Diagnosis and Management of Rhinitis

Weldon, David

doi:10.1016/s0095-4543(05)70091-9

Cited by 3 publications

(3 citation statements)

References 93 publications

(8 reference statements)

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“…Finally, the modest efficacy of antihistamines in vasomotor rhinitis has been generally ascribed to local anticholinergic side effects [3], a potential local mechanism of azelastine also deserving further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…Vasomotor rhinitis (also referred to as idiopathic rhinitis or NANIPER: nonallergic noninfectious perennial rhinitis) is a rhinitis of clearly defined nonallergic origin, where nasal hyperreactivity triggers neurovascular mechanisms leading to nasal congestion and rhinorrhea [for reviews, see [1][2][3]. It is therefore a diagnosis of exclusion and the cause is rarely identified.…”

Section: Introductionmentioning

confidence: 99%

“…These agents are not always fully efficient to suppress symptoms and may produce some undesirable side effects (nasal and pharyngeal mucosa dryness with irritation leading to sometime scabs and epistaxis). Finally, antihistamines are considered poorly active in vasomotor rhinitis [1][2][3] and, at best, are recommended in association with topical decongestants. In this respect, it is interesting to mention that setastatine tablets were reported successful in some patients with vasomotor rhinitis [5], and a placebo-controlled study [6] showed a significant improvement of clinical symptoms with mequitazine.…”

Section: Introductionmentioning

confidence: 99%

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Vasomotor Rhinitis: Clinical Efficacy of Azelastine Nasal Spray in Comparison with Placebo

Géhanno

Deschamps²,

Garay³

et al. 2001

ORL

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The H₁ antagonist azelastine is used in nasal sprays for the treatment of allergic rhinitis, but its therapeutic efficacy in vasomotor rhinitis is unknown. We performed a multicenter randomized double-blind placebo-controlled study of the efficacy and tolerance of azelastine nasal spray in 89 adult patients with vasomotor rhinitis (confirmed by negative Phadiatop). Following a washout period, patients were treated for 15 days with one puff three times daily per nostril of azelastine (n = 44) or placebo (n = 45) nasal spray. Efficacy was evaluated by the reduction in symptomatology and by rhinoscopy. Intent-to-treat analysis revealed better results in the azelastine group for all assessed symptoms; the significance level was reached for nasal obstruction on day 15 (p = 0.042). Using per protocol analysis (in 85 patients complying with the protocol), the significance level was reached for nasal obstruction on day 15 (p = 0.017) and for the percentage of success in rhinorrhea (p = 0.023). In the azelastine group, rhinoscopy examination showed a significantly higher reduction in the inflammatory level and edema of the nasal mucosa (p = 0.03 and 0.02 for VAS on day 15 respectively, per protocol analysis). General efficacy assessment by the physician and the patient was in favor of azelastine (with significance levels <0.01). No drowsiness or serious adverse event was reported, and the frequency of mouth dryness and headaches was similar in the two treatment groups. The present study demonstrates the efficacy of azelastine nasal spray in the treatment of vasomotor rhinitis. The best achieved results were a decrease in nasal obstruction and mucosal edema. Further studies are required to investigate if this therapeutic benefit results from H₁ antagonism or from another, not well-characterized pharmacological action of azelastine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%