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Fluticasone Outperforms Levocabastine In Drug-Induced Rhinitis: Presented at EAACI

By Michael Smith

AMSTERDAM, THE NETHERLANDS -- June 15, 2004 -- Fluticasone is more effective than is levocabastine in treating rhinitis caused by over-use of nasal decongestants, say Polish researchers.

Presenting findings at the 23rd Congress of the European Academy of Allergology and Clinical Immunotherapy (EAACI), Andrzej Wojdas, MD, of Warsaw's Military Medical Institute, said, "Drug-induced rhinitis … is the negative influence of pharmacological substances applied to the nasal mucosa." The most common culprits are the alphamimetic nasal decongestants.

The approved treatment for this form of rhinitis is cessation of nose drops and administration of corticosteroids and antihistamines. To evaluate and compare the effectiveness of 2 nasally administered drugs, fluticasone (a corticosteroid) and levocabastine (a selective antihistamine whose primary indication is for ophthalmic use), Dr. Wojdas and colleagues studied 62 patients (33 males) aged 25 to 58 who had been diagnosed with drug-induced rhinitis, based on history, a physical exam, dermal tests and specific immunoglobulin E levels.

The patients were assigned to 1 of 4 groups: group 1 received fluticasone, group 2 received levocabastine, group 3 received both drugs, and the control group received an inert physiological solution. Fluticasone was administered once a day, 100 micrograms into each nostril. Levocabastine was administered twice per day into each nostril. For those in the control group, the solution were administered by aerosol into each nasal tract. Treatment was for 6 weeks.

The investigators considered the intensity of nasal discharge, the patients' feeling of nasal obstruction, and the patients' life quality and general well-being – all evaluated on a 10-point scale. They also looked at the appearance of the nasal mucosa, and the continuing need for nasal decongestants.

Both of the fluticasone groups did significantly better than did either the control group or the group using levocabastine alone, Dr. Wojdas said.

However, when the 2 groups getting fluticasone -- fluticasone alone and fluticasone plus levocabastine – were compared, the researchers obtained similar results, implying that the levocabastine was playing a lesser role in the therapeutic effect.

Based on these findings, the researchers concluded that fluticasone is more effective than is levocabastine in treating drug-induced rhinitis.


251 - Fluticasone vs. levocabastine in the treatment of drug-induced rhinitis

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