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Desloratadine Lessens Bronchial Response to Nasal Provocation: Presented at EAACI

By Jill Stein

PARIS, FRANCE -- June 13, 2003 -- Researchers report that the new H1 receptor antagonist desloratadine improves nasal patency in patients with grass pollen allergic rhinitis and mild asthma.

Their findings suggest, they say, that the drug might provide relief of minimal persistent allergic nasal mucosal inflammation.

Dr. Susanne Reinartz, with AMC Hospital in Amsterdam presented the findings here June 10^th at the 22^nd Congress of the European Academy of Allergy and Clinical Immunology.

They enrolled 26 patients with grass pollen allergic rhinitis and asthma who were randomised to 8 days of treatment with desloratadine 5 mg once daily or placebo outside the grass pollen season. Sensitization to other allergens was permitted.

After 7 days of treatment, patients were challenged with 10,000 BU/mL of grass pollen extract via a pump spray that delivered a fixed dose of 89 uL into each nostril.

The researchers recorded symptoms on a 100 mm visual analogue scale (VAS) during the week before the nasal provocation and 24 hours afterwards. Symptoms measured were rhinorrhoea, watery eyes, nasal itching, sneezing, nasal blockage, wheezing coughing, shortness of breath, and decreased exercise tolerance. They also measured peak nasal inspiratory flow and peak pulmonary expiratory flow at the same time-points. The highest value of the three measurements was recorded.

Five subjects dropped out of the study because they were unable to comply with the study protocol. The 21 remaining subjects were comparable for demographic and clinical parameters at baseline.

During treatment in the week prior to nasal provocation, peak nasal inspiratory flow improved by 60 L/min in the desloratadine group compared to a 10-L/min increase in the placebo group (p=0.01).

During the 2 hours following nasal provocation, the desloratadine achieved a greater but not statistically significant increase in total nasal symptom scores.

Desloratadine also resulted in a significantly lower total bronchial symptom score (p=0.05) and had a tendency towards a greater decrease in peak pulmonary expiratory flow (p=0.09) compared to placebo.

The effect of desloratadine on nasal and bronchial symptoms was more pronounced in subjects who were sensitised to house dust mite in addition to grass pollen than in those sensitized only to seasonal rhinitis, although this effect was not statistically significant.


[Study title: Effects Of Desloratadine Versus Placebo On Upper And Lower Airways Allergic Reaction Following Nasal Allergen Provocation In Patients With Allergic Rhinitis And Asthma. Abstract 972]

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