Ciebiada M, Ciebiada M Gorska, Kmiecik T, DuBuske L M, Gorski P
Medical University of Lodz, Department of Pneumology and Allergy, Lodz, Poland.
J Investig Allergol Clin Immunol. 2008;18(5):343-9.
Persistent allergic rhinitis often impairs quality of life.
We assessed the extent to which treating persistent allergic rhinitis with montelukast, desloratadine, and levocetirizine alone or in combination improved quality of life.
A 32-week randomized, double-blind, placebo-controlled, crossover study was performed in 2 arms: 20 patients received montelukast 10 mg/d and/or desloratadine 5 mg/d or placebo; 20 patients received montelukast 10 mg/d and/or levocetirizine 5 mg/d or placebo. The treatment periods were separated by 2-week washout periods. Quality of life was assessed on the day before starting treatment and on the last day of each treatment period using the Rhinoconjunctivitis Quality of Life Questionnaire. Sleep problems were also assessed.
In the desloratadine plus montelukast arm, the mean (SEM) quality of life score before treatment was 3.1 (0.41). After placebo, this score was 2.16 (0.43), after desloratadine it was 1.79 (0.38), after montelukast it was 1.48 (0.37), and after montelukast plus desloratadine it was 1.59 (0.37). In the montelukast plus levocetirizine arm, the mean quality of life score before treatment was 2.58 (0.49). After placebo it was 1.78 (0.46), after levocetirizine it was 1.38 (0.42), after montelukast it was 1.36 (0.37), and after montelukast plus levocetirizine it was 1.26 (0.39).
Placebo, montelukast, desloratadine and levocetirizine significantly improved quality of life. Combining montelukast with either levocetirizine or desloratadine gave additional benefits in comparison to each agent alone and could be considered for patients whose quality of life is impaired by persistent allergic rhinitis.
持续性变应性鼻炎常损害生活质量。
我们评估了单用孟鲁司特、地氯雷他定和左西替利嗪或联合使用这些药物治疗持续性变应性鼻炎对生活质量改善的程度。
进行了一项为期32周的随机、双盲、安慰剂对照、交叉研究，分为两组：20例患者接受孟鲁司特10mg/d和/或地氯雷他定5mg/d或安慰剂；20例患者接受孟鲁司特10mg/d和/或左西替利嗪5mg/d或安慰剂。治疗期之间有2周的洗脱期。在开始治疗前一天以及每个治疗期的最后一天，使用变应性鼻结膜炎生活质量问卷评估生活质量。还评估了睡眠问题。
在地氯雷他定加孟鲁司特组，治疗前生活质量评分均值（标准误）为3.1（0.41）。服用安慰剂后，该评分为2.16（0.43），服用地氯雷他定后为1.79（0.38），服用孟鲁司特后为1.48（0.37），服用孟鲁司特加地氯雷他定后为1.59（0.37）。在孟鲁司特加左西替利嗪组，治疗前生活质量评分均值为2.58（0.49）。服用安慰剂后为1.78（0.46），服用左西替利嗪后为1.38（0.42），服用孟鲁司特后为1.36（0.37），服用孟鲁司特加左西替利嗪后为1.26（0.39）。
安慰剂、孟鲁司特、地氯雷他定和左西替利嗪均能显著改善生活质量。与单独使用每种药物相比，孟鲁司特与左西替利嗪或地氯雷他定联合使用有额外益处，对于因持续性变应性鼻炎而生活质量受损的患者可考虑使用。
