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Antiallergic and Vasoactive Drugs for Allergic Rhinitis

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Allergy Frontiers: Therapy and Prevention

Part of the book series: Allergy Frontiers ((ALLERGY,volume 5))

Rhinitis is defined as the inflammation of the lining of the nose with one or more symptoms. The symptom profile of allergic rhinitis (AR) includes sneezing, itching of the eyes, nose, and throat, nasal obstruction, and rhinorrhoea. However, other problems and symptoms are also commonly associated with AR. For example, patients with seasonal AR commonly have conjunctivitis and may also have bronchial asthma. In central Europe, the association with bronchial asthma is greater with birch pollen allergy than grass pollen allergy. Headache and fatigue are other symptoms commonly associated with AR [1]. The most bothering symptom of AR is blocked nose, but loss of taste and smell are also associated symptoms.

AR is linked with asthma; more than 30% of patients with perennial AR have signs of asthma, and about 75% of patients with allergic asthma also have perennial AR [2].

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References

  1. Temmel AFP, Schleinzer K, Marks B, et al (1998) Prospective epidemiological longitudinal study in allergic diseases. Otorhinolaryngol Nova 8:47

    Google Scholar 

  2. Corren J (1997) Allergic rhinitis and asthma: how important is the link? J Allergy Clin Immunol 99(2):781–786

    Article  Google Scholar 

  3. Juniper EF, Thompson AK, Ferrie PJ, et al (2000) Development and validation of the mini Rhinoconjunctivitis Quality of Life Questionaire. Clin Exp Allergy 30:132–140

    Article  CAS  PubMed  Google Scholar 

  4. Mygind N, Dahl R, Pedersen S, et al (1996) Pathogenesis of allergic rhinitis. In: Mygind N, Dahl R, Pedersen S, Thestrup-Pedersen K, eds. Essential allergy. Second edition. Berlin: Blackwell Science:201–206

    Google Scholar 

  5. International Rhinitis Management Working Group. International consensus report on the diagnosis and management of rhinitis (1994). Allergy 49 (suppl 19):1–34

    Google Scholar 

  6. Bousquet J, Van Cauwenberge P, Khaltaev N, Aria Workshop Group, World Health Organization (2001) Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 108 (suppl 5):S147–334

    Article  CAS  PubMed  Google Scholar 

  7. Bousquet J, Van Cauwenberge P, Aït Khaled N, et al (2006) Pharmacologic and anti-IgE treatment of allergic rhinitis ARIA update (in collaboration with GA2LEN). Allergy 61:1086–1096

    Article  CAS  PubMed  Google Scholar 

  8. Bachert C, Vignola AM, Gevaert P, et al (2004) Allergic rhinitis, rhinosinusitis and asthma: one airway disease. Immunol Allergy Clin North Am 24:19–43

    Article  PubMed  Google Scholar 

  9. Demoly P, Allaert FA, Lecasble M, et al (2003) Validation of the classification of ARIA. Allergy 58:672–675

    Article  CAS  PubMed  Google Scholar 

  10. Simons FER (1994) H1-receptor antagonists: comparative tolerability and safety. Drug Saf 10:350–380

    Article  CAS  PubMed  Google Scholar 

  11. Walsh GM, Annunziato L, Frossard N, et al (2001) New insights into the second-generation antihistamines. Drugs 61:207–236

    Article  CAS  PubMed  Google Scholar 

  12. Hadley JA (1999) Evaluation and management of allergic rhinitis. Med Clin North Am 83:13–25

    Article  CAS  PubMed  Google Scholar 

  13. Howarth PH, Salagean M, Dokic D (2000) Allergic rhinitis: not purely a histamine-related disease. Allergy 55:7–16

    Article  PubMed  Google Scholar 

  14. Taborda-Barata L, Jacobson M, Walker S, et al (1996) Effect of cetirizine and prednisolone on cellular infiltration and cytokine mRNA expression during allergen-induced late cutaneous responses. Clin Exp Allergy 26:68–78

    Article  CAS  PubMed  Google Scholar 

  15. Zweiman B, Atkins PC, Moskovitz A, et al (19997) Cellular inflammatory responses during immediate, developing, and established late-phase allergic cutaneous reactions: effects of ceti-rizine. J Allergy Clin Immunol 100:341–347

    Article  Google Scholar 

  16. Atkins PC, Zweiman B, Moskovitz A, et al (1997) Cellular inflammatory responses and mediator release during early developing late-phase allergic cutaneous inflammatory responses: effects of cetirizine. J Allergy Clin Immunol 99:806–811

    Article  CAS  PubMed  Google Scholar 

  17. Horak F (2000) Clinical advantages of dual activity in allergic rhinitis. Allergy 55 (suppl 64):34–39

    Article  PubMed  Google Scholar 

  18. Corey JP, Houser SM (2000) Nasal congestion: a review of its etiology, evaluation and treatment. Ear Nose Throat J 79:690–702

    CAS  PubMed  Google Scholar 

  19. Horak F (2002) Impact and modulation of nasal obstruction. Allergy 57 (suppl 75):25–28

    Article  PubMed  Google Scholar 

  20. Ciprandy G, Cirillo I, Vizzaccaro A, et al (2004) Nasal obstruction in patients with seasonal allergic rhinitis: Relationship between allergic inflammation and nasal airflow. Int Arch Allergy Immunol 134:34–40

    Article  CAS  Google Scholar 

  21. Ciprandi G, Cirillo I, Vizzaccaro A, et al (2005) Levocetirizine improves nasal symptoms and airflow in patients with perennial allergic rhinitis: A pilot study. Eur Ann Allergy Clin Immunol 37:25–29

    CAS  PubMed  Google Scholar 

  22. Horak F, Stübner P, Zieglmayer R, et al (2003) Comparison of the effect of desloratadine 5-mg daily and placebo on nasal airflow and seasonal allergic rhinitis symptoms induced by grass pollen exposure. Allergy 58:481–485

    Article  CAS  PubMed  Google Scholar 

  23. Horak F, Stübner UP (2002) Decongestant activity of desloratadine in controlled-allergen-exposure trials. Clin Drug Invest 22 (suppl 2):13–20

    Article  CAS  Google Scholar 

  24. Horak F, Stuebner UP, Zieglmayer R, et al (2002) Effect of desloratadine versus placebo on nasal airflow and subjective measures of nasal obstruction in subjects with grass pollen induced allergic rhinitis in an allergen exposure unit. J Allergy Clin Immunol 109:956–961

    Article  CAS  PubMed  Google Scholar 

  25. Horak F, Stuebner UP (1999) Comparative tolerability of second generation antihistamines. Drug Saf 20:385–401

    Article  CAS  PubMed  Google Scholar 

  26. Mann RD, Pearce GL, Dunn N, et al (2000) Sedation with “non-sedating” antihistamines: four prescription-event monitoring studies in general practice. Br Med J 320:1184–1186

    Article  CAS  Google Scholar 

  27. Gonzalez MA, Estes KS (1998) Pharmacokinetic overview of oral second-generation H 1 anti-histamines. Int J Clin Pharmacol Ther 36:292–300

    CAS  PubMed  Google Scholar 

  28. Devillier P, Bousquet J (2007) Inhibition of the histamine-induced weal and flare response: a valid surrogate measure for antihistamine clinical efficacy? Clin Exp Allergy 37:400–414

    Article  CAS  PubMed  Google Scholar 

  29. Plaut M, Valentine MD (2005) Clinical practice. Allergic rhinitis. N Engl J Med 353:1934–1944

    Article  CAS  PubMed  Google Scholar 

  30. Horak F, Stübner P, Zieglmayer R, et al (2006) Azelastine nasal spray and desloratadine tablets in pollen-induced seasonal allergic rhinitis: A pharmacodynamic study of onset of action and efficacy. Curr Med Res Opin 22:151–157

    Article  CAS  PubMed  Google Scholar 

  31. Drouin MA, Yang WH, Horak F (1995) Faster onset of action with topical levocabastine than with oral cetirizine. Mediators Inflamm 44:5–10

