Fexofenadine: review of safety, efficacy and unmet needs in children with allergic rhinitis

AbstractAllergic rhinitis (AR) is the most common undiagnosed chronic condition in children. Moderate/severe AR symptoms significantly impair quality of life, and cause sleep disruption, absenteeism and decreased productivity. Additionally, untreated AR predisposes children to asthma and other chronic conditions. Although intranasal corticosteroids are the most effective pharmacologic treatment for AR, oral antihistamines are often preferred. First-generation antihistamines may be chosen to relieve AR symptoms as they are inexpensive and widely available; however, they cause sedative and cardiovascular negative effects due to poor receptor selectivity. Therefore, second-generation antihistamines were developed to reduce adverse effects while retaining efficacy. There are fewer clinical trials in children than adults, therefore, efficacy and safety data is limited, particularly in children under 6 years, highlighting the need to generate these data in young children with AR. Fexofenadine, a highly selective second-generation antihistamine, effectively alleviates symptoms of AR, is non-sedating due to decreased blood–brain barrier permeability, and is devoid of cardiovascular side effects. Importantly, fexofenadine relieves the ocular symptoms of allergic conjunctivitis, which occur concomitantly with AR, improving quality of life. Overall, fexofenadine displays a favorable safety profile and results in greater treatment satisfaction in children compared with other second-generation antihistamines. This review aimed to evaluate and compare the safety and efficacy of fexofenadine with other available first- and second-generation antihistamines in children with AR.

Download Full-text

MP-AzeFlu in Moderate-to-Severe Allergic Rhinitis: A Literature Review

International Archives of Allergy and Immunology ◽

10.1159/000516417 ◽

2021 ◽

pp. 1-10

Author(s):

Ludger Klimek ◽

William E. Berger ◽

Jean Bousquet ◽

Paul K. Keith ◽

Peter Smith ◽

...

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Fluticasone Propionate ◽

Treatment Options ◽

Symptomatic Disease ◽

Intranasal Corticosteroids ◽

Need For Treatment ◽

Ocular Symptoms ◽

Symptom Complex

Allergic rhinitis (AR) is prevalent, and many patients present with moderate-to-severe symptomatic disease. The majority of patients are not satisfied with their AR treatment, despite the use of concurrent medications. These gaps underscore the need for treatment with more effective options for moderate-to-severe AR. The authors’ objective was to review systematically the efficacy and safety of MP-AzeFlu for the treatment of AR. The primary outcomes studied were nasal, ocular, and total symptoms. Other outcomes included time to onset and of AR control, quality of life, and safety. Searches of PubMed and Cochrane databases were conducted on May 14, 2020, with no date restrictions, to identify publications reporting data on MP-AzeFlu. Clinical studies of any phase were included. Studies were excluded if they were not in English, were review articles, did not discuss the safety and efficacy of MP-AzeFlu for AR symptoms. Treatment of AR with MP-AzeFlu results in effective, sustained relief of nasal and ocular symptoms, and faster onset and time to control compared with intranasal azelastine or fluticasone propionate. Long-term use of MP-AzeFlu was safe, with benefits in children, adults, and adults aged ≥65 years. Other treatment options, including fluticasone propionate and azelastine alone or the combination of intranasal corticosteroids and oral antihistamine, do not provide the same level of efficacy as MP-AzeFlu in terms of rapid and sustained relief of the entire AR symptom complex. Furthermore, MP-AzeFlu significantly improves patient quality of life. MP-AzeFlu is a currently available combination that may satisfy all these patient needs and expectations.

Download Full-text

Intranasal Ciclesonide in Allergic Rhinitis

Clinical Medicine Insights Therapeutics ◽

10.4137/cmt.s4120 ◽

2010 ◽

Vol 2 ◽

pp. CMT.S4120

Author(s):

Harissios Vliagoftis

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Indirect Costs ◽

Pharmacokinetic Profile ◽

Improve Quality ◽

Perennial Allergic Rhinitis ◽

Direct And Indirect Costs ◽

Intranasal Corticosteroids ◽

Very High

Allergic rhinitis affects more than 20% and is responsible for very high direct and indirect costs. Nasal corticosteroids are the principle pharmaceutical option for the treatment of allergic rhinitis. They are more effective than all other therapeutic options and in addition to improving symptoms of allergic rhinitis they also improve quality of life in patients suffering from allergic rhinitis. There are many intranasal corticosteroids approved for the treatment of allergic rhinitis in pediatric and adult populations. Ciclesonide has shown so far a very good safety and pharmacokinetic profile and is effective for treatment of symptoms in both seasonal and perennial allergic rhinitis. This review summarizes the studies describing these effects of intranasal ciclesonide.

