Zyrtec scientific update |
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Ann Allergy Asthma Immunol 2002 Dec;89(6):589-98
Lai DS, Lue KH, Hsieh JC, Lin KL, Lee HS
Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC.
The comparison of the efficacy and safety of cetirizine, oxatomide, ketotifen, and a placebo for the treatment of childhood perennial allergic rhinitis
A comparison study which was conducted recently reported that Cetirizine was more effective than oxatomide and ketotifen for the treatment of childhood perennial allergic rhinitis. The efficacy and safety of cetirizine, oxatomide, ketotifen, and a placebo were tested during the study. Cetirizine and oxatomide decreased the mean Pediatric Rhinoconjunctivitis when compared with the placebo.
BACKGROUND: There has been no study comparing the long-term effects of ketotifen, oxatomide, and cetirizine for the treatment of perennial allergic rhinitis among children. OBJECTIVE: We conducted a study to compare the efficacy of the three agents for the treatment of perennial allergic rhinitis among children. METHODS: The study consisted of a double-blind, placebo-controlled, randomized design, comprising 69 perennial allergic rhinitis patients with mite allergy, aged 6 to 12 years, randomly assigned to 1 of 4 test treatment groups for 3 months: 19 in the cetirizine group (10 mg daily), 18 in the ketotifen group (1 mg, twice daily), 16 in the oxatomide group (1 mg/kg, twice daily), and 16 in the placebo group. We used the nasal symptom score of diary card and the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire and eosinophil cation protein peripheral blood total eosinophil count and immunoglobulin E level, eosinophil proportion from a nasal smear, and nasal peak expiratory flow rate to evaluate the effect of the four agents. RESULTS: Cetirizine was significantly more effective at reducing the mean rhinorrhea score compared with oxatomide for both weeks 8 and 12 (P < 0.01). Before the end of week 12, cetirizine was significantly more effective than ketotifen (P < 0.01). Cetirizine and oxatomide significantly decreased the mean Pediatric Rhinoconjunctivitis Quality of Life Questionnaire score compared with the placebo for week 12 (P < 0.05). CONCLUSIONS: Cetirizine was more effective than oxatomide and ketotifen for the relief of nasal congestion and rhinorrhea, and was responsible for significantly decreasing the eosinophil representation of a posttreatment nasal smear.
Allerg Immunol (Paris). 1989 Oct;21(8):312-3, 316, 318.
Billardon M.
Laboratoires Nanterre, France.
Importance of Zyrtec in the treatment of chronic urticaria and allergic rhinopathies apropos of 1168 cases seen by hospital practitioners
Here the author reports the importance of Zyrtec in the treatment of chronic urticaria allergic rhinopathies. Around 1000 cases were studied to evaluate the efficacy of Zyrtec. The researchers reported Zyrtec as the best anti-allergic agent.
This was a phase IV prospective trial involving out-patients from 80 hospital respiratory diseases and ENT departments, and 40 hospital dermatology departments. More than 1,000 cases were collected and used to evaluate the efficacy of Zyrtec at the dose of 10 mg per day. The aim of the trial was to assess the rapidity of action and good acceptability of treatment for 10 days and 2 weeks respectively in cases of seasonal and perennial rhinopathy. Similarly, in pruritic allergic skin disorders, the aim was to measure the degree of activity and acceptability of treatment for 2 weeks. Overall evaluation of results provided clinical evidence of satisfactory rapidity of action with an appreciable acceptability level. This prospective study confirms the good therapeutic index of Zyrtec as a new anti-allergic agent.
BMJ. 2002 Jan 19;324(7330):144-6.
Schapowal A; Petasites Study Group.
Allergy Clinic, Hochwangstrasse 3, CH-7302 Landquart, Switzerland.
Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis.
A randomized controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. Butterbur and cetirizine were equally effectual with regard to global improvement scores. Butterbur is more useful for treating seasonal allergic rhinitis when the narcotic effects of antihistamines must be avoided.