    Article  Google Scholar 

  32. Horak F, Jäger S, Toth J, et al (1994) Azelastine in pollen-induced allergic rhinitis. A pharma-codynamic study of action and efficacy. Drug Invest 7:34–40

    Google Scholar 

  33. Noble S, Mc Tavish D (1995) Levocabastine. An update of its pharmacology, clinical efficacy and tolerability in the topical treatment of allergic rhinitis and conjunctivitis. Drugs 50:1032–1049

    CAS  Google Scholar 

  34. Mc Neeley W, Wiseman LR (1998) Intranasal azelastine. A review of its efficacy in the management of allergic rhinitis. Drugs 56:91–114

    Google Scholar 

  35. Crampton HJ (2003) Comparison of ketotifen fumerate ophthalmic solution alone, deslorata-dine alone, and their combination for inhibition of the signs and symptoms of seasonal allergic rhinoconjunctivitis in the conjunctival allergen challenge model: A double-masked, placeboand active-controlled trial. Clin Ther 25:1975–1987

    Article  CAS  PubMed  Google Scholar 

  36. Corren J, Storms W, Azelastine Cetirizine Trial No. 1 (ACT 1) Study Group (2005) Effevtiveness of azelastine nasal spray compared with oral cetirizine in patients with seasonal allergic rhinitis. Clin Ther 27(5):543–553

    Article  CAS  PubMed  Google Scholar 

  37. Berger WE, White MV (2003) Efficacy of azelastine nasal spry in patients with an unsatisfactory response to loratadine. Ann Allergy Asthma Immunol 91:205–211

    CAS  PubMed  Google Scholar 

  38. Laforce CF, Corren J, Wheeler WJ, et al (2004) Efficacy of azelastine nasal spray in seasonal allergic rhinitis patients whose symptoms remain after treatment with fexofenadine. Ann Allergy Asthma Immunol 93:154–159

    CAS  PubMed  Google Scholar 

  39. Yanez A, Rodrigo GJ (2002) Intranasal corticosteroids versus topical H1 receptor antagonists for the treatment of allergic rhinitis: A systematic review with meta-analysis. Ann Allergy Asthma Immunol 89:479–484

    Article  CAS  PubMed  Google Scholar 

  40. Fokkkens WJ, Godthelp T, Holm AF, et al (1998) Local corticosteroid treatment: The effect on cells and cytokines in nasal allergic inflammation. Am J Rhinol 12:21–26

    Article  Google Scholar 

  41. Weiner JM, Abramson MJ, puy RM (1998) Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: Systematic review of randomised controlled trials. BMJ 317:1624–1629

    CAS  PubMed  Google Scholar 

  42. Jen A, Baroody F, De Tineo M, et al (2000) As-need use of fluticasone propionate nasal spray reduces symptoms of seasonal allergic rhinitis. J Allergy Clin Immunol 105:732–738

    Article  CAS  PubMed  Google Scholar 

  43. Graft D, Aaronson D, Chervinsky P, et al (1996) A placebo- and active-controlled randomized trial of prophylactic treatment of seasonal allergic rhinitis with mometasone fuorate aqueous nasal spray. J Allergy Clin Immunol 98:724–731

    Article  CAS  PubMed  Google Scholar 

  44. Fokkens WJ, Cserhati E, Dos Santos JM, et al (2002) Budesonide queousus nasal spray is an effective treatment in children with perennial allergic rhinitis, with an onset of action within 12 hours. Ann Allergy Asthma Immunol 89:279–284

    Article  CAS  PubMed  Google Scholar 

  45. Lumry WR (1999) A review of the preclinical and clinical data of newer intranasal steroids used in the treatment of allergic rhinitis. J Allergy Clin Immunol 104:150–158

    Article  Google Scholar 

  46. Trangsrud AJ, Whitaker AL, Small RE (2002) Intranasal corticosteroids for allergic rhinitis. Pharmacotherapy 22:1458–1467

    Article  CAS  PubMed  Google Scholar 

  47. Szelenyi I, Hochhaus G, Heer S, et al (2000) Loteprednol etabonate: A soft steroid for the treatment of allergic diseases of the airways. Drugs Today 36:313–320

    CAS  PubMed  Google Scholar 

  48. Bodor N, Buchwald P (2000) Soft drug design: General principles and recent applications. Med Res Rev 20:58–101

    Article  CAS  PubMed  Google Scholar 

  49. Nasser SM, Ewan PW (2001) Lesson of the week: Ddepot corticosteroid treatment for hay fever causing avascular necrosis of both hips. BMJ 322:1589–1591

    Article  CAS  PubMed  Google Scholar 

  50. Busse W, Kraft M (2005) Cysteinyl leukotrienes in allergic inflammation. Strategic target for therapy. Chest 127:1312–1326

    CAS  Google Scholar 

  51. Haberal I, Corey JP (2003) The role of leukotrienes in nasal allergy. Otolaryngol Head Neck Surg 129:274–279

    Article  PubMed  Google Scholar 

  52. Shahab R, Phillips DE, Johnes AS (2004) Prostaglandins, leukotrienes and perennial rhinitis. J Laryngol Otol 118:500–507

    Article  PubMed  Google Scholar 

  53. Turner P, Dear J, Scadding G, et al (2001) Role of kinins in seasonal allergic rhinitis: Icatibant, a bradykinin B2 receptor antagonist, abolished the hyperresponsiveness and nasal eosino-philia induced by antigen. J Allergy Clin Immunol 107:105–113

    Article  CAS  PubMed  Google Scholar 

  54. Lipworth BJ (1999) Leukotriene-receptor antagonists. Lancet 353:57–62

    Article  CAS  PubMed  Google Scholar 

  55. Philip G, Malmstrom K, Hampel FC, et al (2002) Montelucast for treating seasonal allergic rhinitis: A randomized, double-blind, placebo-controlled trial performed in the spring. Clin Exp Allergy 32:1020–1028

    Article  CAS  PubMed  Google Scholar 

  56. Currie GP, Srivastava P, Dempsey OJ, et al (2005) Therapeutic modulation of allergic airways disease with leukotrien receptor antagonists. Q J Med 98:171–182

    CAS  Google Scholar 

  57. Nayak AS, Philip G, Lu S, et al (2002) Efficacy and tolerability of montelukast alone or in combination with loratadine in seasonal allergic rhinitis: A multicenter, randomized, doubleblind, placebo controlled trial performed in fall. Ann Allergy Asthma Immunol 88:592–600

    Article  CAS  PubMed  Google Scholar 

  58. Meltzer EO, Malmstrom K, Lu S, et al (2000) Concomitant montelukast and loratadine as treatment for seasonal allergic rhinitis: Aa randomized, placebo-controlled clinical trial. J Allergy Clin Immunol 105:917–922

    Article  CAS  PubMed  Google Scholar 

  59. Keskin O, Alyamac E, Tuncer A, et al (2006) Do the leukotriene receptor antagonists work in children with grass pollen-induced allergic rhinitis? Pediatr Allergy Immunol 17:259–268

    Article  PubMed  Google Scholar 

  60. Pawankar R (2003) Exploring the role of leukotriene receptor antagonists in the management of allergic rhinitis and comorbid asthma. Clin Exp Allergy Rev 3:74–80

    Article  CAS  Google Scholar 

  61. Bousquet J, Chanal I, Alquie MC, et al (1993) Prevention of pollen rhinitis symptoms: Comparison of fluticasone propionate aqueous nasal spray and disodium cromoglycate aqueous nasal spray. A multicenter, double-blind, double-dummy, parallel-group study. Allergy 48:327–333

    Article  CAS  PubMed  Google Scholar 

  62. Bousquet J, van Cauwenberge P, Khaltaev N (2004) ARIA in the pharmacy: Management of allergic rhinitis symptoms in the pharmacy. Allergy 59:373–387

    Article  Google Scholar 

  63. Hadley JA (2003) Cost-effective pharmacotherapy for inhalant allergic rhinitis. Otolaryngol Clin North Am 36:825–836

    Article  PubMed  Google Scholar 

  64. Easthope S, Jarvis B (2001) Omalizumab. Drugs 61:253–260

    Article  CAS  PubMed  Google Scholar 

  65. Jardieu PM, Fick RB (1999) IgE inhibition as a therapy for allergic disease. Int Arch Allergy Immunol 118:112–115

    Article  CAS  PubMed  Google Scholar 

  66. Bez C, Schubert R, Kopp M, et al (2004) Effect of anti-immunoglobulinE on nasal inflammation in patients with seasonal allergic rhinoconjunctivitis. Clin Exp Allergy 34:1079–1085

    Article  CAS  PubMed  Google Scholar 

  67. Holgate ST, Corne J, Jardieu P, et al (1998) Treatment of allergic disease with anti-IgE. Allergy 53(suppl 45):83–88

    Article  CAS  PubMed  Google Scholar 

  68. Casale TB, Bernstein IL, Busse WW, et al (1997) Use of an anti-IgE humanized monoclonal antibody in ragweed-induced allergic rhinitis. J Allergy Clin Immunol 100:110–121

    Article  CAS  PubMed  Google Scholar 

  69. Adelroth E, Rak S, Haahtela T, et al (2000) Recombinant humanized mAb-E25, and anti-IgE mAb, in birch pollen-induced seasonal allergic rhinitis. J Allergy Clin Immunol 106:253–259

    Article  CAS  PubMed  Google Scholar 

  70. Van Cauwenberge P, Bachert C, Passalacqua G, et al (2000) Consensus statement on the treatment of allergic rhinitis. European Acad Allergol Clin Immunol Allergy 55:116–134

    Article  Google Scholar 

  71. Storms WW (2004) Pharmacologic approaches to daytime and night time symptoms of allergic rhinitis. J Allergy Clin Immunol 114:146–153

    Article  CAS  Google Scholar 

  72. Scadding GK (1995) Rhinitis medicamentosa. Clin Exp Allergy 25:391–394

    Article  CAS  PubMed  Google Scholar 

  73. Beck RA, Mercado DL, Seguin SM, et al (1992) Cardiovascular effects of pseudoephedrine in medically controlled hypertensive patients. Arch Intern Med 152:1242–1245

    Article  CAS  PubMed  Google Scholar 

  74. Bradley JG (1991) Nonprescription drugs and hypertension. Which ones affect blood pressure? Postgrad Med 89:195–202

    CAS  PubMed  Google Scholar 

  75. Zieglmayer UP, Horak F, Toth J, et al (2005) Efficacy and safety of an oral formulation of cetirizine and prolonged-release pseudoephedrine versus budesonide nasal spray in the management of nasal congestion in allergic rhinitis. Treat Respir Med 4:283–287

    Article  CAS  PubMed  Google Scholar 

  76. Horak F, Toth J, Marks B, et al (1998) Efficacy and safety relative to placebo of an oral formulation of cetirizine and sustained-release pseudoephedrine in the management of nasal congestion. Allergy 53:849–856

    Article  CAS  PubMed  Google Scholar 

  77. Hendeles L, Hatton RC (2006) Oral phenylephrine: an ineffective replacement for pseu-doephedrine? J Allergy Clin Immunol. 118: 279–280

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Ear Nose and Throat Department, Allergy Centre Vienna West, Medical University Vienna, Huetteldorferstrasse 46, Vienna, A-1150, Austria

    Friedrich Horak

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Correspondence to Friedrich Horak .

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  1. Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan

    Ruby Pawankar

  2. University of Southampton Southampton General Hospital, Tremona Road, Southampton, UK

    Stephen T. Holgate

  3. Children's Mercy Hospitals and Clinics UMKC School of Medicine, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Lanny J. Rosenwasser

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Horak, F. (2009). Antiallergic and Vasoactive Drugs for Allergic Rhinitis. In: Pawankar, R., Holgate, S.T., Rosenwasser, L.J. (eds) Allergy Frontiers: Therapy and Prevention. Allergy Frontiers, vol 5. Springer, Tokyo. https://doi.org/10.1007/978-4-431-99362-9_4

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