Efficacy of Desloratadine in Persistent Allergic Rhinitis – A GA²LEN Study

Abstract

Background: The ARIA (Allergic Rhinitis and its Impact on Asthma) guidelines proposed a classification for allergic rhinitis based on the duration of symptoms (intermittent or persistent) rather than on the time of allergen exposure (seasonal or perennial). There had been no placebo-controlled, randomized, clinical trial of desloratadine (DL) in patients with persistent allergic rhinitis to date. Objectives: To assess the efficacy and safety of DL in patients with persistent allergic rhinitis based on the ARIA classification. Methods: Patients 12 years of age and older with persistent allergic rhinitis were assessed over 85 days of treatment with DL 5 mg once daily (n = 360) or placebo (n = 356). The primary endpoint was the AM/PM reflective total 5-symptom score (T5SS) averaged over days 1–29. Secondary endpoints included AM/PM instantaneous T5SS and individual symptoms, therapeutic response, symptom severity assessed by a visual analogue scale and quality of life. Results: The mean reduction in AM/PM reflective T5SS was significantly greater with DL than placebo over days 1–29 (–3.76 vs. –2.87, p < 0.001) and on each individual day (p < 0.05). The mean AM instantaneous T5SS was significantly reduced with DL compared with placebo as early as day 2 (–1.90 vs. –1.46; p < 0.001). The therapeutic response and improvement in quality of life were significantly greater with DL than placebo (p < 0.001 for each). The frequency of treatment-related adverse events was low and similar between DL (10.0%) and placebo (8.4%). Conclusions: This study showed DL to be effective and safe in the treatment of persistent allergic rhinitis.

MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation

“…VAS can be used in all age groups including preschool children (guardian evaluation) (90) and the elderly (91). Furthermore, it can be used in a wide variety of languages (81,(91)(92)(93)(94)(95)(96)(97). VAS levels vary with the ARIA classification in many languages (76, 79, …”

“…VAS was highly responsive to change in double-blind, placebo-controlled RCTs (92,93,102,(105)(106)(107)(108). These multicentre studies in Europe and Canada showed that patients easily cope with VAS in different languages.…”

Fluticasone Furoate Inhibits Cytokine Secretion from Nasal Epithelial Cells and Reduces Eosinophil Survival in an in vitro Model of Eosinophilic Inflammation

“…Among these, topical GC are recommended as one of the first-line therapies [16,17,18,19], since they are the most effective drugs for reducing symptoms and NM inflammation. Their anti-inflammatory action includes a wide range of mechanisms, including the reduction of the concentration of proinflammatory mediators in nasal secretions and the inhibition of inflammatory cell infiltration in NM [20].…”

The Loss of Smell in Persistent Allergic Rhinitis Is Improved by Levocetirizine due to Reduction of Nasal Inflammation but Not Nasal Congestion (the CIRANO Study)

“…A recent study (ACCEPT-2) [25] demonstrated that desloratadine was effective in reducing the total symptom burden and individual symptom scores associated with PER, with a safety profile similar to that of placebo, as has been shown before for IAR (ACCEPT-1) [26]. Improvements were also noted in various measures of QoL (RQLQ) and school/work productivity.…”