Effect of oral and inhaled cetirizine in allergen induced bronchoconstriction

Abstract

Cetirizine is a potent, selective H1 histamine receptor antagonist. The effect of oral and inhaled cetirizine was assessed on the early bronchoconstrictor response to inhaled allergen in 10 mild atopic asthmatic patients in a double-blind, randomized, placebo controlled trial. All were sensitive to Dermatophagoides pteronyssinus and this was used as the provoking allergen. The geometric mean PD20 FEV1 values obtained at allergen challenge were measured as cumulative breath units (c.b.u.) and following oral cetirizine, inhaled cetirizine and placebo were 124.5, 75.7 and 76.7 c.b.u. respectively. These did not differ significantly. We conclude that neither oral nor inhaled cetirizine significantly attenuates the early response to inhaled allergen in atopic asthmatic subjects. However, the method of repeated allergen challenge is likely to be relatively insensitive.

Characterization of a primate model of asthma using anti-allergy/ anti-asthma agents

“…The literature is inconsistent regarding this particular aspect of cetirzine activity. Some studies have demonstrated no effect of cetirizine on acute Ag-induced bronchoconstriction [19] while other studies have shown that cetirizine is protective against nasal responses to antigen [20]. It may be that nasal responses to Ag are easier to inhibit than bronchoconstriction.…”

Prospects for antihistamines in the treatment of asthma

“…Preadministration of cetirizine, usually 15 mg twice daily (bid) for periods of 3 days to 3 weeks, repeatedly failed to diminish the early response to allergen challenge. [16][17][18][19][20][21][22] In 1 study, the late response was decreased by cetirizine, 20 whereas in 3 other studies the late response was unaffected. 17,18,21 In 2 studies with cetirizine in which the late decrease in FEV 1 was not reduced, there was either reduction in the postchallenge increase in methacholine sensitivity 17 or in the influx of eosinophils into the bronchoalveolar lavage fluid.…”

The clinical relevance of the anti‐inflammatory properties of antihistamines

“…A similar study also concluded that cetirizine could prevent exacerbation of seasonal asthma caused by grass pollen (73). In contrast, Rafferty et al were unable to demonstrate a significant protective effect by either oral or inhaled cetirizine on allergen‐induced early bronchoconstriction in a double‐blind, randomized, placebo‐controlled trial (74), while a similar study demonstrated only a nonsignificant tendency for cetirizine to protect against the allergen‐induced immediate asthmatic response (75). Azelastine treatment (4 mg a day for 3 months) of 13 asthmatic patients resulted in significant improvements in asthma symptoms accompanied by a reduction of activated eosinophils and T cells in the bronchial mucosa compared with the placebo‐treated group, and significant correlations were found between clinical data and immunohistochemical parameters (76).…”