盐酸氮卓斯汀喷鼻剂与辅舒良在治疗变应性鼻炎中的疗效分析

目的比较盐酸氮卓斯汀喷鼻剂同辅舒良在治疗常年性变应性鼻炎中的疗效。方法在确诊为常年性变应性鼻炎的231例患者,随机分成两组,其中123例患者对其用盐酸氮卓斯汀喷鼻剂进行治疗,另外108例用辅舒良(丙酸氟替卡松鼻喷剂)进行治疗,对比两组的疗效。结果盐酸氮卓斯汀组与辅舒良组治疗效果相当,但盐酸氮卓斯汀起效时间更快。从不良反应看,盐酸氮卓斯汀有个别患者诉有一过性轻微口苦;辅舒良组有10例出现鼻黏膜干燥,有3例出现鼻出血。盐酸氮卓斯汀不良反应更少。结论当常年性变应性鼻炎需要快速、安全和高效减轻症状时盐酸氮卓斯汀喷鼻剂是重要的选择之一。     

氮斯汀喷鼻剂治疗常年性变应性鼻炎随机双盲试验

目的 :探讨氮斯汀喷鼻剂治疗常年性变应性鼻炎的疗效及安全性。方法 :38例中、重度常年性变应性鼻炎病人行随机、双盲、对照研究。分氮斯汀组 19例 ,给予氮斯汀液体喷鼻剂喷鼻 ,每日 2次 ,每次每侧鼻孔 1揿 (每揿 140 μg氮斯汀 ) ,治疗 4wk。左卡巴斯汀组 19例 ,用左卡巴斯汀喷鼻剂喷鼻 ,每日 2次 ,每次 2揿 ,作为对照。治疗 2wk末及 4wk末时 ,根据主观评分及客观检查结果 ,综合评定疗效。结果 :氮斯汀喷鼻剂组总有效率为 95 % ,左卡巴斯汀喷鼻剂组为 84 % (P >0 .0 5 )。 2组治疗前后喷嚏、流涕、鼻痒、鼻塞及眼部症状积分下降分别为 1.4± 0 .8和 1.3± 1.0 ,1.0±0 .7和 0 .8± 0 .9,1.3± 0 .6和 1.4± 0 .7,0 .7± 0 .7和 0 .7± 0 .8,0 .8± 0 .8和 0 .5± 0 .7(均P >0 .0 5 ) ,未发生严重的不良反应。结论 :氮斯汀喷鼻剂与左卡巴斯汀喷鼻剂在治疗常年性变应性鼻炎时具相似的疗效和安全性     

盐酸氮卓斯汀与曲安奈德治疗变应性鼻炎的临床观察

目的:比较盐酸氮卓斯汀与曲安奈德治疗变应性鼻炎的临床疗效和安全性。方法:96例变应性鼻炎患者按随机数字表法分为A组(55例)和B组(41例)。A组患者给予盐酸氮卓斯汀鼻喷雾剂,每鼻孔1喷,bid,于晨起和睡前给药;B组患者给予曲安奈德鼻喷雾剂,每鼻孔2喷,qd,于晨起给药。两组患者疗程均为4周。观察两组患者的临床疗效、治疗前后的症状与体征评分及不良反应发生情况。结果:两组患者总有效率比较,差异无统计学意义(P>0.05)。治疗前两组患者症状与体征评分比较,差异均无统计学意义(P>0.05);治疗后两组患者症状与体征评分均显著低于同组治疗前,差异均有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05)。A组患者不良反应发生率为5.5%,B组患者为19.5%,A组显著低于B组,两组比较差异有统计学意义(P<0.05)。结论:盐酸氮卓斯汀与曲安奈德治疗变应性鼻炎均具有显著疗效,但盐酸氮卓斯汀安全性更好。     

盐酸氮（艹卓）斯汀与氯雷他定随机对照治疗变应性鼻炎的临床试验

目的 与对照药氯雷他定片比较,评价盐酸氮(?)斯汀片治疗变应性鼻炎的临床疗效及安全性。方法 用多中心、随机、双盲、平行对照的临床试验,试验组变应性鼻炎病人58例,每日服用盐酸氮(?)斯汀片2次,每次1 mg;对照组病人63例,每日口服氯雷他定片1 0 mg和安慰剂各1次。两组均连续服药14天。对治疗前后的喷嚏、流涕、鼻堵、鼻痒及鼻腔情况进行评分。结果 盐酸氮革斯汀片和氯雷他定片治疗变应性鼻炎的有效率分别为87.93％,82.54％;药物不良反应发生率分别为8.62％,14.06％。经统计学检验,两者差异均无显著性。 结论 盐酸氮(?)斯汀片治疗变应性鼻炎安全有效。     

盐酸氮斯汀与氯雷他定随机对照治疗变应性鼻炎的临床试验

目的与对照药氯雷他定片比较,评价盐酸氮     

Review of azelastine nasal spray in the treatment of allergic and non-allergic rhinitis

Azelastine is a potent H(1)-antihistamine, which is available as a topical nasal spray and indicated for both seasonal allergic and non-allergic vasomotor rhinitis. In addition to its antihistaminic effects, it has also been shown to have a number of other potentially important attributes, including effects on cytokines, adhesion molecules and inflammatory cells. Azelastine nasal spray has been shown to benefit patients who have not responded adequately to loratadine and fexofenadine, and is significantly more efficacious than cetirizine and levocabastine in patients with seasonal allergic rhinitis. Given its unique pharmacologic properties and clinical profile, azelastine maintains an important role in the treatment of chronic rhinitis.     

Open-label evaluation of azelastine nasal spray in patients with seasonal allergic rhinitis and nonallergic vasomotor rhinitis

OBJECTIVE: The objective of the study was to evaluate the effectiveness of azelastine (Astelin) nasal spray, a topical second-generation antihistamine, in the treatment of symptoms of seasonal allergic rhinitis, seasonal allergic rhinitis with nonallergic triggers (mixed rhinitis), and nonallergic vasomotor rhinitis. RESEARCH DESIGN AND METHODS: A total of 2343 primary care physicians, allergists, ENT specialists, and other health professionals participated in this 2-week, open-label evaluation of azelastine nasal spray. Data were collected through a physician questionnaire that included patient demographics, rhinitis diagnosis, medication history, and inclusion/exclusion criteria; and two patient questionnaires that included symptom history, response to previous rhinitis medications, symptom control, and level of satisfaction with azelastine nasal spray. A completed physician questionnaire and two completed patient questionnaires were required for each patient to be included in the analysis. Patients who qualified for enrollment were given open-label azelastine nasal spray and instructed to administer 2 sprays per nostril twice daily for 2 weeks. RESULTS: A total of 1225 health professionals enrolled 7864 patients into the study. Completed physician and patient questionnaires were returned by 1081 health professionals and 5073 patients, 4364 of whom used azelastine nasal spray as their only rhinitis medication during the 2-week study period. The patients were predominantly caucasian (82.6%) and female (61.1%), with a mean age of 50 years. The majority had a diagnosis of mixed rhinitis (51.5%), followed by seasonal allergic rhinitis (32.3%), and nonallergic (vasomotor) rhinitis (16.2%). After 2 weeks of treatment, the percentage of patients reporting some control or complete control of individual symptoms ranged from 78% for postnasal drip in patients with nonallergic vasomotor rhinitis to 90% for sneezing in patients with seasonal allergic rhinitis. More than 85% of patients who reported difficulty sleeping or impairment of daytime activities due to rhinitis symptoms had improvement in these parameters. Azelastine nasal spray was well tolerated, the discontinuation rate due to adverse events was 2.3%. CONCLUSIONS: Azelastine nasal spray was reported to control all rhinitis symptoms, including nasal congestion, regardless of rhinitis diagnosis during the 2-week study period. Patients with seasonal allergic rhinitis and patients with seasonal allergic rhinitis plus nonallergic triggers were identified as patient types most likely to respond to azelastine nasal spray.     

Efficacy and Tolerability of Azelastine Nasal Spray in the Treatment of Allergic Rhinitis: Large Scale Experience in Community Practice

Summary

Two Spanish prospective monitoring studies evaluated efficacy and tolerability of azelastine nasal spray* containing azelastine hydrochloride for allergic rhinitis. Both studies were conducted by community practitioners over two weeks (Study I) or one month (Study II).

The numbers of patients recruited were 3680 (I) and 4002 (II). Of these, 56.1% (I) and 51.7% (II) had been previously treated with oral antihistamines with/without other medications. Patients rated the severity of 10 symptoms of allergic rhinitis as absent, mild. moderate or severe. Azelastine nasal spray was generally administered at a dose of one spray puff (0.14?mg) per nostril twice daily. Follow-up was after 14 days (I) or 31 days (II), when symptoms were rated and patients questioned about treatment.

Assessment was by a sum score for all 10 symptoms. A symptom sum score of 1620 occurred in 21.1% (I) and 13.7% (II) of patients before treatment and only 0.8% (I) and 0.6% (II) after treatment. A symptom sum score of 11—15 occurred in 35.9% (I) and 30.5% (II) of patients before treatment and only 2.6% (I) and 2.8% (II) after treatment. Overall, 92.3% (I) and 90.7% (II) of patients were completely pee of adverse events, 7.0% (I) and 8.8% (II) experienced one and 0.7% (I) and 0.6% (II) two adverse events. The number of doctors who rated efficacy as either very good or good was 89.4% (I) and 84.6% (II). General tolerance was rated as good or very good by 97.5% (I) and 97.3% (II), and local tolerance by 93.1% (I) and 91.5% (II) of physicians, respectively.

Overall, azelastine nasal spray was highly effective and very well tolerated in normal clinical practice.     

Azelastine nasal spray and desloratadine tablets in pollen-induced seasonal allergic rhinitis: a pharmacodynamic study of onset of action and efficacy

OBJECTIVE: To assess the efficacy and onset of action of azelastine nasal spray and desloratadine tablets in patients with allergen-induced seasonal allergic rhinitis (SAR). RESEARCH DESIGN AND METHODS: 46 adult patients with a history of SAR were exposed to a controlled grass pollen concentration for 6 h in the Vienna Challenge Chamber (VCC) in each treatment period according to a randomised, double-blind (double-dummy), three-period, three-sequence crossover design (wash-out period of 12 days). Single doses of study medication (one puff nasal spray into each nostril of azelastine, 0.2 mg, or placebo before swallowing one encapsulated tablet of desloratadine, 5 mg) were administered 2 h after the start of the allergen challenge. Results of subjective and objective assessments were recorded throughout the challenge. RESULTS: Efficacy of azelastine nasal spray was significantly superior compared to desloratadine tablets (p = 0.005) and placebo (p < 0.001). Desloratadine was significantly better than placebo (p < 0.001). Decrease both in Major Nasal Symptom Score (MNSS) and in Total Nasal Symptom Score (TNSS) was fastest after azelastine treatment. Improvement of nasal symptom severity was most pronounced after azelastine treatment for all nasal symptoms including nasal congestion. Onset of action was 15 min for azelastine compared to 150 min for desloratadine. Both active preparations were safe and well tolerated. CONCLUSIONS: This study confirms the usefulness of azelastine nasal spray for the symptomatic treatment of seasonal allergic rhinitis. Concerning onset of action in particular, the results favour the topical treatment over systemic therapy.     

Azelastine hydrochloride:a review of pharmacology,pharmacokinetics, clinical efficacy and tolerability

ABSTRACT

Introduction: Azelastine hydrochloride (Astelin) nasal spray 0.1% solution is a second-generation intranasal antihistamine available in the US for treatment of both seasonal allergic rhinitis (SAR) and nonallergic vasomotor rhinitis (VMR).

Scope: Searches of journal articles including the title word ‘azelastine’ from 1979 through the present were conducted by the product manufacturer primarily through Medline and EMBASE but also included, at various times, Dialog, Biosis, Toxline, and Diogenes (an adverse-event database). One limitation of the present review is that it could not exclude the possibility of publication bias, whereby findings from smaller studies and/or trials with negative findings may not have been published.

Findings: Azelastine is a phthalazinone derivative with H₁-receptor binding approximately tenfold greater than chlorpheniramine on a milligram-per-milligram basis. Azelastine has demonstrated a wide range of pharmacologic effects on chemical mediators of inflammation including leukotrienes, kinins, and platelet activating factor in vitro and in vivo. The molecule also has been shown to downregulate intercellular adhesion molecule-1 expression and to reduce inflammatory cell migration in patients with rhinitis. Well-controlled studies in SAR and VMR demonstrated that azelastine nasal spray improves nasal symptoms of rhinitis, including congestion and postnasal drip, and has a rapid onset of action that appears likely due to topical activity. Azelastine nasal spray has demonstrated greater efficacy when used in combination with fluticasone propionate nasal spray when compared to either agent alone, and this combination may provide benefit for patients with moderate-to-severe rhinitis. Bitter taste is the most common side effect associated with azelastine nasal spray and this problem can be mitigated by the dosing technique recommended by the manufacturer in the product labeling. The incidence of somnolence also may be reduced with the recommended administration technique.

Conclusions: Azelastine is an effective, rapid-acting, and well-tolerated second-generation antihistamine that improves nasal symptoms associated with SAR and VMR. Clinical studies demonstrated that azelastine nasal spray can improve symptoms of SAR in patients who remained symptomatic after treatment with oral antihistamines and that azelastine nasal spray in combination with fluticasone nasal spray provided significantly (?p < 0.05) greater relief than either agent alone in patients with SAR.     

盐酸氮卓斯汀与丙酸氟替卡松喷鼻剂治疗变应性鼻炎临床对比观察

目的观察并比较盐酸氮卓斯汀与丙酸氟替卡松喷鼻剂在治疗变应性鼻炎中的效果。方法 146例变应性鼻炎患者,随机分为观察组和对照组,观察组应用盐酸氮卓斯汀喷鼻剂,对照组应用丙酸氟替卡松喷鼻剂(辅舒良),比较两组疗效及不良反应。结果两组治疗效果比较差异无统计学意义。但观察组起效快、不良反应明显少于对照组。结论对于常年性变应性鼻炎的治疗,应首选盐酸氮卓斯汀,该药起效快、安全有效,值得临床推广应用。     

Desloratadine and levocetirizine improve nasal symptoms, airflow, and allergic inflammation in patients with perennial allergic rhinitis: a pilot study

BACKGROUND: Nasal obstruction is the main symptom in patients with perennial allergic rhinitis. Some new antihistamines have been demonstrated to be capable of improving this symptom. OBJECTIVE: The aim of this pilot study was to evaluate nasal symptoms, nasal airflow, eosinophils, and IL-4 in patients with perennial allergic rhinitis, before and after treatment with two new antihistamines: desloratadine and levocetirizine. METHODS: Thirty patients with perennial allergic rhinitis were evaluated, 26 males and 4 females (mean age 26+/-7.1 years). All of them received either desloratadine (5 mg/daily) or levocetirizine (5 mg/daily) or placebo for 4 weeks. The study was double-blind, parallel-group, placebo-controlled, and randomized. Total symptom score (including: rhinorrhea, nasal itching, sneezing, and nasal obstruction) was assessed before and after treatment. Rhinomanometry and decongestion test, nasal lavage, and nasal scraping were performed in all subjects before and after treatment. Eosinophils were counted by conventional staining; IL-4 was measured by immunoassay of fluids recovered from nasal lavage. RESULTS: Desloratadine and levocetirizine treatment induced significant symptom relief and significant reduction of IL-4. Both antihistamines significantly affected all parameters in comparison with placebo. CONCLUSIONS: This pilot study demonstrates the effectiveness of antihistaminic treatment in: i) relieving nasal symptoms, including obstruction, ii) improving nasal airflow, iii) exerting decongestant activity, iv) reducing eosinophil infiltration, and v) diminishing IL-4 levels.     

Comparative efficacy and safety of azelastine and levocabastine nasal sprays in patients with seasonal allergic rhinitis.

The aim of the present investigation was to compare the efficacy and tolerability of azelastine (CAS 58581-89-8) (1.12 mg/day) and levocabastine (CAS 79547-78-7) (0.4 mg/day) nasal spray administered twice daily to patients with seasonal allergic rhinitis. A total of 180 patients participated in a 4-week, double-blind, parallel group (n = 90 each) study. Symptom severity of nasal, ocular and other symptoms were recorded, out of which a total symptom score (TSS) was calculated. Physicians assessed symptoms at baseline and at days 7, 14, and 28, patients and physicians evaluated the efficacy and tolerability. After 4 weeks of treatment with azelastine the mean overall TSS was reduced from a baseline score of 18.7 to 4.2, after levocabastine from 17.8 to 5.9. Patients morning scores for treatment days 1 to 28 gave a mean total score of 212.4 for the azelastine group and 230.6 for the levocabastine group; the equivalent evening scores yielded a mean total score of 115.5 and 175.6 respectively. Global efficacy was judged by physicians as either 'very good' or 'good' for 90% of azelastine patients and for 74% of the levocabastine group; 92% of azelastine patients and 76% of levocabastine patients judged treatment to be either 'very good' or 'good'. No serious adverse events were reported, all adverse events were related to nasal symptoms. Both azelastine and levocabastine administered twice daily as a nasal spray provide effective and well tolerated symptomatic treatment of seasonal allergic rhinitis. Azelastine, however, was statistically superior in efficacy as well as in safety (PWei-Lachin < 0.0001, combined results).     

Paediatric issues relating to the pharmacotherapy of allergic rhinitis

The prevalence of allergic rhinitis in children has risen significantly over the last two decades. Important comorbidities like asthma have grown in parallel due to a complex mix of environmental and genetic factors. These conditions have similar allergic inflammatory mechanisms, which raises the possibility of treating both conditions by targeting shared inflammatory mediators pharmacologically. The first line treatment for paediatric allergic rhinitis is a topical nasal corticosteroid or a non-sedating antihistamine. Available intranasal corticosteroids show superior symptom control to second-generation antihistamines. However, most topical steroids and non-sedating antihistamines have equivalent clinical efficacy within their respective classes, so the choice of agent depends on safety and tolerability. Ideally, topical nasal steroids should exhibit high local receptor binding affinity and low systemic bioavailability, allied with a lack of long-term growth suppression in children and adolescents. Regular use of topical steroids is advisable, but intermittent and prophylactic use is also effective. Second-generation antihistamines are effective and some have no adverse cardiac or sedative effects. Non-sedating antihistamine treatment can ameliorate rhinitis-induced decrements in learning. α-Adrenergic nasal decongestants provide short-term benefit, but topical agents can cause rebound symptoms. Prophylactic treatment with chromones is safe and effective, but multiple daily dosing is needed. Ipratroprium bromide nasal spray is useful as an intermittent therapy for mild disease or as add-on treatment, but its effect is limited to the control of rhinorrhoea. Children with allergic rhinitis should receive pharmacotherapy if allergen avoidance measures are ineffective, ideally with a topical intranasal steroid or a second-generation antihistamine.     

