The effect of regular versus on-demand desloratadine treatment in children with allergic rhinitis

• Published in: International journal of pediatric otorhinolaryngology 2007-06, Vol.71 (6), p.843-849
• Main Authors: Dizdar, E.A, Sekerel, B.E, Keskin, O, Kalayci, O, Adalioglu, G, Dogan, C, Tuncer, A
• Format: Article
• Language: English
• Subjects: Adolescent; Albuterol - therapeutic use; Allergic rhinitis; Bronchial Hyperreactivity - drug therapy; Bronchoconstrictor Agents; Bronchodilator Agents - therapeutic use; Child; Children; Desloratadine; Drug Administration Schedule; Eosinophil Cationic Protein - analysis; Eosinophils - pathology; Ephedrine - therapeutic use; Female; Forced Expiratory Volume - drug effects; Histamine H1 Antagonists, Non-Sedating - administration & dosage; Humans; Immunoglobulin E - blood; Loratadine - administration & dosage; Loratadine - analogs & derivatives; Male; Methacholine Chloride; Nasal Mucosa - drug effects; Nasal Mucosa - secretion; Nasal Provocation Tests; On demand; Otolaryngology; Pediatrics; Pollen; Prospective Studies; Rhinitis, Allergic, Seasonal - drug therapy; Secretory Rate - drug effects
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2007.02.003

Summary Objective Desloratadine is a potent antihistamine. Whether regular or on-demand use of desloratadine influences its therapeutic efficacy in allergic rhinitis is unknown. The aim of the study was to compare the clinical efficacy and the anti-inflammatory activity of regularly administered desloratadine to its on-demand use in children with allergic rhinitis due to pollen allergy. Methods Thirty-seven patients with allergic rhinitis with or without mild intermittent asthma were enrolled in a prospective parallel group study. Patients were treated with desloratadine regularly or on-demand during pollen season. Rescue medications and symptom scores were recorded on a diary card. Nasal flow rate and inflammatory markers were recorded, and methacholine (Mch) challenge test was administered before and within the pollen season. Results Though symptoms were lower in the evening than in the morning ( p < 0.001), there was no difference between the two groups. There was no difference between the groups with respect to medication score except that the salbutamol use was lower in the regular treatment group during the fourth week ( p = 0.032) in the pollen season. Nasal flow rate and inflammatory markers failed to show any difference between the groups. A significant reduction in PC20 values (provocative concentration of Mch causing a 20% fall in FEV1 ) was observed in regular ( p = 0.016) and on-demand ( p = 0.005) treatment groups compared to the pre-season measurements. The number of children with a PC20 below 8 mg/ml increased significantly in the on-demand group. Conclusion Our study demonstrates that on-demand use of desloratadine during the pollen season is clinically as effective as regular treatment. However, regular treatment may provide better control of lower airway symptoms and airway reactivity.