Drugs

, Volume 67, Issue 18, pp 2717–2726

Histamine and Leukotriene Receptor Antagonism in the Treatment of Allergic Rhinitis

An Update
  • Helen Van Hoecke
  • Liesbet Vandenbulcke
  • Paul Van Cauwenberge
Review Article

DOI: 10.2165/00003495-200767180-00006

Cite this article as:
Van Hoecke, H., Vandenbulcke, L. & Van Cauwenberge, P. Drugs (2007) 67: 2717. doi:10.2165/00003495-200767180-00006
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Abstract

Allergic rhinitis represents a global health burden. The disease can seriously affect quality of life and is associated with multiple co-morbidities. Histamine and leukotrienes are important pro-inflammatory mediators in nasal allergic inflammation. Their actions on target cells are mediated through specific receptors and, consequently, molecules that block the binding of histamine and leukotrienes to their receptors have been important areas of pharmacological research.

The published literature of the pathophysiology of histamine and leukotrienes, and the effects of histamine H1-receptor antagonists (H1 antihistamines) and leukotriene antagonists in monotherapy or in combination therapy in the treatment of allergic rhinitis was reviewed. The presented results are based on the best available evidence.

The efficacy of H1 antihistamines and leukotriene antagonists (montelukast in particular) in allergic rhinitis has been established in numerous randomised placebo-controlled trials. Results from meta-analyses indicate that H1 antihistamines and leukotriene antagonists are equally effective in improving symptoms of allergic rhinitis and quality of life, but that both drugs are less effective than intranasal corticosteroids.

Data on the combination of H1 antihistamines and leukotriene antagonists in allergic rhinitis are limited. The available evidence shows that a combined mediator inhibition has additional benefits over the use of each agent alone, but is still inferior to intranasal corticosteroids. More well designed studies are needed to fully understand the benefits of a concomitant use of these agents.

Copyright information

© Adis Data Information BV 2007

Authors and Affiliations

  • Helen Van Hoecke
    • 1
  • Liesbet Vandenbulcke
    • 1
  • Paul Van Cauwenberge
    • 1
  1. 1.Department of OtorhinolaryngologyGhent University HospitalGhentBelgium

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