Download Full-text

Leukotriene Receptor Antagonist Addition to H1-Antihistamine Is Effective for Treating Allergic Rhinitis: A Systematic Review and Meta-analysis

American Journal of Rhinology and Allergy ◽

10.1177/1945892419844459 ◽

2019 ◽

Vol 33 (5) ◽

pp. 591-600 ◽

Cited By ~ 4

Author(s):

Kachorn Seresirikachorn ◽

Wirach Chitsuthipakorn ◽

Dichapong Kanjanawasee ◽

Likhit Khattiyawittayakun ◽

Kornkiat Snidvongs

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Receptor Antagonist ◽

Meta Analysis ◽

Leukotriene Receptor Antagonist ◽

Ocular Symptoms ◽

Nasal Symptoms ◽

Subgroup Analyses ◽

Leukotriene Receptor

Background Histamine and leukotriene are released after being triggered by allergen exposure. The combination of leukotriene receptor antagonist (LTRA) and H1-antihistamine (AH) is utilized to control the allergic rhinitis (AR) symptoms after the failure of either AH or LTRA. Objective This study aimed to investigate the effects of the combination of H1-antihistamine and leukotriene receptor antagonist (AH-LTRA) in patients with AR. Methods Randomized controlled trials studying the effects of AH-LTRA versus AH alone on rhinoconjuncitivits symptoms in patients with AR were included. Data were pooled for meta-analysis. The outcomes were nasal symptoms, ocular symptoms, disease-specific quality of life, and adverse events. Meta-analyses were performed to compare the outcomes between AH-LTRA and AH. Subgroup analyses by AR subtype, asthma, and pediatric patients were performed. Results Fourteen studies (3271 participants) met the inclusion criteria. The results favored the effects of AH-LTRA on (1) composite nasal symptom score (standardized mean difference [SMD]: −0.20; 95% confidence interval [CI]: −0.36, −0.03), (2) rhinorrhea (SMD: −0.14; 95% CI: −0.27, −0.02), and (3) sneezing (SMD: −0.15; 95% CI: −0.27, −0.02). Subgroup analyses revealed that results favored the effects of AH-LTRA for perennial AR (SMD: −0.57; 95% CI: −0.87, −0.26) but not in the seasonal AR subgroup (SMD: −0.09; 95% CI: −0.21, 0.04), P = .004. There were no differences between AH-LTRA and AH on nasal obstruction, itching, ocular symptoms, Rhinoconjunctivitis Quality of life Questionnaire and adverse events. Due to limited number of included studies, effects on asthma and pediatric subgroups could not be assessed. Conclusion For controlling rhinoconjunctivitis symptoms in patients with AR, AH-LTRA provided greater beneficial effects on composite nasal symptoms, rhinorrhea, and sneezing compared to AH alone. These effects were shown in patients with perennial AR.

Download Full-text

The Effect of Intranasal Corticosteroids on Asthma Control and Quality of Life in Allergic Rhinitis with Mild Asthma

Journal of Asthma ◽

10.3109/02770903.2010.528821 ◽

2010 ◽

Vol 48 (1) ◽

pp. 41-47 ◽

Cited By ~ 18

Author(s):

Nicola Scichilone ◽

Rita Arrigo ◽

Alessandra Paternò ◽

Roberta Santagata ◽

Silvana Impellitteri ◽

...

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Asthma Control ◽

Mild Asthma ◽

Intranasal Corticosteroids

Download Full-text

PRS29 QUALITY OF LIFE AND WORK PRODUCTIVITY IN ALLERGIC RHINITIS PATIENTS SUFFERING FROM BOTH NASAL AND OCULAR SYMPTOMS—AN OBSERVATIONAL, CROSS SECTIONAL STUDY IN 4 COUNTRIES IN EUROPE

Value in Health ◽

10.1016/s1098-3015(10)74491-0 ◽

2009 ◽

Vol 12 (7) ◽

pp. A304

Author(s):

B Gueron ◽

JC Virchow ◽

J Cristino

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Work Productivity ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Ocular Symptoms

Download Full-text

THE ROLE OF MODERN ANTIHISTAMINES IN THE TREATMENT OF ALLERGIC DISEASES

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja299 ◽

2017 ◽

Vol 14 (4-5) ◽

pp. 80-88

Author(s):

N M Nenasheva

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Second Generation ◽

Allergic Diseases ◽

Pharmaceutical Market ◽

Common Diseases ◽

First Choice ◽

Antihistamine Drug

Allergic rhinitis and urticaria - are common diseases which influence on the quality of life of patients reducing day activity and educability. The second generation of antihistamines are the first choice in the treatment of these diseases. At Russian pharmaceutical market a few dozens of different preparations of this group are available. Most of them are generic forms. The purpose of this article is to show the place of modern antihistamines in allergic rhinitis and urticaria therapy and to find out the best equivalent of generic antihistamine drug in comparison with the original one.

Download Full-text