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Published in: Italian Journal of Pediatrics 1/2019

Open Access 01-12-2019 | Allergic Rhinitis | Research

A polycentric, randomized, parallel-group, study on Lertal®, a multicomponent nutraceutical, as preventive treatment in children with allergic rhinoconjunctivitis: phase II

Authors: Gianluigi Marseglia, Amelia Licari, Salvatore Leonardi, Maria Papale, Anna Maria Zicari, Laura Schiavi, Giorgio Ciprandi, Italian Study Group on Pediatric Allergic Rhinoconjunctivitis

Published in: Italian Journal of Pediatrics | Issue 1/2019

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Abstract

Background

Lertal®, an oral nutraceutical, contains extract of Perilla, quercetin, and Vitamin D3. The current polycentric, randomized, parallel-group, controlled study aimed in the Phase II to evaluate the efficacy and safety of Lertal® in preventing allergic rhinitis (AR) exacerbations in children after the end of the pharmacological treatment phase.

Materials and methods

One hundred twenty-eight children completed Phase II. Sixty-four children continued Lertal® treatment (Lertal® Group: LG) and 64 ones did not assume any medication (Observation Group: OG) for 4–12 weeks.
The study endpoints were the number, intensity, and duration of AR exacerbations, and the length of symptom-free time.

Results

Children of LG halved the risk (HR = 0.54) of having AR exacerbation. Children of LG had significantly (p = 0.039) less AR exacerbations than OG children. In children with AR exacerbations, the total number of days in which each patient took at least one rescue medication was significantly (p = 0.018) lesser in LG children than OG ones. In the global population, the cumulative days treated with rescue medication was significantly (p < 0.0001) higher in OG than in LG. There was no clinically relevant adverse event.

Conclusions

The present study documented that prolonged Lertal® assumption was safe and able to significantly reduce, such as halving, the risk of AR exacerbation, their duration and the use of rescue medications, after the suspension of the one-month antihistamine treatment. Therefore, Lertal® could be envisaged as an effective preventive treatment in AR children able to guarantee long symptom-free time.

