Storms W W, Pearlman D S, Chervinsky P, Grossman J, Halverson P C, Freitag J J, Widlitz M D
Allergy Associates, Colorado Springs, Colorado.
Ear Nose Throat J. 1994 Jun;73(6):382-6, 390-4.
Azelastine is a novel antiallergy medication currently under investigation for the treatment of allergic rhinitis and asthma. Pharmacologic studies in laboratory animals and in vitro model systems indicate that azelastine exerts multiple actions including modulation of airways smooth muscle response, interference with inflammatory processes, and inhibition of allergic reactions. In a previous controlled clinical trial, azelastine nasal solution (ASTELIN N.S.) demonstrated effectiveness in controlling symptoms of seasonal allergic rhinitis (SAR). The objective of this 2-week double-blind, parallel-group study was to further assess the effectiveness of azelastine nasal solution in improving allergic rhinitis symptoms. Two hundred forty-seven patients (> or = 12 years) with symptomatic SAR who satisfied a minimum symptoms score during a 1-week, single-blind, baseline evaluation period were randomized to receive azelastine 2 sprays per nostril bid, azelastine 2 sprays per nostril qd, chlorpheniramine 12 mg bid, or placebo using a double-dummy technique to insure blinding. The primary efficacy variables were changes in Major Symptom Complex (nose blows, sneezes, runny nose/sniffles, itch nose, and watery eyes) and Total Symptom Complex (Major plus itchy eyes/ears/throat/palate, cough, and postnasal drip) severity scores. Patients treated with azelastine nasal solution qd and bid had mean percent improvements in the Total and Major Symptom Complex severity scores that were clinically significant (> or = 50% improvement over placebo) after both weeks, at endpoint, and overall. The improvements for the azelastine bid group were statistically significant (P < or = .05) at all evaluation points. Adverse experiences occurred infrequently, and none was considered serious or potentially limiting to the clinical utility of the nasal solution.(ABSTRACT TRUNCATED AT 250 WORDS)
氮卓斯汀是一种新型抗过敏药物,目前正在进行治疗过敏性鼻炎和哮喘的研究。对实验动物和体外模型系统的药理学研究表明,氮卓斯汀具有多种作用,包括调节气道平滑肌反应、干扰炎症过程以及抑制过敏反应。在之前的一项对照临床试验中,氮卓斯汀鼻用溶液(ASTELIN N.S.)在控制季节性过敏性鼻炎(SAR)症状方面显示出有效性。这项为期2周的双盲、平行组研究的目的是进一步评估氮卓斯汀鼻用溶液改善过敏性鼻炎症状的有效性。247例年龄≥12岁、有症状的SAR患者在为期1周的单盲基线评估期内达到最低症状评分后,采用双模拟技术随机接受每侧鼻孔每日2喷氮卓斯汀、每侧鼻孔每日1喷氮卓斯汀、12毫克每日2次氯苯那敏或安慰剂治疗,以确保盲法。主要疗效变量是主要症状复合体(擤鼻、打喷嚏、流涕/鼻塞、鼻痒和流泪)和总症状复合体(主要症状加上眼/耳/喉/腭痒、咳嗽和鼻后滴漏)严重程度评分的变化。每日1次和每日2次使用氮卓斯汀鼻用溶液治疗的患者,在第2周、终点和总体上,总症状复合体和主要症状复合体严重程度评分的平均改善百分比在临床上具有显著意义(比安慰剂改善≥50%)。氮卓斯汀每日2次治疗组在所有评估点的改善均具有统计学意义(P≤0.05)。不良事件发生率低,且无一被认为严重或可能限制鼻用溶液的临床应用。(摘要截短于250字)