Grubbe R E, Lumry W R, Anolik R
Center of Research Excellence, LLC, Oxford, Alabama, USA.
J Investig Allergol Clin Immunol. 2009;19(2):117-24.
Antihistamines are first-line therapy for the treatment of seasonal allergic rhinitis (AR); however, an oral decongestant is often added to improve control of nasal congestion.
To examine whether a tablet combining the nonsedating antihistamine desloratadine and the decongestant pseudoephedrine was more effective than either drug administered alone in reducing the symptoms of seasonal AR, including nasal congestion.
In this multicenter, double-blind study, participants (N = 598) with symptomatic seasonal AR were administered either a combination tablet of desloratadine 2.5 mg/pseudoephedrine 120 mg (DL/PSE) bid, a desloratadine 5.0 mg qd and a placebo tablet, or pseudoephedrine 120 mg bid. Participants assessed their symptom severity twice daily over the 2-week treatment period.
The primary variable to assess the effects of the antihistamine component--mean change from baseline in average AM/PM reflective total symptom score (TSS), excluding nasal congestion--was significantly greater (-6.54) for DL/PSE than for desloratadine (-5.09) or pseudoephedrine (-5.07) monotherapy (P < .001 for both). The primary variable to assess the effects of the decongestant component--mean change from baseline in average AM/PM reflective nasal congestion score--was also significantly greater (-0.93) for DL/PSE than for desloratadine (-0.66) or pseudoephedrine (-0.75) (P < .001 vs desloratadine; P = .006 vs pseudoephedrine).
This study demonstrated that DL/PSE therapy was more effective in reducing symptoms of seasonal AR, including nasal congestion, than the individual components when administered alone, thus supporting use of this combination in participants with symptomatic seasonal AR and prominent nasal congestion.
抗组胺药是治疗季节性变应性鼻炎(AR)的一线疗法;然而,常加用口服减充血剂以改善鼻充血的控制。
研究一种将非镇静性抗组胺药地氯雷他定与减充血剂伪麻黄碱联合的片剂在减轻季节性AR症状(包括鼻充血)方面是否比单独使用这两种药物中的任何一种更有效。
在这项多中心、双盲研究中,对有症状的季节性AR患者(N = 598)给予地氯雷他定2.5 mg/伪麻黄碱120 mg的联合片剂(DL/PSE),每日两次,或地氯雷他定5.0 mg每日一次及安慰剂片剂,或伪麻黄碱120 mg每日两次。在为期2周的治疗期间,参与者每天评估两次症状严重程度。
评估抗组胺药成分效果的主要变量——上午/下午平均反映性总症状评分(TSS,不包括鼻充血)相对于基线的平均变化——DL/PSE组(-6.54)显著大于地氯雷他定单药治疗组(-5.09)或伪麻黄碱单药治疗组(-5.07)(两者P均<0.001)。评估减充血剂成分效果的主要变量——上午/下午平均反映性鼻充血评分相对于基线的平均变化——DL/PSE组(-0.93)也显著大于地氯雷他定组(-0.66)或伪麻黄碱组(-0.75)(与地氯雷他定相比P<0.001;与伪麻黄碱相比P = 0.006)。
本研究表明,与单独使用各成分相比,DL/PSE疗法在减轻季节性AR症状(包括鼻充血)方面更有效,从而支持在有症状的季节性AR且鼻充血明显的患者中使用这种联合制剂。