title: [Nasal budesonide plus zafirlukast vs nasal budesonide plus loratadine-pseudoephedrine for controlling the symptoms of rhinitis and asthma].
abstract: 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.
authors.affiliation: Serivico de alergia e inmunnologia clínica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, México.
authors.forename: Hector Hugo Salas
authors.initials: HH
authors.lastname: Benitez
authors.forename: Victor Manuel Almeida
authors.initials: VM
authors.lastname: Arvizu
authors.forename: Daniel Jijón
authors.initials: DJ
authors.lastname: Gutiérrez
authors.forename: Guillermo Arturo Guidos
authors.initials: GA
authors.lastname: Fogelbach
authors.forename: Antonio
authors.initials: A
authors.lastname: Castellanos Olivares
authors.forename: Francisco
authors.initials: F
authors.lastname: Vázquez Nava
authors.forename: Héctor Chong
authors.initials: HC
authors.lastname: Velázquez
authors.forename: Maria del Carmen
authors.initials: Mdel C
authors.lastname: González Pérez
authors.forename: Alejandra
authors.initials: A
authors.lastname: Mora Nieto
authors.forename: Eduardo Castro
authors.initials: EC
authors.lastname: Rodríguez
mesh_terms: 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
chemical_list: 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