Desloratadine therapy improves allergic rhinitis symptoms in latin american children aged 6 to 12 years

Paolo Tassinari, Nelson R Suárez, Jorge Centeno, Janina Vergara Velásquez, Héctor Aguirre-Mariscal, Sandra N Gonzálezdíaz, Alfredo Fernández de Córdova Jerves, LA Desloratadine Study Group, Paolo Tassinari, Nelson R Suárez, Jorge Centeno, Janina Vergara Velásquez, Héctor Aguirre-Mariscal, Sandra N Gonzálezdíaz, Alfredo Fernández de Córdova Jerves, LA Desloratadine Study Group

Abstract

Objective: : To determine the effectiveness of desloratadine syrup in relieving symptoms of allergic rhinitis (AR) among children in Latin America.

Methods: : In an open-label trial conducted in 5 Latin American countries, 455 children aged 6 to 12 years with seasonal or perennial AR were treated with desloratadine syrup 2.5 mg/d for 6 weeks. Thirty percent of subjects were concomitantly taking corticosteroids, and 21.3% had a history of asthma. Efficacy was measured by improvement in the Total Symptom Severity 4 questionnaire and decrease in severity of individual nasal symptoms of congestion, rhinorrhea, pruritus, and sneezing. Physicians and subjects' caregivers rated symptom improvement in a separate assessment at final visit.

Results: : Treatment with desloratadine led to a significant decrease in mean Total Symptom Severity 4 score, from 7.54 at baseline to 1.96 at study end (P < 0.0001), and in individual symptom scores, including congestion (P < 0.0001 for all). Similar improvements were found in groups receiving desloratadine monotherapy and desloratadine plus corticosteroids. Allergic rhinitis symptoms were rated "better" or "much better" by 94% of caregivers. Incidence of adverse events was 6%.

Conclusions: : Desloratadine, with or without concomitant corticosteroids, was efficacious and safe in the treatment of AR in this group of Latin American children.

Figures

Figure 1
Figure 1
The Total Symptom Severity 4 questionnaire.
Figure 2
Figure 2
Percentage of children with moderate or severe symptoms of AR at baseline.
Figure 3
Figure 3
The TSS4 scores at baseline and after 6 weeks of desloratadine therapy in all subjects and according to the use of concomitant corticosteroid therapy.
Figure 4
Figure 4
Changes in individual symptom scores in all subjects and according to the use of concomitant corticosteroid therapy.
Figure 5
Figure 5
Caregivers' perceptions of improvement.

