Comprehensive evaluation of cetirizine in the management of seasonal allergic rhinitis: impact on symptoms, quality of life, productivity, and activity impairment.
Improvement in patient daily functioning and well-being resulting from disease-related symptom relief is increasingly viewed as a clinically relevant therapeutic outcome. The objective of this study was to evaluate the health-related quality of life (HRQL) effects, safety and efficacy of cetirizine in the treatment of seasonal allergic rhinitis, and impact on self-reported work/school-related productivity and activity impairment (WPAI). This was a double-blind, placebo-controlled, parallel-group study. Adult patients (n = 865) were randomized to daily treatment for 2 weeks with cetirizine or placebo. Patient disease-specific HRQL and WPAI were assessed at baseline and weeks 1 and 2 of treatment using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and Allergy-Specific Work Productivity and Activity Impairment (WPAI-AS) Instrument, respectively. Treatment with cetirizine resulted in greater (p < 0.001) improvement in overall RQLQ and individual domain scores (activities, sleep, non-nose/eye symptoms, practical problems, nasal symptoms, eye symptoms, emotional), as compared with placebo. Cetirizine therapy produced a 28.9% mean reduction in total symptom severity complex (TSSC) score versus 12.7% with placebo at study end. Work/school productivity and activity impairment were significantly (p < 0.001) decreased from baseline for cetirizine-treated patients compared with placebo. The incidence of treatment-related side effects was similar between groups. Cetirizine provides safe and effective symptomatic relief in adults with SAR while significantly improving HRQL and providing a positive impact on work/school-related productivity and activity impairment. These results provide a more comprehensive assessment of cetirizine, indicating that its benefits extend beyond conventional measures of clinical outcome.
Murray
John J
JJ
Vanderbilt University, Asthma Sinus, Allergy Program, 2611 West End Ave. #120, Nashville, TN 37203, USA.
Nathan
Robert A
RA
Bronsky
Edwin A
EA
Olufade
Abayomi O
AO
Chapman
Douglass
D
Kramer
Benjamin
B
D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D017332:Cetirizine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy* / Q000523:psychology; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D039563:Histamine H1 Antagonists, Non-Sedating; D017332:Cetirizine