Levocetirizine improves quality of life and reduces costs in long-term management of persistent allergic rhinitis.
BACKGROUND
Allergic Rhinitis and its Impact on Asthma in collaboration with the World Health Organization initiative reclassified allergic rhinitis, like asthma, by duration and severity. The Xyzal in Persistent Rhinitis Trial is the first large, long-term clinical trial studying patients with persistent rhinitis as defined by Allergic Rhinitis and its Impact on Asthma.


OBJECTIVE
Two primary objectives were defined: comparison of the Rhinoconjunctivitis Quality of Life Questionnaire overall score and Total 5 Symptoms Score (rhinorrhea, sneezing, nasal congestion, and nasal and ocular pruritus) over a period of 4 weeks between levocetirizine 5 mg and placebo. Secondary endpoints included similar evaluations at 1 week and 3, 4.5, and 6 months, summary scores for a general health status questionnaire (Medical Outcomes Survey Short Form 36), a pharmacoeconomic assessment, comorbidities, and a safety evaluation.


METHODS
The Xyzal in Persistent Rhinitis Trial was a 6-month double-blind, placebo-controlled, multicenter, multinational trial in 551 patients. Adults with persistent rhinitis sensitized to both grass pollen and house dust mite were randomized to receive levocetirizine 5 mg/d or placebo.


RESULTS
A total of 421 patients completed the full study. Levocetirizine significantly improved both the Rhinoconjunctivitis Quality of Life Questionnaire overall score and the Total 5 Symptoms Score from week 1 to 6 months (all P values <.001). Medical Outcomes Survey Short Form 36 summary scores were also improved in the levocetirizine group compared with the placebo group. Treatment cessation because of lack of effect, comorbidities, and overall costs of disease, and comorbidities per working patient per month (160.27 vs 108.18) were lower in the levocetirizine group.


CONCLUSIONS
Levocetirizine was shown to improve quality of life and symptoms and to decrease the overall costs of the disease over the 6-month treatment period.
Department of Oto-Rhino-Laryngology, University Hospital, Ghent, Belgium. Claus.Bachert@ugent.be
Claus
C
Bachert
Jean
J
Bousquet
G Walter
GW
Canonica
Stephen R
SR
Durham
Ludger
L
Klimek
Joaquim
J
Mullol
Paul B
PB
Van Cauwenberge
Geneviève
G
Van Hammée
D000293:Adolescent; D000328:Adult; D000368:Aged; D017332:Cetirizine / Q000191:economics / Q000627:therapeutic use*; D003233:Conjunctivitis, Allergic / Q000188:drug therapy; D003365:Costs and Cost Analysis; D004311:Double-Blind Method; D005060:Europe; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000191:economics / Q000627:therapeutic use*; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy*; D016896:Treatment Outcome
D039563:Histamine H1 Antagonists, Non-Sedating; D010879:Piperazines; C472067:levocetirizine; D017332:Cetirizine