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Azelastine (Astelin) Improves Nasal Symptoms Versus Cetirizine for Springtime Allergies: Presented at ACAAI

By Crystal Phend

ANAHEIM, CA -- November 7, 2005 -- Azelastine (Astelin) nasal spray may reduce some springtime symptoms and improve quality of life compared with cetirizine (Zyrtec), confirming earlier results in patients with fall seasonal allergies,* according to a study presented here at American College of Allergy, Asthma and Immunology (ACAAI).

Both treatments were found to be effective, however, and superior efficacy may not change the preference of some consumers, said lead author Frank Hampel, MD, medical director, Central Texas Health Research, New Braunfels, Texas.

"The US market is more attuned to pop a pill" than to use a nasal spray, Dr. Hampel said.

In the double-blind study, 360 patients with moderate to severe seasonal allergic rhinitis were randomized to receive 2 sprays of azelastine per nostril twice daily plus placebo capsules (179) or a 10-mg cetirizine tablet daily plus placebo nasal spray.

Patients recorded runny nose, itchy nose, sneezing, and nasal congestion symptoms in a diary twice daily to give a total nasal symptom score, the primary endpoint.

Mean overall improvement was not significantly different between treatment groups. The overall mean daily improvement on a maximum 24-point scale was 4.6 with azelastine compared with 3.9 with cetirizine. The overall mean improvement over baseline was 23.9% with azelastine and 19.6% with cetirizine.

The total nasal symptom score of patients that completed the 2-week follow-up was significantly higher with azelastine compared with cetirizine on days 1, 6, 7, 13, and 14. In the intent-to-treat population, only day 6 showed a significant difference.

Of the individual symptoms, nasal congestion and sneezing improved from baseline significantly more in the azelastine group.

Nasal and eye symptoms according to the rhinoconjunctivitis-related quality-of-life questionnaire responses at the end of the study were also significantly better in the azelastine group.

Overall quality-of-life scores and scores for each individual domain were also significantly higher than baseline scores in the azelastine group compared with the cetirizine group.

The most common adverse events in azelastine-treated patients compared with those receiving cetirizine were bitter taste (7.7% vs 0%), epistaxis (1.6% vs 1.1%), pharyngolaryngeal pain (1.6% vs 1.1%), and headache (1.1% vs 0%).

* Corren J, et al. Clin Ther. 2005 May;27(5):543-53.


[Presentation title: Effectiveness of Azelastine (Astelin(R)) Nasal Spray Compared to Cetirizine (Zyrtec(R)) Tablets in Patients With Seasonal Allergic Rhinitis. Abstract P106]

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