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糠酸莫米松鼻喷雾剂与氯雷他定联合治疗对比糠酸莫米松单药治疗季节性变应性鼻炎的临床疗效

Clinical benefits of combination treatment with mometasone furoate nasal spray and loratadine vs monotherapy with mometasone furoate in the treatment of seasonal allergic rhinitis.

作者信息

Anolik Robert

机构信息

Allergy & Asthma Specialists PC, East Blue Bell, Pennsylvania 19422, USA.

出版信息

Ann Allergy Asthma Immunol. 2008 Mar;100(3):264-71. doi: 10.1016/S1081-1206(10)60452-8.

Abstract

BACKGROUND

Intranasal corticosteroids and nonsedating antihistamines are the drug classes most often prescribed to treat allergic rhinitis (AR). Treatment guidelines recommend a combination of these agents for moderate-to-severe AR. However, clinical studies have found that combining an antihistamine with an intranasal corticosteroid provides few or no advantages over monotherapy with an intranasal corticosteroid.

OBJECTIVE

To compare the efficacy of mometasone furoate nasal spray (NS) plus loratadine with that of monotherapy with the individual agents in patients 12 years and older with at least a 2-year history of seasonal AR.

METHODS

In a multicenter, randomized, double-blind, parallel-group, placebo-controlled clinical study, 702 patients were randomized to receive mometasone furoate NS, 200 microg, plus loratadine, 10 mg (n = 169); mometasone furoate NS, 200 microg (n = 176); loratadine, 10 mg (n = 181); or placebo (n = 176) once daily for 15 days. Primary efficacy variables were total nasal symptom score (TNSS) and total symptom score (TSS) as recorded on diary cards.

RESULTS

No statistically significant differences were observed between mometasone furoate NS plus loratadine and mometasone furoate NS monotherapy for the primary efficacy variables. For TNSS and TSS, all 3 active drug therapies were more effective than placebo (P < or = .02). Both mometasone furoate NS treatment regimens were more effective than loratadine or placebo for TNSS (P < .01 for both) and TSS (P < or = .03 for both), whereas loratadine was more effective than placebo for TNSS only (P = .02).

CONCLUSIONS

Combination therapy with mometasone furoate NS and loratadine provided benefits similar to monotherapy with mometasone furoate NS for the symptoms of seasonal AR. Therefore, mometasone furoate NS monotherapy was shown to be an effective treatment for seasonal AR.

摘要

背景

鼻用皮质类固醇和非镇静性抗组胺药是最常用于治疗变应性鼻炎(AR)的药物类别。治疗指南推荐将这些药物联合用于中重度AR。然而,临床研究发现,将抗组胺药与鼻用皮质类固醇联合使用相较于单独使用鼻用皮质类固醇几乎没有优势。

目的

比较糠酸莫米松鼻喷雾剂(NS)加氯雷他定与单独使用这两种药物对12岁及以上有至少2年季节性AR病史患者的疗效。

方法

在一项多中心、随机、双盲、平行组、安慰剂对照的临床研究中,702例患者被随机分为接受200μg糠酸莫米松NS加10mg氯雷他定(n = 169);200μg糠酸莫米松NS(n = 176);10mg氯雷他定(n = 181);或安慰剂(n = 176),每日一次,共15天。主要疗效变量为日记卡上记录的总鼻症状评分(TNSS)和总症状评分(TSS)。

结果

对于主要疗效变量,糠酸莫米松NS加氯雷他定与糠酸莫米松NS单药治疗之间未观察到统计学上的显著差异。对于TNSS和TSS,所有3种活性药物治疗均比安慰剂更有效(P≤0.02)。两种糠酸莫米松NS治疗方案在TNSS(两者均P<0.01)和TSS(两者均P≤0.03)方面均比氯雷他定或安慰剂更有效,而氯雷他定仅在TNSS方面比安慰剂更有效(P = 0.02)。

结论

糠酸莫米松NS与氯雷他定联合治疗对季节性AR症状的疗效与糠酸莫米松NS单药治疗相似。因此,糠酸莫米松NS单药治疗被证明是治疗季节性AR的有效方法。

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