Efficacy and safety of montelukast add-on therapy in allergic rhinitis

Allergic rhinitis is a common airways hypersensitivity disease. Histamine and leukotrienes are involved in the pathogenesis of allergic rhinitis. Conventional treatments include topical steroids and antihistamines. Due to the adverse effects of these treatments, new drugs like leukotriene receptor antagonists are being investigated for the treatment of allergic rhinitis. A total of 90 patients suffering from allergic rhinitis were enrolled in this prospective, randomized, controlled study. Patients were divided randomly into three groups of 30 patients each. Group I was administered fluticasone nasal spray (200 μg in each nostril) once a day, Group II was administered fluticasone nasal spray (200 μg in each nostril) plus cetrizine (10 mg) orally once a day and Group III was administered fluticasone nasal spray (200 μg in each nostril) plus montelukast (10 mg) orally once a day. Efficacy was measured based on daytime and nighttime symptom scores. Safety was evaluated on the basis of psychomotor tests, laboratory investigations and subjective assessment. The present study showed that montelukast add-on therapy is as efficacious as conventional therapies in controlling total symptom score, but it is more efficacious in controlling nighttime symptoms. Furthermore, montelukast add-on therapy does not cause psychomotor impairment as observed with cetrizine.     

辛芩颗粒联合盐酸氮卓斯汀治疗变应性鼻炎的临床研究

目的探讨辛芩颗粒联合盐酸氮卓斯汀治疗变应性鼻炎的临床疗效。方法选取2015年1月—2016年1月在商洛市中心医院接受治疗的变应性鼻炎患者176例为研究对象,随机分为对照组和治疗组,每组各88例。对照组鼻喷盐酸氮卓斯汀鼻喷剂,1喷/鼻孔,2次/d。治疗组在对照组基础上口服辛芩颗粒,5 g/次,3次/d。两组均连续用药28 d。观察两组的临床疗效,比较两组的症状评分、RQLQ评分和血清学指标。结果治疗后,对照组和治疗组的总有效率分别为85.23%、94.32%,两组比较差异有统计学意义(P0.05)。治疗后,两组鼻塞、鼻痒、喷嚏和流涕评分及总评分均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组日常活动、睡眠、非鼻–结膜炎症、相关行为、鼻部症状、眼部症状和情感反应评分均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组白细胞介素-4(IL-4)、白细胞介素-5(IL-5)、转化生长因子-α(TGF-α)和免疫球蛋白E(Ig E)均明显升高,而白细胞介素-12(IL-12)和γ-干扰素(IFN-γ)均明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论辛芩颗粒联合盐酸氮卓斯汀治疗变应性鼻炎具有较好的临床疗效,改善患者临床症状和生活质量,提高机体免疫力,具有一定的临床推广应用价值。     

Azelastine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential

Azelastine is an antiallergic agent which demonstrates histamine H1-receptor antagonist activity and also inhibits histamine release from mast cells following antigen and non-antigen stimuli. Azelastine antagonises histamine- and leukotriene-induced bronchospasm in animal studies and reduces airway responsiveness to inhaled antigen or distilled water, and exercise challenge. In comparative studies, orally administered azelastine in doses up to 4 mg/day consistently relieved symptoms in patients with seasonal or perennial rhinitis - comparable to inhaled sodium cromoglycate (cromolyn sodium) 80 mg/day, oral chlorpheniramine (chlorphenamine) and oral terfenadine 120 mg/day. In addition, azelastine administered as an intranasal spray was as effective as oral terfenadine 120 mg/day and intranasal budesonide 0.4 mg/day in alleviating symptoms of rhinitis. Azelastine is also a potent antiasthmatic agent which produces significant and long lasting bronchodilation in patients with bronchial asthma. The drug is superior to placebo and comparable to oral ketotifen 2 mg/day and sustained release theophylline 700 mg/day when administered as a twice daily oral 4 mg dose. Azelastine is generally well tolerated: the most common adverse effects are altered taste perception and drowsiness. Adverse effects are mild and transient and result in withdrawal of treatment in less than 2% of patients. In a comparative study oral azelastine 2 or 4 mg/day produced no more sedation than terfenadine 120 mg/day. Thus, barring unexpected findings with wider clinical use, azelastine offers an effective and well tolerated choice of treatment for patients with allergic rhinitis and/or bronchial asthma, which may be particularly beneficial in patients in whom inhaled drug treatment is contraindicated.     

