Mösges R, Köberlein J
Institut für Medizinische Statistik, Informatik und Epidemiologie der Universität zu Köln (IMSIE), Kerpener Str. 62, 50937, Köln, Deutschland.
HNO. 2007 Jun;55(6):457-64. doi: 10.1007/s00106-006-1509-1.
The guidelines of German and European associations of allergology recommend the treatment of severe allergic rhinitis with a combination of oral antihistamines and nasal steroids. Many patients face this option rather skeptically, so that ENT specialists mostly use antihistamine monotherapy with a higher dosage. This increased dose may cause drowsiness, as has been demonstrated for cetirizine and loratadine. However, ebastine is a non-sedating antihistamine. Furthermore, it has been shown that improved clinical efficacy can be attained with an increased dosage of 20 mg daily in comparison to the usual dosage of 10 mg/day without increasing the rate of side effects.
In this prospective post-marketing survey, the treatment of 4,307 patients with allergic rhinitis was documented during the pollen season 2005. The severity of rhinitis symptoms and satisfaction with the treatment were recorded.
Treatment with 20 mg ebastine daily as monotherapy led to a significantly greater reduction in symptoms (P=0.002) than the combination therapy.
This outcome could be attributed to an assumed better compliance in patients with monotherapy.
德国和欧洲过敏学协会的指南推荐使用口服抗组胺药和鼻用类固醇联合治疗重度过敏性鼻炎。许多患者对此治疗方案持怀疑态度，因此耳鼻喉科专家大多使用更高剂量的抗组胺药单一疗法。如已证实的西替利嗪和氯雷他定那样，这种增加的剂量可能会导致嗜睡。然而，依巴斯汀是一种非镇静性抗组胺药。此外，与每天10毫克的常规剂量相比，每天增加至20毫克的剂量已显示可在不增加副作用发生率的情况下提高临床疗效。
在这项前瞻性上市后调查中，记录了2005年花粉季节期间4307例过敏性鼻炎患者的治疗情况。记录鼻炎症状的严重程度和对治疗的满意度。
每天使用20毫克依巴斯汀单一疗法治疗导致症状减轻程度显著大于联合疗法（P = 0.002）。
这一结果可能归因于单一疗法患者更好的依从性。