OBJECTIVES: To compare the efficacy and tolerability of butterbur (Petasites hybridus) with cetirizine in patients with seasonal allergic rhinitis (hay fever). DESIGN: Randomised, double blind, parallel group comparison. SETTING: Four outpatient general medicine and allergy clinics in Switzerland and Germany. PARTICIPANTS: 131 patients were screened for seasonal allergic rhinitis and 125 patients were randomised (butterbur 61; cetirizine 64). INTERVENTIONS: Butterbur (carbon dioxide extract tablets, ZE 339) one tablet, four times daily, or cetirizine, one tablet in the evening, both given for two consecutive weeks. MAIN OUTCOME MEASURES: Scores on SF-36 questionnaire and clinical global impression scale. RESULTS: Improvement in SF-36 score was similar in the two treatment groups for all items tested hierarchically. Butterbur and cetirizine were also similarly effective with regard to global improvement scores on the clinical global impression scale (median score 3 in both groups). Both treatments were well tolerated. In the cetirizine group, two thirds (8/12) of reported adverse events were associated with sedative effects (drowsiness and fatigue) despite the drug being considered a non-sedating antihistamine. CONCLUSIONS: The effects of butterbur are similar to those of cetirizine in patients with seasonal allergic rhinitis when evaluated blindly by patients and doctors. Butterbur should be considered for treating seasonal allergic rhinitis when the sedative effects of antihistamines need to be avoided.
Drugs. 2005;65(2):215-28.
Bielory L, Lien KW, Bigelsen S.
Department of Medicine, Pediatrics and Ophthalmology, Division of Allergy, Immunology and Rheumatology, UMDNJ-New Jersey Medical School, Immuno-Ophthalmology Service, 90 Bergen Street, DOC Suite 4700, Newark, NJ 07103, USA.
Efficacy and tolerability of newer antihistamines in the treatment of allergic conjunctivitis.
An article on the efficacy and tolerability of newer antihistamines in the treatment of allergic conjunctivitis. A monotherapy using oral antihistamines is the best choice for the treatment of allergic symptoms in the eyes, nose and pharynx. The anti-inflammatory properties oral antihistamines are also reported
Treatment for allergic conjunctivitis has markedly expanded in recent years, providing opportunities for more focused therapy, but often leaving both physicians and patients confused over the variety of options. As monotherapy, oral antihistamines are an excellent choice when attempting to control multiple early-phase, and some late-phase, allergic symptoms in the eyes, nose and pharynx. Unfortunately, despite their efficacy in relief of allergic symptoms, systemic antihistamines may result in unwanted adverse effects, such as drowsiness and dry mouth. Newer second-generation antihistamines (cetirizine, fexofenadine, loratadine and desloratadine) are preferred over older first-generation antihistamines in order to avoid the sedative and anticholinergic effects that are associated with first-generation agents. When the allergic symptom or complaint, such as ocular pruritus, is isolated, focused therapy with topical (ophthalmic) antihistamines is often efficacious and clearly superior to systemic antihistamines, either as monotherapy or in conjunction with an oral or intranasal agent.Topical antihistaminic agents not only provide faster and superior relief than systemic antihistamines, but they may also possess a longer duration of action than other classes including vasoconstrictors, pure mast cell stabilisers, NSAIDs and corticosteroids. Many antihistamines have anti-inflammatory properties as well. Some of this anti-inflammatory effect seen with 'pure' antihistamines (levocabastine and emedastine) may be directly attributed to the blocking of the histamine receptor that has been shown to downregulate intercellular adhesion molecule-1 expression and, in turn, limit chemotaxis of inflammatory cells. Some topical multiple-action histamine H(1)-receptor antagonists (olopatadine, ketotifen, azelastine and epinastine) have been shown to prevent activation of neutrophils, eosinophils and macrophages, or inhibit release of leukotrienes, platelet-activating factors and other inflammatory mediators. Topical vasoconstrictor agents provide rapid relief, especially for redness; however, the relief is often short-lived, and overuse of vasoconstrictors may lead to rebound hyperaemia and irritation. Another class of topical agents, mast cell stabilisers (sodium cromoglicate [cromolyn sodium], nedocromil and lodoxamide), may be considered; however, they generally have a much slower onset of action. The efficacy of mast cell stabilisers may be attributed to anti-inflammatory properties in addition to mast cell stabilisation. In the class of topical NSAIDs, ketorolac has been promoted for ocular itching but has been found to be inferior for relief of allergic conjunctivitis when compared with olopatadine and emedastine. Lastly, topical corticosteroids may be considered for severe seasonal ocular allergy symptoms, although long-term use should be avoided because of risks of ocular adverse effects, including glaucoma and cataract formation.
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 Zyrtec scientific update
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