Desloratadine and levocetirizine improve nasal symptoms, airflow, and allergic inflammation in patients with perennial allergic rhinitis: a pilot study.
BACKGROUND
Nasal obstruction is the main symptom in patients with perennial allergic rhinitis. Some new antihistamines have been demonstrated to be capable of improving this symptom.


OBJECTIVE
The aim of this pilot study was to evaluate nasal symptoms, nasal airflow, eosinophils, and IL-4 in patients with perennial allergic rhinitis, before and after treatment with two new antihistamines: desloratadine and levocetirizine.


METHODS
Thirty patients with perennial allergic rhinitis were evaluated, 26 males and 4 females (mean age 26+/-7.1 years). All of them received either desloratadine (5 mg/daily) or levocetirizine (5 mg/daily) or placebo for 4 weeks. The study was double-blind, parallel-group, placebo-controlled, and randomized. Total symptom score (including: rhinorrhea, nasal itching, sneezing, and nasal obstruction) was assessed before and after treatment. Rhinomanometry and decongestion test, nasal lavage, and nasal scraping were performed in all subjects before and after treatment. Eosinophils were counted by conventional staining; IL-4 was measured by immunoassay of fluids recovered from nasal lavage.


RESULTS
Desloratadine and levocetirizine treatment induced significant symptom relief and significant reduction of IL-4. Both antihistamines significantly affected all parameters in comparison with placebo.


CONCLUSIONS
This pilot study demonstrates the effectiveness of antihistaminic treatment in: i) relieving nasal symptoms, including obstruction, ii) improving nasal airflow, iii) exerting decongestant activity, iv) reducing eosinophil infiltration, and v) diminishing IL-4 levels.
Ciprandi
Giorgio
G
Allergologia-U.O. ORL, Dipartimento Regionale Testa-Collo, Padiglione Specialità (piano terzo), Ospedale San Martino, Largo R. Benzi 10, 16132, Genoa, Italy. gio.cip@libero.it
Cirillo
Ignazio
I
Vizzaccaro
Andrea
A
Civardi
Elisa
E
Barberi
Salvatore
S
Allen
Michela
M
Marseglia
Gian Luigi
GL
D000293:Adolescent; D000328:Adult; D017332:Cetirizine / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004804:Eosinophils / Q000187:drug effects*; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D015847:Interleukin-4 / Q000032:analysis; D007958:Leukocyte Count; D017336:Loratadine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D017817:Nasal Lavage Fluid / Q000737:chemistry; D009297:Nasal Mucosa / Q000166:cytology / Q000187:drug effects; D015508:Nasal Obstruction / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D010865:Pilot Projects; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use*; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D025363:Rhinomanometry
D039563:Histamine H1 Antagonists, Non-Sedating; D010879:Piperazines; D015847:Interleukin-4; C472067:levocetirizine; D017336:Loratadine; C121345:desloratadine; D017332:Cetirizine