title: Levocetirizine in persistent allergic rhinitis: continuous or on-demand use? A pilot study.
abstract: BACKGROUND
  Allergic rhinitis is a high-prevalence disease that affects quality of life (QOL), sleep quality and productivity of patients. According to the ARIA initiative, it is classified as intermittent and persistent, the latter being the most troublesome.
  
  
  METHODS
  The aim of this randomized, open-label, 6-month, pilot study was to determine whether levocetirizine 5 mg administered continuously once daily in the morning was better than levocetirizine 5 mg on-demand in symptomatic subjects with persistent allergic rhinitis. Total and individual symptom scores were recorded in a diary card throughout the study. QOL, quality of sleep, nasal cytology, rate of drug intake, and safety were also assessed at pre-defined time-points.
  
  
  RESULTS
  In all, adult patients (31 in each group) were enrolled, of whom 22 dropped out. Both treatment regimens considerably decreased the total and individual symptoms scores from baseline and achieved similar levels up to week 14. Continuous treatment was generally better than on-demand from week 15 onwards, reaching statistical significance from weeks 17 to 21 (from week 19 to 21 for nasal pruritus). Both regimens substantially improved QOL and sleep quality. Both treatments were well tolerated, although the on-demand group reported more adverse events.
  
  
  CONCLUSIONS
  The present open label study in 62 patients indicates that levocetirizine 5 mg reliably controls persistent rhinitis over a period of 6 months, and shows a trend to be more effective in controlling the symptoms of rhinitis, improving QOL and decreasing nasal inflammation, when administered as long-term continuous therapy rather than as on-demand therapy.
authors.affiliation: University of Genoa, Allergy and Respiratory Diseases, Department of Internal Medicine, Genoa, Italy. canonica@unige.it
authors.forename: Giorgio Walter
authors.initials: GW
authors.lastname: Canonica
authors.forename: Federica
authors.initials: F
authors.lastname: Fumagalli
authors.forename: Laura
authors.initials: L
authors.lastname: Guerra
authors.forename: Ilaria
authors.initials: I
authors.lastname: Baiardini
authors.forename: Enrico
authors.initials: E
authors.lastname: Compalati
authors.forename: Anthi
authors.initials: A
authors.lastname: Rogkakou
authors.forename: Pierangela
authors.initials: P
authors.lastname: Massacane
authors.forename: Cinzia
authors.initials: C
authors.lastname: Gamalero
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Riccio
authors.forename: Antonio
authors.initials: A
authors.lastname: Scordamaglia
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua