Desloratadin monoterapisi veya desloratadin artı montelukast kombinasyonu ile tedavi edilen inatçı alerjik rinit hastalarının yaşam kalitesi
Amaç: Bu çalışmada inatçı alerjik rinit hastalarında desloratadin monoterapisi ve desloratadin artı montelukast kombinasyon tedavisinin yaşam kalitesi üzerine etkinliği karşılaştırıldı.Hastalar ve Yöntemler: Mayıs 2010 - Eylül 2010 tarihleri arasında kulak, burun, boğaz polikliniğine sevk edilen 40 hasta 28 kadın, 12 erkek, ort. yaş 29.8 yıl; dağılım 17-44 yıl çalışmaya alındı. Altı haftalık randomize, çift kör, kesitsel çalışma iki koldan gerçekleştirildi: Grup 1’deki 20 hastaya yalnızca desloratadin 5 mg/gün ; grup 2’deki 20 hastaya ise desloratadin 5 mg/gün artı montelukast 10 mg/gün kombinasyon tedavisi verildi. Yaşam kalitesi tedaviye başlamadan önceki gün ve tedavinin son günü Rinokonjonktivit Yaşam Kalitesi Anketi ve Gece Semptom Skoru ile değerlendirildi.Bulgular: Grup 1’de tedavi öncesi ve sonrası ortalama yaşam kalitesi skoru, sırasıyla 3.17 ve 2.43 idi. Grup 2’de ise, tedavi öncesi ve sonrası ortalama yaşam kalitesi skoru, sırasıyla 2.94 ve 1.73 idi.Sonuç: Desloratadin artı montelukast kombinasyon tedavisinin, özellikle uyku semptomları olmak üzere, yaşam kalitesi üzerine olumlu bir etkisi olabilir
Anahtar Kelimeler:
Desloratadin, montelukast, inatçı allerjik rinit, yaşam kalitesi
Quality of life in patients with persistent allergic rhinitis treated with desloratadine monotherapy or desloratadine plus montelucast combination
Objectives: This study aims to compare the effectiveness of desloratadine monotherapy and desloratadine plus montelukast combination therapy on quality of life in patients with persistent allergic rhinitis. Patients and Methods: This study consists of 40 patients 28 females, 12 males, mean age 29.8 years; range 17 to 44 years referred to ear, nose, and throat outpatient clinic between May 2010 and September 2010. A six-week randomized, doubleblind, cross-sectional study was performed in two arms: In group 1, 20 patients received desloratadine 5 mg/d alone; in group 2, 20 patients received desloratadine 5 mg plus montelukast 10 mg combination therapy. Quality of life was assessed on the day before starting treatment and on the last day of each treatment period using the Rhinoconjunctivitis Quality of Life Questionnaire and Nighttime Symptom Scores. Results: In group 1, the mean quality of life scores before and after treatment were 3.17 and 2.43, respectively. In group 2, the mean quality of life scores before and after treatment were 2.94 and 1.73, respectively. Conclusion: Desloratadine plus montelukast combination therapy may have a positive impact on quality of life, sleep symptoms in particular.
Keywords:
Desloratadine, montelukast, persistent allergic rhinitis, quality of life,
___
- Dykewicz MS, Fineman S, Skoner DP, Nicklas R, Lee R, Blessing-Moore J, et al. Diagnosis and management of rhinitis: complete guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. American Academy of Allergy, Asthma, and Immunology. Ann Allergy Asthma Immunol 1998;81:478-518.
- Tahamiler R, Edizer DT, Canakcioglu S, Guvenc MG, Inci E, Dirican A. Nasal sound analysis: a new method for evaluating nasal obstruction in allergic rhinitis. Laryngoscope 2006;116:2050-4.
- Marshall PS, O’Hara C, Steinberg P. Effects of seasonal allergic rhinitis on selected cognitive abilities. Ann Allergy Asthma Immunol 2000;84:403-10.
- 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;108:S147-334.
- Ledford DK, Lockey RF. Allergic rhinitis: Understanding the process (a major contributor to health problems-and on the rise). J Respir Dis 1998;19:576-84.
- Meltzer EO, Prenner BM, Nayak A. Desloratadine Study Group. Efficacy and tolerability of once-daily 5 mg desloratadine, an H1 receptor antagonist, in patients with seasonal allergic rhinitis. Clin Drug Invest 2001;21:25-32.
- Day JH, Briscoe MP, Rafeiro E, Ratz JD. Comparative clinical efficacy, onset and duration of action of levocetirizine and desloratadine for symptoms of seasonal allergic rhinitis in subjects evaluated in the Environmental Exposure Unit (EEU). Int J Clin Pract 2004;58:109-18.
- Patel P, Philip G, Yang W, Call R, Horak F, LaForce C, et al. Randomized, double-blind, placebo- controlled study of montelukast for treating perennial allergic rhinitis. Ann Allergy Asthma Immunol 2005;95:551-7.
- Juniper EF, Guyatt GH. Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis. Clin Exp Allergy 1991;21:77-83.
- Dzaman K, Jadczak M, Rapiejko P, Usowski J, Jurkiewicz D. Life quality analysis based on a self- administered questionnaire in patient with nasal obstruction. Annales UMCS. 2005;90:416-20.
- Lundbäck B. Epidemiology of rhinitis and asthma. Clin Exp Allergy 1998;28 Suppl 2:3-10.
- Ciebiada M, Ciebiada MG, Kmiecik T, DuBuske LM, Gorski P. Quality of life in patients with persistent allergic rhinitis treated with montelukast alone or in combination with levocetirizine or desloratadine. J Investig Allergol Clin Immunol 2008;18:343-9.
- van Adelsberg J, Philip G, Pedinoff AJ, Meltzer EO, Ratner PH, Menten J, et al. Montelukast improves symptoms of seasonal allergic rhinitis over a 4-week treatment period. Allergy 2003;58:1268-76.
- Jordana G, Dolovich J, Briscoe MP, Day JH, Drouin MA, Gold M, et al. Intranasal fluticasone propionate versus loratadine in the treatment of adolescent patients with seasonal allergic rhinitis. J Allergy Clin Immunol 1996;97:588-95.
- Graf P, Hallén H, Juto JE. Four-week use of oxymetazoline nasal spray (Nezeril) once daily at night induces rebound swelling and nasal hyperreactivity. Acta Otolaryngol 1995;115:71-5.
- Graf P, Hallén H. Effect on the nasal mucosa of long- term treatment with oxymetazoline, benzalkonium chloride, and placebo nasal sprays. Laryngoscope 1996;106:605-9.
- Bernstein DI, Levy AL, Hampel FC, Baidoo CA, Cook CK, Philpot EE, et al. Treatment with intranasal fluticasone propionate significantly improves ocular symptoms in patients with seasonal allergic rhinitis. Clin Exp Allergy 2004;34:952-7.
- Singulair PI. Singulair prescribing information. Whitehouse Station, NJ: Merck & Co. Inc.; June 1998- 2005.
- Miadonna A, Tedeschi A, Leggieri E, Lorini M, Folco G, Sala A, et al. Behavior and clinical relevance of histamine and leukotrienes C4 and B4 in grass pollen-induced rhinitis. Am Rev Respir Dis 1987;136:357-62.
- Okuda M, Watase T, Mezawa A, Liu CM. The role of leukotriene D4 in allergic rhinitis. Ann Allergy 1988;60:537-40.
- Bisgaard H, Olsson P, Bende M. Effect of leukotriene D4 on nasal mucosal blood flow, nasal airway resistance and nasal secretion in humans. Clin Allergy 1986;16:289-97.
- Meltzer EO, Malmstrom K, Lu S, Prenner BM, Wei LX, Weinstein SF, et al. Concomitant montelukast and loratadine as treatment for seasonal allergic rhinitis: a randomized, placebo-controlled clinical trial. J Allergy Clin Immunol 2000;105:917-22.
- Nayak AS, Philip G, Lu S, Malice MP, Reiss TF; Montelukast Fall Rhinitis Investigator Group. Efficacy and tolerability of montelukast alone or in combination with loratadine in seasonal allergic rhinitis: a multicenter, randomized, double-blind, placebo-controlled trial performed in the fall. Ann Allergy Asthma Immunol 2002;88:592-600.
- Philip G, Malmstrom K, Hampel FC, Weinstein SF, LaForce CF, Ratner PH, et al. Montelukast for treating seasonal allergic rhinitis: a randomized, double-blind, placebo-controlled trial performed in the spring. Clin Exp Allergy 2002;32:1020-8.
- Philip G, Nayak AS, Berger WE, Leynadier F, Vrijens F, Dass SB, et al. The effect of montelukast on rhinitis symptoms in patients with asthma and seasonal allergic rhinitis. Curr Med Res Opin 2004;20:1549-58.
- van Adelsberg J, Philip G, LaForce CF, Weinstein SF, Menten J, Malice MP, et al. Randomized controlled trial evaluating the clinical benefit of montelukast for treating spring seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2003;90:214-22.
- Van Cauwenberge P. Advances in allergy management. Allergy 2002;57 Suppl 75:29-36.
- Potter PC; Paediatric Levocetirizine Study Group. Efficacy and safety of levocetirizine on symptoms and health-related quality of life of children with perennial allergic rhinitis: a double-blind, placebo- controlled randomized clinical trial. Ann Allergy Asthma Immunol 2005;95:175-80.
- Bachert C, Bousquet J, Canonica GW, Durham SR, Klimek L, Mullol J, et al. Levocetirizine improves quality of life and reduces costs in long-term management of persistent allergic rhinitis. J Allergy Clin Immunol 2004;114:838-44.
- Walter Canonica G, Bousquet J, Van Hammée G, Bachert C, Durham SR, Klimek L, et al. Levocetirizine improves health-related quality of life and health status in persistent allergic rhinitis. Respir Med 2006;100:1706-15.
- Ciebiada M, Górska-Ciebiada M, DuBuske LM, Górski P. Montelukast with desloratadine or levocetirizine for the treatment of persistent allergic rhinitis. Ann Allergy Asthma Immunol 2006;97:664-71.
- ISSN: 2602-4837
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 1991
- Yayıncı: İstanbul Üniversitesi