Levocetirizine Offers Relief for Symptoms of Allergic Rhinitis

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allergic rhinitisA significant portion of the population suffers from allergic rhinitis. Rhinorrhea, sneezing, nasal congestion, itchy nose, and conjunctivitis are common symptoms associated with allergic rhinitis, and antihistamines are considered a first-line treatment for the management of these symptoms.

Improvements in health-related quality of life and health status were measured in this randomized, double-blind, placebo-controlled trial of levocetirizine, a new antihistamine, in patients with persistent allergic rhinitis.

Patients recorded responses to the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) at the beginning of the randomization visit and at 1 and 4 weeks later, as well as at 3, 4.5, and 6 months after the randomization visits. Health status was also assessed using the Short Form (SF)-36 measure at all of the same time points, with the exception of Week 1.

A total of 551 patients were included in the 2 treatment groups; 273 were given placebo, and 278 were given levocetirizine 5 mg once daily. At baseline, RQLQ and SF-36 responses generally correlated with the severity of persistent allergic rhinitis. Disease severity was assessed using a score (ranging from 1 to 4) for common symptoms of allergic rhinitis; differences between the 4 severity groups were significant (P < .001).

Treatment with levocetirizine over a 6-month period produced significantly greater improvements for all scores on both the RQLQ and the SF-36, compared with placebo. For the RQLQ overall score, the relative improvement with levocetirizine over placebo was 36.4%.

Viewpoint

Health-related quality of life is increasingly recognized as an important measure of efficacy for new therapies. Especially with conditions characterized by persistent symptoms that often impact daily functioning, such as perennial allergic rhinitis, the patient's perception of medication value is important.

This study provides evidence of the positive impact of a new antihistamine on health-related quality of life. Caution should be used when interpreting these data, as the medication is compared only to placebo and not to other well-accepted treatments for persistent perennial allergic rhinitis. In addition, the authors note that patients were permitted to use limited amounts of cromolyn (ocular or nasal) and rescue medication (oral prednisone), which could have influenced the findings.

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