A controlled study on the effectiveness of loratadine in combination with flunisolide in the treatment of nonallergic rhinitis with eosinophilia (NARES).
BACKGROUND
Nonallergic rhinitis with eosinophilia (NARES), accounting for some 15% of perennial rhinitis, is a nasal disorder whose main features are eosinophil counts in nasal smear higher than 10% and negative IgE tests. The mainstay of treatment is topical corticosteroids.


OBJECTIVE
To evaluate the adjunctive effect of loratadine, a non-sedating antihistamine with anti-allergic activity, on nasal symptoms and eosinophil counts in nasal secretions in patients with NARES.


METHODS
Thirty patients with NARES were divided in two groups, half receiving flunisolide two 25 microg puffs per nostril morning and night plus loratadine 10 mg u.i.d. and half the same doses of flunisolide plus placebo, according to a double-blind fashion, for 3 weeks. The effectiveness of the treatment in the two groups was evaluated by comparing symptom scores and eosinophil counts, and safety was assessed by comparing the adverse effects.


RESULTS
The loratadine treated group had better results both in nasal symptoms, with a decrease in sneezing (P < 0.000001) and rhinorrhoea (P < 0.006), respectively, corresponding with 73.4% and 66.7% with respect to 46.6% and 26.7% in the control group, and in eosinophil counts which decreased by 20% compared with 14.3% in patients treated with placebo and flunisolide. As to safety, only nasal irritation in two patients, one in each group, was reported.


CONCLUSIONS
Loratadine improves the effectiveness of flunisolide in treatment of NARES with no change in safety, and with no sedation.
Purello-D'Ambrosio
F
F
Scuola di Specializzazione in Allergologia ed Immunologia Clinica, University of Messina, Italy.
Isola
S
S
Ricciardi
L
L
Gangemi
S
S
Barresi
L
L
Bagnato
G F
GF
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004802:Eosinophilia / Q000188:drug therapy*; D004804:Eosinophils / Q000276:immunology; D005260:Female; D005446:Fluocinolone Acetonide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007958:Leukocyte Count; D017336:Loratadine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012220:Rhinitis / Q000097:blood / Q000188:drug therapy*; D012720:Severity of Illness Index
D000893:Anti-Inflammatory Agents; D006634:Histamine H1 Antagonists; D005446:Fluocinolone Acetonide; C007734:flunisolide; D017336:Loratadine