Frossard N, Lacronique J, Melac M, Benabdesselam O, Braun J J, Glasser N, Pauli G
INSERM U 425, Service de Pneumologie, Hôpitaux Universitaires, Strasbourg, France.
Allergy. 1997 Feb;52(2):205-9. doi: 10.1111/j.1398-9995.1997.tb00976.x.
Several studies have compared the cutaneous efficacy of cetirizine and loratadine and their onset of action. We assessed the nasal effect of these two antihistamines in a randomized, double-blind, crossover, placebo-controlled trial in order to compare objectively their efficacy and onset of action in the noses of patients with allergic rhinitis. Nasal challenge was performed by nebulization of increasing doubling doses of histamine (0, 0.04-1.28 mg/nostril) in 12 patients (eight men, four women, aged 22-39 years). Nasal airway resistance (NAR) was measured by posterior rhinomanometry either 1.5 h or 4 h after intake of cetirizine (10 mg), loratadine (10 mg), or placebo. Baseline NAR was identical between all study days (2.60-2.88 cmH2O.l-1.s). One and a half hours after intake, the increase in NAR induced by histamine was significantly reduced by both cetirizine and loratadine in contrast to placebo. However, with cetirizine the nasal obstruction was significantly lower than with loratadine (P < 0.05). Four hours after intake, a similar inhibition of the nasal obstruction caused by histamine was observed with both cetirizine and loratadine (P < 0.05). In conclusion, this study found cetirizine and loratadine to have similar nasal efficacy at therapeutic dosage 4 h after intake, whereas cetirizine was more effective than loratadine 1.5 h after intake. In agreement with the results observed in the skin, our study suggests a more rapid onset of action of cetirizine in the nose in allergic rhinitis.
多项研究比较了西替利嗪和氯雷他定的皮肤疗效及其起效时间。我们在一项随机、双盲、交叉、安慰剂对照试验中评估了这两种抗组胺药的鼻部效果，以便客观比较它们在过敏性鼻炎患者鼻部的疗效和起效时间。对12名患者（8名男性，4名女性，年龄22 - 39岁）进行组胺雾化激发试验，组胺剂量以加倍递增（每侧鼻孔0、0.04 - 1.28 mg）。在服用西替利嗪（10 mg）、氯雷他定（10 mg）或安慰剂后1.5小时或4小时，通过后鼻测压法测量鼻气道阻力（NAR）。所有研究日的基线NAR相同（2.60 - 2.88 cmH₂O·l⁻¹·s）。服药后1.5小时，与安慰剂相比，西替利嗪和氯雷他定都能显著降低组胺诱导的NAR升高。然而，西替利嗪引起的鼻塞明显低于氯雷他定（P < 0.05）。服药后4小时，西替利嗪和氯雷他定对组胺引起的鼻塞均有类似的抑制作用（P < 0.05）。总之，本研究发现服用4小时后，西替利嗪和氯雷他定在鼻部的疗效相似，而服药后1.5小时，西替利嗪比氯雷他定更有效。与在皮肤中观察到的结果一致，我们的研究表明在过敏性鼻炎患者中，西替利嗪在鼻部起效更快。
