[Nasal budesonide plus zafirlukast vs nasal budesonide plus loratadine-pseudoephedrine for controlling the symptoms of rhinitis and asthma].
OBJECTIVE
To compare the efficacy of nasal budesonide plus oral zafirlukast against nasal budesonide plus oral loratadine/pseudoephedrine combination in the control of symptoms of rhinitis and asthma.


METHODS
A controlled, clinical, randomized, double blind and crossover study was made in 36 patients with allergic rhinitis and asthma following one of the next treatment regimes: group a) nasal budesonide plus oral zafirlukast twice a day or group b) nasal budesonide plus oral loratadine/pseudoephedrine twice a day, both of them during six weeks, and two weeks of washing and crossover of the treatments during six more weeks. Changes in the rhinitis and asthma symptoms, blood eosinophils, pulmonary function testing, and nasal cytology were evaluated before and after the treatment.


RESULTS
19 patients were assigned to group a, whereas 17 patients to group b. The age ranged between 16 to 45 years, and it predominated the female group, 70 and 89%, respectively (statistically no significant). During the first six weeks of the treatment, V0 to V3, both groups of patients got better nasal symptoms but group a was superior to group b. However, in bronchial symptoms, cough, wheezing and breathlessness, group a showed efficacy in comparison with group b, where no significant improvement was shown. Once the crossover was made, from V5 to V7, there was no difference between both groups. The other evaluated indicators, such as eosinophilia, VEF1 and nasal eosinophils, had a significant improvement before and at the end of the study.


CONCLUSIONS
The association of a nasal steroid with a leukotriene modifier (zafirlukast) was more effective for controlling nasal symptoms and especially bronchial symptoms than the association of a nasal steroid with antihistamines (loratadine) with pseudoephedrine. Other inflammation indicators, such as eosinophilia and nasal eosinophilia, were diminished; the VEF1 increased significantly in both treatment groups. All the above may be due to the nasal steroid use associated to a leukotriene modifier.
Benitez
Hector Hugo Salas
HH
Serivico de alergia e inmunnologia clínica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, México.
Arvizu
Victor Manuel Almeida
VM
Gutiérrez
Daniel Jijón
DJ
Fogelbach
Guillermo Arturo Guidos
GA
Castellanos Olivares
Antonio
A
Vázquez Nava
Francisco
F
Velázquez
Héctor Chong
HC
González Pérez
Maria del Carmen
Mdel C
Mora Nieto
Alejandra
A
Rodríguez
Eduardo Castro
EC
D000281:Administration, Intranasal; D000284:Administration, Oral; D000293:Adolescent; D018663:Adrenergic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy; D019819:Budesonide / Q000008:administration & dosage / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004809:Ephedrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007211:Indoles; D020024:Leukotriene Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D017336:Loratadine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D048448:Phenylcarbamates; D012130:Respiratory Hypersensitivity / Q000188:drug therapy*; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy; D013449:Sulfonamides; D014105:Tosyl Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D018663:Adrenergic Agents; D018926:Anti-Allergic Agents; D018927:Anti-Asthmatic Agents; D039563:Histamine H1 Antagonists, Non-Sedating; D007211:Indoles; D020024:Leukotriene Antagonists; D048448:Phenylcarbamates; D013449:Sulfonamides; D014105:Tosyl Compounds; D019819:Budesonide; D017336:Loratadine; D004809:Ephedrine; C062735:zafirlukast