Efficacy of fexofenadine in the prophylactic control of cat allergen-induced allergic rhinitis

Berkowitz, Ruth; Braker, S.; Lutz, Cheryl; Jones, Pat; Meeves, Suzanne; Qiu, Chunfu; Varghese, Santosh T.; Georges, George

doi:10.1016/s1081-1206(10)61243-4

Cited by 16 publications

(11 citation statements)

References 20 publications

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“…TRSS is commonly used as an outcome measure in studies evaluating the efficacy of pharmacotherapy and immunotherapy in allergic rhinoconjunctivitis. The observed improvement of 3.9 TRSS units reported at 1 year and the sustained improvement of 3.85 TRSS units at 2 years reported here compare favourably with existing pharmacotherapy and immunotherapy for cat allergy, including whole allergen immunotherapy , sublingual drops immunotherapy and treatment with the antihistamine fexofenadine . A recent review has summarized the treatment effects observed in these studies and compared them to the treatment effects reported with Cat‐PAD at 1 year and concluded the treatment effects with Cat‐PAD are favourable.…”

Section: Discussionsupporting

confidence: 69%

Fel d 1‐derived synthetic peptide immuno‐regulatory epitopes show a long‐term treatment effect in cat allergic subjects

Couroux¹,

Patel²,

Armstrong³

et al. 2015

Clin Experimental Allergy

103

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SummaryBackground Cat-PAD, the first in a new class of synthetic peptide immuno-regulatory epitopes (SPIREs), was shown to significantly improve rhinoconjunctivitis symptoms in subjects with cat allergy up to 1 year after the start of a short course of treatment. Objective To evaluate the long-term effects of Cat-PAD on rhinoconjunctivitis symptoms following standardized allergen challenge 2 years after treatment. Methods In a randomized, double-blind, placebo-controlled, parallel group study, subjects were exposed to cat allergen in an environmental exposure chamber (EEC) before and after treatment with two regimens of Cat-PAD (either eight doses of 3 nmol or four doses of 6 nmol) given intradermally over a 3-month period. In this follow-up study, changes from baseline in rhinoconjunctivitis symptoms were reassessed 2 years after the start of treatment. Results The primary endpoint showed a mean reduction in total rhinoconjunctivitis symptom scores of 3.85 units in the 4 9 6 nmol Cat-PAD group compared to placebo 2 years after the start of treatment (P = 0.13), and this difference was statistically significant in the secondary endpoint at the end of day 4 when the cumulative allergen challenge was greatest (P = 0.02). Consistent reductions in nasal symptoms of between 2 and 3 units were observed for 4 9 6 nmol Cat-PAD compared to placebo between the 2 and 3 h time points on days 1-4 of EEC challenge at 2 years (P < 0.05). The 8 9 3 nmol dose did not show a meaningful effect in this study. Conclusion and Clinical Relevance A persistent, clinically meaningful reduction in rhinoconjunctivitis symptoms was observed on EEC challenge 2 years after the start of a short course of treatment with 4 9 6 nmol Cat-PAD. This study is the first to provide evidence of a long-term therapeutic effect with this new class of SPIREs.

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Section: Discussionsupporting

confidence: 69%

Fel d 1‐derived synthetic peptide immuno‐regulatory epitopes show a long‐term treatment effect in cat allergic subjects

Couroux¹,

Patel²,

Armstrong³

et al. 2015

Clin Experimental Allergy

103

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“…For example, studies of similar design reported TRSS changes of approximately 2 units for adjuvanted subcutaneous immunotherapy 20 and daily sublingual grass immunotherapy, 21 whereas a single 180-mg dose of the antihistamine fexofenadine achieved a mean difference in TRSSs of 1.3. 22 Moreover, the change in TRSSs reported here was observed after just 4 administrations of Cat-PAD and persisted 9 months after treatment cessation.…”

Section: Discussionsupporting

confidence: 49%

Fel d 1–derived peptide antigen desensitization shows a persistent treatment effect 1 year after the start of dosing: A randomized, placebo-controlled study

