

Cited by 36 publications

(34 citation statements)

References 11 publications

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“…The latter assessed 5 symptoms (nasal congestion/blockage, rhinorrhea, sneezing, nasal itch, and postnasal drip) on an integer scale of 0 to 3. 3,23 Zero represented absent symptoms; 1, trivial, and not bothersome; 2, bothersome but not disabling or intolerable; and 3, disabling and/or intolerable.…”

Section: Methodsmentioning

confidence: 99%

Central Nervous System Side Effects of First- and Second-Generation Antihistamines in School Children With Perennial Allergic Rhinitis: A Randomized, Double-Blind, Placebo-Controlled Comparative Study

Chong

Wong

et al. 2004

Pediatrics

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ABSTRACT. Objective. Allergic rhinitis is common and on the rise. Antihistamines are the mainstay of treatment and are the most commonly prescribed drugs in Singapore. Treatment-related sedation and its effect on cognition are a major concern. First-and second-generation antihistamines show varying degrees of sedation, but to date, objective studies in children are lacking. The objective of this study was to assess the sedating effect of cetirizine (second-generation antihistamine) and chlorpheniramine (first-generation antihistamine) compared with placebo using an objective neurophysiological test.Methods. This was a prospective, double-blind, placebo-controlled, randomized, single-dose, 3-way crossover study. Twenty-four children aged 7 to 14 years with allergic rhinitis completed the study. All children were randomly allocated to medication sequences and received 3 different drugs on 3 different days, at least 1 week apart. The P300 event-related potential was used as an objective test of sedation. Subjective assessment was by a visual analog scale.Results. Chlorpheniramine and cetirizine increased P300 latency when compared with baseline. No significant increase was obtained with placebo. The significant increase in P300 latency was not accompanied by significant change in subjective somnolence as measured by the visual analog scale.Conclusion. We have shown that cetirizine has sedative properties in children. The lack of correlation between P300 latency and the visual analog scale indicates that sedation induced by these drugs may not be subjectively noted. Pediatrics 2004;113:e116 -e121. URL: http: //www.pediatrics.org/cgi/content/full/113/2/e116; sedation, cetirizine, chlorpheniramine, P300 event-related potential.ABBREVIATIONS. CNS, central nervous system; ERP, event-related potential; VAS, visual analog scale; Fz , frontal location; Cz, central location; Pz, parietal location; T max , time to peak plasma drug concentration.A llergic rhinitis is on the increase worldwide as well as in Singapore. A 1994 survey showed the prevalence of rhinitis in Singapore children to be at a staggering 44%. 1 In children with allergic rhinitis, inadequate symptom control may contribute to learning impairment; school absences; poor quality of life; and emotional, social, or behavioral disturbances. 2 Oral antihistamines are the mainstay of therapy for allergic rhinitis in children 3 and have been used effectively for managing symptoms of allergic rhinitis for Ͼ50 years. They are the most commonly prescribed drugs among outpatient doctors in the public service in Singapore. 4 The major limitation of the use of first-generation antihistamines is sedation. 3 Being lipophilic molecules, they easily cross the blood-brain barrier and may exacerbate the decrease in cognitive function already experienced by the patient with allergic rhinitis. Sedating antihistamines have been shown to reduce learning performance in children. 5 In contrast, second-generation antihistamines are relatively lipophobic and therefore cross the blood-br...

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Section: Methodsmentioning

confidence: 99%

Central Nervous System Side Effects of First- and Second-Generation Antihistamines in School Children With Perennial Allergic Rhinitis: A Randomized, Double-Blind, Placebo-Controlled Comparative Study

Chong

Wong

et al. 2004

Pediatrics

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“…The RQLQ has been used in several trials to assess the effect of intranasal glucocorticosteroids (1085,(1089)(1090)(1091)(1092)(1093)(1094), oral H 1 -antihistamines in seasonal (1095)(1096)(1097), perennial (1077,1078) and PER (1066,1067,1098), the combination of intranasal glucocorticosteroids and oral H 1 -antihistamines (1099), leukotriene receptor antagonists (1100, 1101), allergen immunotherapy in pollinosis (1102)(1103)(1104), omalizumab, an anti-IgE monoclonal antibody (768,1105), allergen avoidance (1106) and homeopathy (1107). Studies have also been performed in children (1108).…”

Section: Evolution Of Qol During Interventionsmentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,801

1,761

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“…Significantly (P≤0.05) less effective than beclomethasone in reducing sneezing [113] Equally efficacious as intranasal beclomethasone in reducing total eye symptoms [113] Equivalent to fluticasone propionate in improving TNSS [114] Equivalent to fluticasone propionate in improving ocular itching/tearing/redness [114] Equivalent to fluticasone propionate in improving TNSS [115] Equivalent to fluticasone propionate in improving RQLQ eye symptoms [115] P=0.001 vs oral loratadine in TNSS [116] Comparable efficacy to oral loratadine in reducing ocular symptoms [116] Ciclesonide Ib NA RCTs P≤0.01 vs placebo in rTNSS [117] Ocular outcomes not reported [117] P<0.001 vs placebo in rTNSS [118] Ocular outcomes not reported [118] P≤0.04 vs placebo in rTNSS [119] Ocular outcomes not reported [119] P<0.001 vs placebo in rTNSS [120] P<0.05 in RQLQ non-nose/eye symptoms [120] P<0.001 vs placebo in rTNSS [121] No significant improvement vs placebo in RQLQ eye symptoms [120] Oral medications Antihistamines (eg, desloratadine, bilastine, fexofenadine, levocetirizine)…”

Section: Rctsmentioning

confidence: 99%

Allergic Conjunctivitis and the Impact of Allergic Rhinitis

Bielory¹

2010

Curr Allergy Asthma Rep

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Although nasal allergy has been prominent in allergy research, ocular allergy is increasingly recognized as a distinct symptom complex that imposes its own disease burden and reduction in patients' quality of life. In the past year, knowledge of the relationships between allergic conjunctivitis and allergic rhinitis has increased. Allergic conjunctivitis is highly prevalent and has a close epidemiologic relationship with allergic rhinitis. Both conditions also exhibit similar pathophysiologic mechanisms. Pathways of communication are thought to increase the likelihood of an inflammatory reaction at both sites following allergen exposure of nasal or ocular tissue. Clinical trials of intranasal therapies have demonstrated efficacy in allergic conjunctivitis and rhinitis. Newer intranasal steroids decrease ocular symptoms, potentially achieving efficacy by suppressing the naso-ocular reflex, downregulation of inflammatory cell expression, or restoration of nasolacrimal duct patency. Proposed pathophysiologic interactions between allergic rhinitis and ocular allergy underscore the need for therapies with efficacy in both symptom sets.

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Comparative efficacy, safety, and effect on quality of life of triamcinolone acetonide and fluticasone propionate aqueous nasal sprays in patients with fall seasonal allergic rhinitis

Cited by 36 publications

References 11 publications

Central Nervous System Side Effects of First- and Second-Generation Antihistamines in School Children With Perennial Allergic Rhinitis: A Randomized, Double-Blind, Placebo-Controlled Comparative Study

Central Nervous System Side Effects of First- and Second-Generation Antihistamines in School Children With Perennial Allergic Rhinitis: A Randomized, Double-Blind, Placebo-Controlled Comparative Study

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Allergic Conjunctivitis and the Impact of Allergic Rhinitis

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