Bilastine: in allergic rhinitis and urticaria

Bilastine is an orally administered, second-generation antihistamine used in the symptomatic treatment of seasonal or perennial allergic rhinoconjunctivitis and urticaria. In two well designed phase III trials, 14 days' treatment with bilastine was associated with a significantly lower area under the effect curve (AUEC) for the reflective total symptom score (TSS) than placebo in patients with symptomatic seasonal allergic rhinitis. Additionally, reflective nasal symptom scores were significantly lower in bilastine than placebo recipients in patients with a history of seasonal allergic rhinitis who were challenged with grass pollen allergen in a single-centre, phase II study. Neither bilastine nor cetirizine was effective in the treatment of perennial allergic rhinitis with regard to the mean AUEC for reflective TSS in another well designed phase III trial. However, results may have been altered by differences in some baseline characteristics and placebo responses between study countries. In another well designed phase III trial, compared with placebo, bilastine was associated with a significantly greater change from baseline to day 28 in the mean reflective daily urticaria symptom score in patients with chronic urticaria. There were no significant differences in primary endpoint results between bilastine and any of the active comparators used in these trials (i.e. cetirizine, levocetirizine and desloratadine). Bilastine was generally well tolerated, with a tolerability profile that was generally similar to that of the other second-generation antihistamines included in phase III clinical trials.     

Azelastine reduces allergen-induced nasal response: a clinical and rhinomanometric assessment

Summary The effect of azelastine 2 mg b.d. p.o. for 10 days on grass pollen-induced nasal responses in 16 patients with grass pollen allergic rhinitis has been assessed. The study was a double blind, randomized, placebo controlled, crossover trial, with a 10–14 day wash-out period. Patients were challenged with grass pollen before and after placebo and azelastine. The response was assessed by measurement of nasal resistance using active posterior rhinomanometry, by weighing nasal secretions, and by counting sneezes. The sensation of nasal obstruction was assessed with a visual analogue scale. After measurement of baseline total nasal resistance, doubling doses of allergen were sprayed into both nostrils at 15 min intervals until the nasal resistance was doubled.Cumulative doses of allergen that doubled prechallenge nasal resistance, numbers of sneezes and the amounts of nasal secretions were similar before azelastine as well as before and after placebo (cumulative dose, mean, (g):2.3, 4.2 and 2.1 respectively, N.S.). After azelastine, the cumulative dose of allergen was increased (7.3 g), and nasal secretions and the number of sneezes were decreased. The visual analogue scores were similar before and after azelastine as well as before and after the placebo.It is concluded that azelastine reduced the allergeninduced nasal responses.     

曲安奈德鼻喷雾剂治疗变应性鼻炎的疗效观察

目的观察曲安奈德鼻喷雾剂对变应性鼻炎的临床疗效。方法用曲安奈德鼻喷雾剂治疗42例12-60岁常年性变应性鼻炎患者,治疗时间1个月。在治疗前以及治疗后1周、1个月、6个月分别观察记录并评分。结果42例在治疗后1周、1个月、6个月各项观察指标记分均明显降低,分析差异有统计学意义（P均〈0.05）;治疗后1周、1个月、6个月的有效率有统计学差异（P〈0.05）。无1例发生明显的毒副反应。结论曲安奈德鼻喷雾剂是治疗过敏性鼻炎安全、有效的药物。