Patel¹,

Couroux²,

Hickey³

et al. 2013

Journal of Allergy and Clinical Immunology

182

131

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“…1). Twelve comparative trials did not satisfy the inclusion criteria [34,35,36,37,38,39,40,41,42,43,44,45]. Eight DBPC RCT satisfied the inclusion criteria, but data from 2 were not reported and could not be extracted from the manuscript; the attempt to obtain data directly from the authors failed as well, so graphics were digitized and the SD estimated using an imputation method.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review on the Efficacy of Fexofenadine in Seasonal Allergic Rhinitis: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Clinical Trials

Compalati

Baena-Cagnani

Penagos

et al. 2011

Int Arch Allergy Immunol

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Rationale: Evidence-based medicine represents the effort to highlight the best intervention for patients, clinicians, and policy makers, each from their respective viewpoint, to solve a particular health condition. According to a recently diffused grading system of evidence and recommendations for medical interventions, efficacy and safety represent 2 of the most important features to consider, and data from meta-analyses of randomized controlled clinical trials (RCTs) is the strongest supporting demonstration. Fexofenadine has been used for its efficacy and safety in the treatment of allergic rhinitis (AR) for many years although no meta-analyses supporting its use currently exist. The aim of this study is to assess for the first time the efficacy and safety of fexofenadine in the treatment of AR by means of a meta-analytic analysis of existing RCTs. Since specific evidence should be provided to address recommendations in a pediatric population, the quality of the estimates of this subgroup analysis is assessed. Methods: All double-blind, placebo-controlled randomized trials assessing the efficacy of fexofenadine in AR were searched for in OVID, Medline, and Embase databases up to December 2007. Outcomes were extracted from original articles; when this information was not available, the authors of each trial were contacted. Some graphics were digitalized. The RevMan 5 program was used to perform the analysis. GradePro 3.2.2 was used to assess the quality of the evidence for a pediatric population. Results: Of 2,152 identified articles, 20 were potentially relevant trials. Eight studies satisfied the inclusion criteria and were included in the meta-analysis. The main reasons for exclusion were: unnatural exposure, strong study limitations, an atypical outcome measurement, a design for other outcomes, and not being a placebo-controlled, single-blind study. Seven trials investigated a mixed population of adults and children, 1 trial investigated only children, and 1 trial only adults. In 1,833 patients receiving fexofenadine (1,699 placebo), a significant reduction of the daily reflective total symptom scores (TSS) (SMD –0.42; 95% CI –0.49 to –0.35, p < 0.00001) was found. Positive results were also found for morning instantaneous TSS and individual nasal symptom scores (sneezing, rhinorrhea, itching, and congestion). The safety analysis did not show a significant difference in reported adverse events (AE) between the active and placebo treatment groups (OR = 1.03; 95% CI 0.87–1.22, p = 0.75). A very low heterogeneity between the studies was detected, so a fixed-effects model was used. The mean quality level of the included trials was medium. Specific information for a pediatric population may be assumed with a moderate quality of evidence from only 1 study and with a low quality of evidence, mainly due to indirectness, from the others. Conclusions: This study has 5 major strengths: it represents the first attempt to evaluate the efficacy and safety of fexofenadine in the treatment of AR by means of a meta-analysis...

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Efficacy of fexofenadine in the prophylactic control of cat allergen-induced allergic rhinitis

Cited by 16 publications

References 20 publications

Fel d 1‐derived synthetic peptide immuno‐regulatory epitopes show a long‐term treatment effect in cat allergic subjects

Fel d 1‐derived synthetic peptide immuno‐regulatory epitopes show a long‐term treatment effect in cat allergic subjects

Fel d 1–derived peptide antigen desensitization shows a persistent treatment effect 1 year after the start of dosing: A randomized, placebo-controlled study

Systematic Review on the Efficacy of Fexofenadine in Seasonal Allergic Rhinitis: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Clinical Trials

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