Comparison of a nasal glucocorticoid, antileukotriene, and a combination of antileukotriene and antihistamine in the treatment of seasonal allergic rhinitis

Pullerits, Teet; Praks, Lea; Ristioja, Vahur; Lötvall, Jan

doi:10.1067/mai.2002.124467

Cited by 165 publications

(123 citation statements)

References 22 publications

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“…Conversely, large double-blind studies have failed to show increased efficacy on nasal symptoms when an antihistamine is given to patients on a topical corticosteroid (61,63).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Penagos

Compalati

Tarantini

et al. 2008

Allergy

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Rationale: Several randomized, double‐blind, placebo‐controlled clinical trials have demonstrated the efficacy of mometasone furoate nasal spray (MFNS) in the treatment of allergic rhinitis (AR) thus allowing for a meta‐analysis to determine the overall treatment effect.Methods: A comprehensive search of the MEDLINE, LILACS, SCOPUS, and the Cochrane Library databases up to 31 October, 2007 was carried out. Randomized, double‐blind, placebo‐controlled, clinical trials evaluating the efficacy of MFNS in patients with AR compared to placebo were included. Total nasal symptom scores (TNSS), individual nasal symptoms, total non‐nasal symptom scores (TNNSS) and nasal airflow were analysed as the standardized mean difference (SMD). Meta‐analysis was performed with the random or the fixed effect models depending on heterogeneity, by using revman 5 software.Data synthesis: Sixteen of the 113 identified articles met the inclusion criteria. For MFNS efficacy on TNSS, 2998 participants were analysed: 1534 received MFNS and 1464 placebo. Mometasone furoate nasal spray was associated with a significant reduction in TNSS (SMD −0.49, 95% CI: −0.60 to −0.38; P < 0.00001; I2 = 50.1%). A significant effect on SMD for nasal stuffiness/congestion (−0.41; 95% CI: −0.56 to −0.27), rhinorrhoea (−0.44; 95% CI: −0.66 to −0.21), sneezing (−0.40; 95% CI: −0.57 to −0.23) and nasal itching (−0.39; 95% CI: −0.53 to −0.25) was also demonstrated. Mometasone furoate nasal spray treated subjects also showed a significant reduction in TNNSS (−0.30; 95% CI: −0.43 to −0.18). The proportion of patients with adverse events was similar for MFNS and placebo (0.99; 95% CI: 0.81–1.20; P = 0.91).Conclusions: This meta‐analysis provides a level Ia evidence for the efficacy of MFSN in the treatment of AR vs placebo. Adverse events frequency was similar in both groups.

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“…Conversely, large double-blind studies have failed to show increased efficacy on nasal symptoms when an antihistamine is given to patients on a topical corticosteroid (61,63).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Penagos

Compalati

Tarantini

et al. 2008

Allergy

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“…1 Unfortunately, while the medications presently used to treat AR are highly effective in controlling symptoms, they are ineffective as curative measures, as they do not reverse the allergen-specific hypersensitivities that perpetuate the disease. 5,13 In contrast, traditional IT can induce long-lasting aeroallergen tolerance and obviate the need for medications but only for a relatively small subset of AR patients. 5,14 Recently, we found that allergen ⁄ISS-ODN covaccination was more effective than IT with allergen alone for the induction of airway allergen tolerance in previously Th2-sensitized mice 11 and Hussain and colleagues have reported that mice receiving ISS-ODN at the time of OVA ⁄alum sensitization were protected from the development of AR.…”

Section: Discussionmentioning

confidence: 99%

Allergen‐independent immunostimulatory sequence oligodeoxynucleotide therapy attenuates experimental allergic rhinitis

Rhee

Libet²,

Chisholm³

et al. 2004

Immunology

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SUMMARYWhile effective for the prevention and treatment of allergic rhinitis (AR) symptoms, currently available medications do not reverse allergen specific hypersensitivities. Therefore, pharmacotherapeutics are not curative and their daily use is often required for years. These investigations were conducted to determine whether immunostimulatory sequence oligodeoxynucleotide (ISS-ODN) delivery protects previously sensitized mice from AR hypersensitivity responses and modulates their allergen specific immune profiles. Mice were first sensitized with ovalbumin (OVA) and alum, twenty-four hr before beginning a series of seven daily intranasal (i.n.) allergen challenges, subsets of mice received a single i.n. or intradermal (i.d.) dose of ISS-ODN or control oligodeoxynucleotide (C-ODN), a single intraperitoneal (i.p.) injection of dexamethasone (DXM), or no intervention. Mice receiving i.d. or i.n. ISS-ODN were found to have attenuated immediate and late phase effector cell responses to i.n. OVA challenge. Specifically, ISS-ODN treated mice had less histamine and cysteinyl leukotriene release and eosinophilic inflammation in their nasal passages than mice treated with C-ODN. In addition, splenocytes from ISS-ODN but not C-ODN treated mice displayed attenuated OVA-specific interleukin (IL)-4, IL-5, and IL-13 but increased interferon-c responses. Finally, ISS-ODN was generally a more effective treatment than DXM, both in blunting AR hypersensitivity responses and in shifting T helper 2 Th2-biased immune parameters towards Th1 dominance. As ISS-ODN delivery rapidly attenuated effector cell responses in this AR model in an allergen independent manner, the present results suggest that therapy with ISS-ODN alone may be an effective alternative to corticosteroid medications for the clinical management of AR.

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“…The combination of oral H 1 -antihistamines and leukotriene receptor antagonists does not increase the efficacy of any single drug and is less effective than intranasal corticosteroids (1594,1596,1597). The combination of ipratropium with beclomethasone dipropionate is more effective than either active agent alone in the treatment of rhinorrhoea (1598).…”

Section: Combination Therapy With Intranasal Glucocorticosteroidsmentioning

confidence: 99%

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

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

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1,761

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Comparison of a nasal glucocorticoid, antileukotriene, and a combination of antileukotriene and antihistamine in the treatment of seasonal allergic rhinitis

Cited by 165 publications

References 22 publications

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Allergen‐independent immunostimulatory sequence oligodeoxynucleotide therapy attenuates experimental allergic rhinitis

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

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