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Effect of cetirizine on bronchial hyperresponsiveness in patients with seasonal allergic rhinitis and asthma
Author(s) -
Aubier M.,
Neukirch C.,
Peiffer C.,
Melac M.
Publication year - 2001
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1034/j.1398-9995.2001.00629.x
Subject(s) - methacholine , medicine , cetirizine , asthma , bronchial hyperresponsiveness , placebo , crossover study , provocation test , allergen , allergy , antihistamine , histamine , anesthesia , gastroenterology , immunology , respiratory disease , pathology , alternative medicine , lung
Although H 1 antihistamine compounds (H 1 ) are highly effective in the treatment of allergic rhinitis (AR), their role in the treatment of asthma is still controversial. Because a strong association between AR and bronchial hyperresponsiveness (BHR) has been reported, this study was designed to assess the effect of a new H 1 anti histamine, cetirizine (C), on nonspecific BHR in patients with AR. Twelve patients were included in a double‐blind, crossover, placebo‐controlled trial. All patients had positive skin tests for common allergens and showed BHR to inhaled methacholine after specific nasal allergenic challenge. After a washout period of 1 week to ensure the stability of the BHR, the patients received, by crossover randomization, C 10 mg daily or placebo (P) for 2 weeks. After each treatment period, BHR and nasal blocking index (NBI) were measured 1 and 6 h after nasal challenge. Bronchial responsiveness was expressed as methacholine PD 20 , the provocation dose of methacholine causing a 20% decrease in FEV 1 . Measurements were then performed after 2 weeks of C and after 2 weeks of P. Baseline values of PD 20 (median) measured before challenge showed no difference after cetirizine or after placebo (1.36 mg). Results 1 h after allergen did not show significant differences between C (methacholine PD 20 =0.522 mg) and placebo (methacholine PD 20 =0.455 mg). By contrast, 6 h after challenge, methacholine PD 20 was 0.918 mg for C and 0.483 mg for P ( P =0.042). Similarly, NBI showed no change between C and P 1 h after challenge, whereas the difference was significant 6 h after challenge ( P =0.011). These data demonstrate a protective nasal effect of C against BHR measured 6 h after nasal allergen challenge in patients with AR. They suggest that C may be useful in patients with asthma associated with AR.