Serra H A, Alves O, Rizzo L F, Devoto F M, Ascierto H
Pharmacological Department, School of Medicine, University of Buenos Aires, Argentina.
Br J Clin Pharmacol. 1998 Feb;45(2):147-50. doi: 10.1046/j.1365-2125.1998.00657.x.
To conduct a randomized placebo controlled double-blind crossover trial in order to evaluate a loratadine-pseudoephedrine combination (L + PS) in children with seasonal allergic rhinitis.
Forty children (15 males; 25 females), aged 3-15 years, were included in this study. They were randomized to receive L + PS (0.2 mg kg[-1] body weight-2.4 mg kg[-1] body weight respectively) or placebo (PLA) for 14 days. After 7 days of washout, patients were shifted to the other treatment for a further 14 days. Nasal symptoms (sneezing/itching, congestion, nasal dripping) and signs (turbinal swelling, retronasal drainage), rated on a scale ranging from: 1. absent to 5. very intense, and their sum or mean total symptom score (MTSS) were used as efficacy measurement.
Significant relief was observed; post-treatment MTSS difference and its percent change were respectively; L + PS = -4.29; 95% CI: -3.64 and -4.94 (27.8%), and PLA = -1.63; 95% CI: -0.95 and -2.31 (10.7%) (P < 0.001 baseline vs endpoint and between treatments). Furthermore, L + PS and PLA significantly modified symptoms, but only L + PS significantly modified signs. No clinical changes were observed during the trial; only one patient showed slight transient insomnia when receiving L + PS.
It is concluded that L + PS is useful and well tolerated in children with seasonal allergic rhinitis. However, elements such as placebo effect must be taken into account for planning future trials.
开展一项随机、安慰剂对照、双盲交叉试验,以评估氯雷他定 - 伪麻黄碱复方制剂(L + PS)对季节性变应性鼻炎儿童的疗效。
本研究纳入了40名3至15岁的儿童(15名男性,25名女性)。他们被随机分为两组,分别接受L + PS(体重0.2 mg/kg - 2.4 mg/kg)或安慰剂(PLA)治疗14天。洗脱期7天后,患者换用另一种治疗方式,再治疗14天。鼻症状(打喷嚏/瘙痒、鼻塞、流涕)和体征(鼻甲肿胀、鼻后滴漏)采用1至5级评分:1. 无,2. 轻度,3. 中度,4. 重度,5. 极重度,其总和或平均总症状评分(MTSS)作为疗效指标。
观察到显著缓解;治疗后MTSS差异及其百分比变化分别为:L + PS = -4.29;95%可信区间:-3.64至-4.94(27.8%),PLA = -1.63;95%可信区间:-0.95至-2.31(10.7%)(基线与终点之间以及治疗组之间P < 0.001)。此外,L + PS和PLA均显著改善了症状,但只有L + PS显著改善了体征。试验期间未观察到临床变化;仅1例患者在接受L + PS治疗时出现轻微短暂失眠。
得出结论,L + PS对季节性变应性鼻炎儿童有效且耐受性良好。然而,在规划未来试验时必须考虑安慰剂效应等因素。