Use of montelukast alone or in combination with desloratadine or levocetirizine
in patients with persistent allergic rhinitis.
Author(s): Ciebiada M, Gorska-Ciebiada M, Barylski M, Kmiecik T, Gorski P.
Affiliation(s): Department of Pneumology and Allergy, Medical University of Lodz, Poland.
maciej_ciebiada@op.pl
Publication date & source: 2011, Am J Rhinol Allergy. , 25(1):e1-6
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.
CONCLUSION: 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.
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