[New generation antihistamines as monotherapy or in combination. What is the relevance for daily clinical routine for allergic rhinoconjunctivitis].
BACKGROUND
The guidelines of German and European associations of allergology recommend the treatment of severe allergic rhinitis with a combination of oral antihistamines and nasal steroids. Many patients face this option rather skeptically, so that ENT specialists mostly use antihistamine monotherapy with a higher dosage. This increased dose may cause drowsiness, as has been demonstrated for cetirizine and loratadine. However, ebastine is a non-sedating antihistamine. Furthermore, it has been shown that improved clinical efficacy can be attained with an increased dosage of 20 mg daily in comparison to the usual dosage of 10 mg/day without increasing the rate of side effects.


METHODS
In this prospective post-marketing survey, the treatment of 4,307 patients with allergic rhinitis was documented during the pollen season 2005. The severity of rhinitis symptoms and satisfaction with the treatment were recorded.


RESULTS
Treatment with 20 mg ebastine daily as monotherapy led to a significantly greater reduction in symptoms (P=0.002) than the combination therapy.


CONCLUSIONS
This outcome could be attributed to an assumed better compliance in patients with monotherapy.
Mösges
R
R
Institut für Medizinische Statistik, Informatik und Epidemiologie der Universität zu Köln (IMSIE), Kerpener Str. 62, 50937, Köln, Deutschland. ralph@moesges.de
Köberlein
J
J
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D002090:Butyrophenones / Q000008:administration & dosage*; D003231:Conjunctivitis / Q000188:drug therapy* / Q000453:epidemiology*; D004338:Drug Combinations; D005260:Female; D005858:Germany / Q000453:epidemiology; D006634:Histamine H1 Antagonists / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D010880:Piperidines / Q000008:administration & dosage*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy* / Q000453:epidemiology*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D002090:Butyrophenones; D004338:Drug Combinations; D006634:Histamine H1 Antagonists; D010880:Piperidines; C058249:ebastine