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A treatment for allergic rhinitis: a view on the role of levocetirizine

A treatment for allergic rhinitis: a view on the role of levocetirizine
A treatment for allergic rhinitis: a view on the role of levocetirizine
Background: Allergic rhinitis is a significant public health concern in many developed countries. However, despite evidence for a significant impact on patients' quality of life (QoL) including sleep disruption and reduced daytime performance, allergic rhinitis remains under-managed and hence poorly controlled. This is largely owing to lack of knowledge about, and poor adherence to, established treatment guidelines.
Scope: The panel considered available evidence and focused on four published studies on the second-generation antihistamine, levocetirizine. Three of these studies explored the clinical impact of levocetirizine in a broad range of different clinical settings.
Findings: Levocetirizine demonstrated an increased benefit over other antihistamines in terms of a more durable antihistamine response: levocetirizine provided improved symptom relief at 24 hours compared to desloratadine or fexofenadine, two frequently prescribed second-generation antihistamines. Levocetirizine also maintained relief of the key symptoms of allergic rhinitis and improved patients' QoL over a treatment period of 6 months, in a real-life setting. The variable efficacy and durability of response of different antihistamines arise from differing modulatory effects on the H1-receptor. The speed of relief of symptoms with levocetirizine is supported by the pharmacokinetic data, which shows that steady state plasma concentrations are achieved in a shorter period of time than other second-generation histamines (additionally levocetirizine Tmax is reached in 0.9 h).
Conclusion: These findings support both the short-term and long-term use of levocetirizine in the clinical management of allergic rhinitis. The World Health Organization (WHO) ARIA Guidelines (Allergic Rhinitis and its Impact on Asthma), recommend using a combination of a non-sedating antihistamine with a decongestant, or glucocorticosteroids for treating allergic rhinitis – with the order and combination of treatment depending on severity and duration of symptoms.
0300-7995
1099-1106
Holgate, Stephen
2e7c17a9-6796-436e-8772-1fe6d2ac5edc
Powell, Richard
1b3e18c8-9e02-4ddf-9dc6-c73d779bdd30
Jenkins, Maureen
dc4a7738-dc2b-4562-b5e9-1fe218afa835
Ali, Omar
6e9a6b3e-d314-42c0-a893-60fc9fa29cca
Holgate, Stephen
2e7c17a9-6796-436e-8772-1fe6d2ac5edc
Powell, Richard
1b3e18c8-9e02-4ddf-9dc6-c73d779bdd30
Jenkins, Maureen
dc4a7738-dc2b-4562-b5e9-1fe218afa835
Ali, Omar
6e9a6b3e-d314-42c0-a893-60fc9fa29cca

Holgate, Stephen, Powell, Richard, Jenkins, Maureen and Ali, Omar (2005) A treatment for allergic rhinitis: a view on the role of levocetirizine. Current Medical Research and Opinion, 21 (7), 1099-1106. (doi:10.1185/030079905X53298).

Record type: Article

Abstract

Background: Allergic rhinitis is a significant public health concern in many developed countries. However, despite evidence for a significant impact on patients' quality of life (QoL) including sleep disruption and reduced daytime performance, allergic rhinitis remains under-managed and hence poorly controlled. This is largely owing to lack of knowledge about, and poor adherence to, established treatment guidelines.
Scope: The panel considered available evidence and focused on four published studies on the second-generation antihistamine, levocetirizine. Three of these studies explored the clinical impact of levocetirizine in a broad range of different clinical settings.
Findings: Levocetirizine demonstrated an increased benefit over other antihistamines in terms of a more durable antihistamine response: levocetirizine provided improved symptom relief at 24 hours compared to desloratadine or fexofenadine, two frequently prescribed second-generation antihistamines. Levocetirizine also maintained relief of the key symptoms of allergic rhinitis and improved patients' QoL over a treatment period of 6 months, in a real-life setting. The variable efficacy and durability of response of different antihistamines arise from differing modulatory effects on the H1-receptor. The speed of relief of symptoms with levocetirizine is supported by the pharmacokinetic data, which shows that steady state plasma concentrations are achieved in a shorter period of time than other second-generation histamines (additionally levocetirizine Tmax is reached in 0.9 h).
Conclusion: These findings support both the short-term and long-term use of levocetirizine in the clinical management of allergic rhinitis. The World Health Organization (WHO) ARIA Guidelines (Allergic Rhinitis and its Impact on Asthma), recommend using a combination of a non-sedating antihistamine with a decongestant, or glucocorticosteroids for treating allergic rhinitis – with the order and combination of treatment depending on severity and duration of symptoms.

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Published date: 2005

Identifiers

Local EPrints ID: 27097
URI: http://eprints.soton.ac.uk/id/eprint/27097
ISSN: 0300-7995
PURE UUID: b097ae26-9553-4e73-b3c8-251c241688a6

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Date deposited: 25 Apr 2006
Last modified: 15 Mar 2024 07:15

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Author: Stephen Holgate
Author: Richard Powell
Author: Maureen Jenkins
Author: Omar Ali

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