The Scope of Pharmacological and Clinical Effects of Modern Antihistamines, With a Special Focus on Rupatadine: Section 2. Persistent Allergic Rhinitis: Long-Term Treatment with Antihistamines

摘要

The Allergic Rhinitis and its Impact on Asthma (ARIA)workshop group, in collaboration with the World Health Organization,introduced a new classification system for allergicrhinitis based on the duration of symptoms and their severity.Persistent allergic rhinitis (PER) is defined as rhinitis in whichthe symptoms occur more than 4 days per week and for morethan 4 weeks. The disease is further classified into mild ormoderate-severe depending on the level of impairment (sleepdisturbances, impairment of activities, etc). Interestingly, theprevalence of PER demonstrates a wide geographic distributionand it is the most common form of rhinitis in Latin America,accounting for about 70% of cases. Rupatadine is a novelnonsedating second-generation antihistamine, which is also aPAF antagonist, which we evaluated in the treatment of PER in500 Latin American patients. In this randomized, doubleblind,placebo-controlled trial rupatadine 10 mg once-daily wascompared with cetirizine 10 mg once daily over a 12-weekperiod. Both rupatadine and cetirizine significantly improved6-symptom Total Symptom Scores at 4 and 8 weeks, but onlyrupatadine produced a statistically significant improvement at 12weeks (P 0.008). Importantly, both rupatadine and cetirizinesignificantly improved overall scores for quality of life, but onlyrupatadine significantly improved ocular symptoms (P 0.01).In this trial, and in a 12-month safety study, rupatadine wasfound to be well-tolerated, produced no evidence of cardiotoxiceffects and was associated with a high rate of treatment compliance. These data indicate that once dailyrupatadine is a good treatment option for patients withPER and it well-received by patients, as evidenced by highrates of long-term compliance.