References

    1. Richards W. Asthma, allergies, and school. Pediatr Ann. 1992;2:575–585.
    1. Richards W. Preventing behavior problems in asthma and allergies. Clin Pediatr (Phila) 1994;2:617–624. doi: 10.1177/000992289403301008.
    1. Blaiss MS. on behalf of The Allergic Rhinitis in Schoolchildren Consensus Group. Allergic rhinitis and impairment issues in schoolchildren: a consensus report. Curr Med Res Opin. 2004;2:1937–1952. doi: 10.1185/030079904X13266.
    1. Klein GL, Ziering RW, Girsh LS, Miller MF. The allergic irritability syndrome: four case reports and a position statement from the Neuroallergy Committee of the American College of Allergy. Ann Allergy. 1985;2:22–24.
    1. Arrighi HM, Maier WC, Redding GJ, Morray BH, Llewellyn CE. The impact of allergic rhinitis in Seattle school children [Abstract 208] J Allergy Clin Immunol. 1995;2:192.
    1. Walker S, Khan-Wasti S, Fletcher M, Cullinan P, Harris J, Sheikh A. Seasonal allergic rhinitis is associated with a detrimental effect on examination performance in United Kingdom teenagers: case-control study. J Allergy Clin Immunol. 2007;2:381–387. doi: 10.1016/j.jaci.2007.03.034.
    1. Sundberg R, Torén K, Höglund D, Åberg N, Brisman J. Nasal symptoms are associated with school performance in adolescents. J Adolesc Health. 2007;2:581–583. doi: 10.1016/j.jadohealth.2007.01.003.
    1. American Academy of Allergy, Asthma & Immunology. Task force on allergic disorders: promoting best practice: raising the standard of care for patients with allergic disorders. Executive summary report. 1998. pp. 1–15.
    1. Bousquet J, van Cauwenberge P, Khaltaev N. ARIA Workshop Group, World Health Organization. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001;2(Suppl 5):S147–S334.
    1. Reinberg S. FDA panel recommends ban on cold medicines for kids. 2007. US News and World Report, . Accessed July 31, 2008.
    1. Bousquet J, van Cauwenberge P, Khaltaev N. the Workshop Expert Panel. Allergic rhinitis and its Impact on Asthma (ARIA), in collaboration with the World Health Organization. Executive summary of the workshop report. Allergy. 2002;2:841–855. doi: 10.1034/j.1398-9995.2002.23625.x.
    1. van Cauwenberge P, Bachert C, Passalacqua G, Bousquet J, Canonica GW, Durham SR. et al.Consensus statement on the treatment of allergic rhinitis. Allergy. 2000;2:116–134. doi: 10.1034/j.1398-9995.2000.00526.x.
    1. Dykewicz MS, Fineman S. Executive summary of Joint Task Force Practice Parameters on Diagnosis and Management of Rhinitis. Ann Allergy Asthma Immunol. 1998;2:463–468. doi: 10.1016/S1081-1206(10)63152-3.
    1. Nayak AS, Schenkel E. Desloratadine reduces nasal congestion in patients with intermittent allergic rhinitis. Allergy. 2001;2:1077–1080. doi: 10.1034/j.1398-9995.2001.00082.x.
    1. Berger WE, Schenkel EJ, Mansfield Le. the Desloratadine Study Group. Safety and efficacy of desloratadine 5 mg in asthma patients with seasonal allergic rhinitis and nasal congestion. Ann Allergy Asthma Immunol. 2002;2:485–491. doi: 10.1016/S1081-1206(10)62086-8.
    1. Holmberg K. Effectiveness of desloratadine in relieving symptoms of perennial allergic rhinitis. Poster presented at: 2005 Annual Meeting of the American College of Allergy, Asthma and Immunology; November 4-9 2005; Anaheim, CA.
    1. Cipriandi G, Cosentino C, Milanese M, Mondino C, Canonica GW. Fexofenadine reduces nasal congestion in perennial allergic rhinitis. Allergy. 2001;2:1068–1070. doi: 10.1034/j.1398-9995.2001.00191.x.
    1. Meltzer EO, Jalowayski AA, Vogt K, Iezzoni D, Harris AG. Effect of desloratadine therapy on symptom scores and measures of nasal patency in seasonal allergic rhinitis: results of a single-center, placebo-controlled trial. Ann Allergy Asthma Immunol. 2006;2:363–368. doi: 10.1016/S1081-1206(10)61249-5.
    1. Salmun LM, Lorber R. 24-Hour efficacy of once-daily desloratadine therapy in patients with seasonal allergic rhinitis [ISRCTN32042139] BMC Fam Pract. 2002;2:14. doi: 10.1186/1471-2296-3-14.
    1. Rossi GA, Tosca MA, Passalacqua G, Bianchi B, Le Grazie C, Canonica GW. Evidence of desloratadine syrup efficacy and tolerability in children with pollen-induced allergic rhinitis. Allergy. 2005;2:416–417. doi: 10.1111/j.1398-9995.2005.00714.x.
    1. Bloom M, Staudinger H, Herron J. Safety of desloratadine syrup in children. Curr Med Res Opin. 2004;2:1959–1965. doi: 10.1185/030079904X14148.
    1. Prenner B, Ballona R, Bueso A, Cardona R, Kim K, Larsen L. et al.Safety of desloratadine syrup in children six months to younger than 2 years of age: a randomized, double-blinded, placebo-controlled study. Pediatr Asthma Allergy Immunol. 2006;2:91–99. doi: 10.1089/pai.2006.19.91.
    1. Gupta S, Kantesaria B, Banfield C, Wang Z. Desloratadine dose selection in children aged 6 months to 2 years: comparison of population pharmacokinetics between children and adults. Br J Clin Pharmacol. 2007;2:174–184. doi: 10.1111/j.1365-2125.2007.02859.x.
    1. Gupta S, Khalilieh S, Kantesaria B, Banfield C. Pharmacokinetics of desloratadine in children between 2 and 11 years of age. Br J Clin Pharmacol. 2007;2:534–540. doi: 10.1111/j.1365-2125.2006.02810.x.
    1. Skoner DP. Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol. 2001;2:S2–S8. doi: 10.1067/mai.2001.115569.
    1. Wright AL, Holberg CJ, Martinez FD, Halonen M, Morgan W, Taussig LM. Epidemiology of physician-diagnosed allergic rhinitis in childhood. Pediatrics. 1994;2:895–901.
    1. Strachan DP, Sibbald B, Weiland SK, Aït-Khaled N, Anabwani G, Anderson HR. et al.Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: the International Study of Asthma and Allergies in Childhood (ISAAC) Pediatr Allergy Immunol. 1997;2:161–176. doi: 10.1111/j.1399-3038.1997.tb00156.x.
    1. Borges WG, Burns DAR, Felizola MLBM, Oliveira BA, Hamu CS, Freitas VC. Prevalence of allergic rhinitis among adolescents from Distrito Federal, Brazil: comparison between ISAAC phases I and III. J Pediatr (Rio J) 2006;2:137–143. doi: 10.2223/JPED.1461.
    1. Del-Río-Navarro BE, Luna-Pech JA, Berber A, Zepeda-Ortega Z, Avila-Castañon L, Del-Río-Chivardi JM. et al.Factors associated with allergic rhinitis in children from northern Mexico City. J Investig Allergol Clin Immunol. 2007;2:77–84.
    1. Ciprandi G, Vizzaccaro A, Cirillo I, Crimi P, Canonica GW. Increase of asthma and allergic rhinitis prevalence in young Italian men. Int Arch Allergy Immunol. 1996;2:279–283. doi: 10.1159/000237378.
    1. Shedden A. Impact of nasal congestion on quality of life and work productivity in allergic rhinitis: findings from a large online survey. Treat Respir Med. 2005;2:439–446. doi: 10.2165/00151829-200504060-00007.
    1. Young T, Finn L, Kim H. the University of Wisconsin Sleep and Respiratory Research Group. Nasal obstruction as a risk factor for sleep-disordered breathing. J Allergy Clin Immunol. 1997;2:S757–S762. doi: 10.1016/S0091-6749(97)70124-6.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera