Ekström T, Osterman K, Zetterström O
Department of Pulmonary Medicine, Linköping University Hospital.
Ann Allergy Asthma Immunol. 1995 Sep;75(3):287-9.
Antihistamines have been shown to be effective in patients with allergic asthma, but their role in chronic and more severe asthma is uncertain.
To evaluate whether loratadine, a selective H1 receptor antagonist, given as an adjunct to standard asthma medication would have any effect in patients with moderate-to-severe asthma.
Thirty-five patients with moderate-to-severe asthma, most receiving inhaled steroids, were enrolled in this double-blind, crossover study. In addition to their maintenance therapy patients received either loratadine, 20 mg once daily, or placebo for 4 weeks before crossing over to the other preparation for a further 4 weeks. Variables of efficacy were daily and nocturnal respiratory symptoms, lung function (PEF, FEV1, FVC), and bronchodilator use.
Three subjects were withdrawn from the study because of deteriorating asthma. There was a trend in favor of loratadine treatment with regard to global assessment of drug efficacy but the difference was not statistically significant. There was no objective improvement in asthma control comparing loratadine with placebo but if each treatment week were compared with the run-in period, PEF was significantly (P < .01) improved during the initial phase of loratadine treatment. This effect gradually decreased with time, suggesting tolerance to any bronchodilatory effect of the antihistamine.
Loratadine, given as an adjunct to standard asthma therapy, has little if any role to play in the treatment of moderate-to-severe asthma.
抗组胺药已被证明对过敏性哮喘患者有效，但其在慢性和更严重哮喘中的作用尚不确定。
评估作为标准哮喘药物辅助用药的选择性H1受体拮抗剂氯雷他定对中重度哮喘患者是否有任何效果。
35例中重度哮喘患者（大多数正在接受吸入性类固醇治疗）被纳入这项双盲交叉研究。除维持治疗外，患者在交叉使用另一种制剂再治疗4周之前，接受氯雷他定（每日一次，20毫克）或安慰剂治疗4周。疗效变量包括每日和夜间呼吸道症状、肺功能（呼气峰流速、第一秒用力呼气容积、用力肺活量）以及支气管扩张剂的使用情况。
3名受试者因哮喘病情恶化退出研究。在药物疗效的整体评估方面有支持氯雷他定治疗的趋势，但差异无统计学意义。与安慰剂相比，氯雷他定在哮喘控制方面没有客观改善，但如果将每个治疗周与导入期进行比较，氯雷他定治疗初始阶段的呼气峰流速显著改善（P <.01）。这种效果随时间逐渐降低，提示对该抗组胺药的任何支气管扩张作用产生了耐受性。
作为标准哮喘治疗的辅助用药，氯雷他定在中重度哮喘治疗中几乎没有作用。
