Efficacy of leukotriene antagonists as concomitant therapy in allergic rhinitis
- 17 August 2010
- journal article
- research article
- Published by Wiley in The Laryngoscope
- Vol. 120 (9), 1718-1723
- https://doi.org/10.1002/lary.20941
Abstract
Objectives/Hypothesis: The symptoms of allergic rhinitis result from an immunoglobulin E‐dependent mast cell activation cascade, marked by the release of inflammatory mediators, including histamine. Patients with perennial allergic rhinitis also have elevated levels of cysteinyl leukotrienes (CysLTs) in nasal lavage fluid. Histamine and CysLTs produce different responses in the pathogenesis of allergic rhinitis, and this study tested the hypothesis that the effects of combined antihistamine and leukotriene antagonist therapy would be more effective than antihistamine alone. Study Design: Multicentered, prospective, randomized, placebo‐controlled, parallel‐group. Methods: Three groups totaling 275 patients using: 1) fexofenadine alone, 2) fexofenadine with montelukast, or 3) fexofenadine with placebo, participated in a 21‐day trial conducted during the spring pollen season. Objective analysis included pre‐ and poststudy physical examination findings and nasal resistance measurements. Subjective data gathered included a daily patient diary and pre‐ and poststudy patient satisfaction measurements. Results: The group using both fexofenadine and montelukast showed significantly better control of nasal congestion both subjectively, using patient diary and visual analog scale evaluations, and objectively, using rhinomanometry and physical examination, compared to groups using antihistamine alone or with placebo. Conclusions: Our data provided both objective and subjective evidence that leukotriene receptor antagonist‐antihistamine combination therapy is more effective than antihistamine alone in the control of allergic rhinitis symptoms. Laryngoscope, 2010Keywords
This publication has 14 references indexed in Scilit:
- Efficacy of desloratadine, 5 mg, compared with fexofenadine, 180 mg, in patients with symptomatic seasonal allergic rhinitisAllergy and Asthma Proceedings, 2006
- Cysteinyl Leukotrienes in Allergic Inflammation*Social psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2005
- Expression of cysteinyl leukotriene synthetic and signalling proteins in inflammatory cells in active seasonal allergic rhinitisClinical & Experimental Allergy, 2003
- Montelukast as an adjuvant to mainstay therapies in patients with seasonal allergic rhinitisClinical & Experimental Allergy, 2003
- Cysteinyl leukotriene interactions with other mediators and with glucocorticosteroids during airway inflammationJournal of Allergy and Clinical Immunology, 2003
- Allergic rhinitis: not purely a histamine‐related diseaseAllergy, 2000
- Double-blind, placebo-controlled study comparing the efficacy and safety of fexofenadine hydrochloride (120 and 180 mg once daily) and cetirizine in seasonal allergic rhinitisJournal of Allergy and Clinical Immunology, 1999
- Inhibition of eicosanoid biosynthesis by glucocorticoids in humans.Proceedings of the National Academy of Sciences of the United States of America, 1990
- Leukotriene C4 release in upper respiratory mucosa during natural exposure to ragweed in ragweed-sensitive childrenJournal of Allergy and Clinical Immunology, 1988
- Effect of leukotriene D4 on nasal mucosal blood flow, nasal airway resistance and nasal secretion in humansClinical & Experimental Allergy, 1986