title: Use of montelukast alone or in combination with desloratadine or levocetirizine in patients with persistent allergic rhinitis.
abstract: BACKGROUND
  We assessed the course of treatment in patients with persistent allergic rhinitis (AR) treated with montelukast, levocetirizine, or desloratadine alone or combinations of antihistamine and montelukast.
  
  
  METHODS
  A 32-week randomized, double-blind, placebo-controlled, crossover, double-armed study in 40 adult patients with history of persistent AR, clinical allergy to house-dust mites, and a total nasal symptom score of at least 5 (congestion of at least 2) has been performed. Patients with asthma, chronic obstructive pulmonary disease, nonallergic rhinitis with clinical allergy associated with seasonal allergens, and other serious diseases were excluded. There were four 6-week treatment periods separated by 2-week washout periods. Twenty patients received either montelukast or antihistamine, a combination of montelukast and antihistamine, or placebo. The sequence of treatment was randomly assigned. Nasal symptoms were assessed using a 4-point scale at baseline, daily during the 1st week and on days 14, 21, 28, 35, and 42 of treatment.
  
  
  RESULTS
  Montelukast alone, levocetirizine alone, desloratadine alone, and the montelukast/antihistamine combinations significantly improved nasal symptoms during the first 24 hours. Improvement gradually increased during the 6 weeks of treatment, especially in patients receiving montelukast alone or in combination therapy with the antihistamine in both arms. Improvement at 42 days of treatment was significantly greater than that achieved on the 1st day of therapy in patients treated with the combination of montelukast and levocetirizine.
  
  
  CONCLUSIONS
  Montelukast alone or in combination with antihistamines gave a gradual increase in nasal symptom improvement within 6 weeks of treatment in patients with persistent AR.
authors.affiliation: Department of Pneumology and Allergy, Medical University of Lodz, Poland. maciej_ciebiada@op.pl
authors.forename: Maciej
authors.initials: M
authors.lastname: Ciebiada
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Gorska-Ciebiada
authors.forename: Marcin
authors.initials: M
authors.lastname: Barylski
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kmiecik
authors.forename: Pawel
authors.initials: P
authors.lastname: Gorski
mesh_terms: D000085:Acetates / Q000008:administration & dosage* / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000009:adverse effects; D017332:Cetirizine / Q000008:administration & dosage* / Q000009:adverse effects; D003521:Cyclopropanes; D018450:Disease Progression; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D039563:Histamine H1 Antagonists, Non-Sedating / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D020024:Leukotriene Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D017336:Loratadine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction; D039981:Pyroglyphidae; D011804:Quinolines / Q000008:administration & dosage* / Q000009:adverse effects; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D013440:Sulfides
chemical_list: D000085:Acetates; D039741:Antigens, Dermatophagoides; D003521:Cyclopropanes; D004338:Drug Combinations; D039563:Histamine H1 Antagonists, Non-Sedating; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; C472067:levocetirizine; D017336:Loratadine; C121345:desloratadine; C093875:montelukast; D017332:Cetirizine