Trial registration

Clinical trial registration: ClinicalTrials gov ID NCT03365648.
Literature
1.
go back to reference Wise SK, Lin SY, Toskala E, Orlandi RR, Akdis CA, Alt JA, et al. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis. Int Forum Allergy Rhinol. 2018;8(2):108–352.CrossRef Wise SK, Lin SY, Toskala E, Orlandi RR, Akdis CA, Alt JA, et al. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis. Int Forum Allergy Rhinol. 2018;8(2):108–352.CrossRef
2.
go back to reference Ciprandi G, Klersy C, Cirillo I, Marseglia GL. Quality of life in allergic rhinitis: relationship with clinical, immunological, and functional aspects. Clin Exp Allergy. 2007;37(10):1528–35.PubMed Ciprandi G, Klersy C, Cirillo I, Marseglia GL. Quality of life in allergic rhinitis: relationship with clinical, immunological, and functional aspects. Clin Exp Allergy. 2007;37(10):1528–35.PubMed
3.
go back to reference Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017;140(4):950–8.CrossRef Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017;140(4):950–8.CrossRef
4.
go back to reference Dykewicz MS, Wallace DV, Baroody F, Bernstein J, Craig T, Finegold I, et al. Treatment of seasonal allergic rhinitis: an evidence-based focused 2017 guideline update. Ann Allergy Asthma Immunol. 2017;119:489–511.e41.CrossRef Dykewicz MS, Wallace DV, Baroody F, Bernstein J, Craig T, Finegold I, et al. Treatment of seasonal allergic rhinitis: an evidence-based focused 2017 guideline update. Ann Allergy Asthma Immunol. 2017;119:489–511.e41.CrossRef
5.
go back to reference Ciprandi G, Ricca V, Ferrero P, Alessandra B, Riccio AM, Milanese M, et al. Duration of antiinflammatory and symptomatic effects after suspension of intranasal corticosteroid in persistent allergic rhinitis. Eur Ann Allergy Clin Immunol. 2004;36:63–6.PubMed Ciprandi G, Ricca V, Ferrero P, Alessandra B, Riccio AM, Milanese M, et al. Duration of antiinflammatory and symptomatic effects after suspension of intranasal corticosteroid in persistent allergic rhinitis. Eur Ann Allergy Clin Immunol. 2004;36:63–6.PubMed
6.
go back to reference de Vries TW, van Hunsel F. Adverse drug reactions of systemic antihistamines in children in the Netherlands. Arch Dis Child. 2016;101(10):968–70.CrossRef de Vries TW, van Hunsel F. Adverse drug reactions of systemic antihistamines in children in the Netherlands. Arch Dis Child. 2016;101(10):968–70.CrossRef
7.
go back to reference Mainardi T, Kapoor S, Bielory L. Complementary and alternative medicine: herbs, phytochemicals and vitamins and their immunologic effects. J Allergy Clin Immunol. 2009;123:283–94.CrossRef Mainardi T, Kapoor S, Bielory L. Complementary and alternative medicine: herbs, phytochemicals and vitamins and their immunologic effects. J Allergy Clin Immunol. 2009;123:283–94.CrossRef
8.
go back to reference El-Qutob López D. New methods of prevention and treatment of allergic diseases. Recent Patents Inflamm Allergy Drug Discov. 2012;6(1):46–64.CrossRef El-Qutob López D. New methods of prevention and treatment of allergic diseases. Recent Patents Inflamm Allergy Drug Discov. 2012;6(1):46–64.CrossRef
9.
go back to reference Derebery MJ, Dicpinigaitis PV. New horizons: current and potential future self-treatments for acute upper respiratory tract conditions. Postgrad Med. 2013;125(1):82–96.CrossRef Derebery MJ, Dicpinigaitis PV. New horizons: current and potential future self-treatments for acute upper respiratory tract conditions. Postgrad Med. 2013;125(1):82–96.CrossRef
10.
go back to reference Yu H, Qiu JF, Ma LJ, Hu YJ, Li P, Wan JB. Phytochemical and phytopharmacological review of Perilla frutescens L. (Labiatae), a traditional edible-medicinal herb in China. Food Chem Toxicol. 2017;108(Pt B):375–91.CrossRef Yu H, Qiu JF, Ma LJ, Hu YJ, Li P, Wan JB. Phytochemical and phytopharmacological review of Perilla frutescens L. (Labiatae), a traditional edible-medicinal herb in China. Food Chem Toxicol. 2017;108(Pt B):375–91.CrossRef
11.
go back to reference Igarashi M, Miyazaki Y. A review on bioactivities of Perilla: progress in research on the functions of Perilla as medicine and food. Evid Based Complement Alternat Med. 2013;2013:925342.CrossRef Igarashi M, Miyazaki Y. A review on bioactivities of Perilla: progress in research on the functions of Perilla as medicine and food. Evid Based Complement Alternat Med. 2013;2013:925342.CrossRef
12.
go back to reference Chirumbolo S. The role of quercetin, Flavonols and flavones in modulating inflammatory cell function. Inflamm Allergy-Drug Targets. 2010;9(4):263–85.CrossRef Chirumbolo S. The role of quercetin, Flavonols and flavones in modulating inflammatory cell function. Inflamm Allergy-Drug Targets. 2010;9(4):263–85.CrossRef
13.
go back to reference Mlcek J, Jurikova T, Skrovankova S, Sochor J. Quercetin and its anti-allergic immune response. Molecules. 2016;21:623.CrossRef Mlcek J, Jurikova T, Skrovankova S, Sochor J. Quercetin and its anti-allergic immune response. Molecules. 2016;21:623.CrossRef
14.
go back to reference Yepes-Nunes JJ, Brozek JL, Fiocchi A, Pawankar R, Cuello-Garcia C, Zhang Y, et al. Vitamin D supplementation in primary allergy prevention: systematic review of randomized and non-randomized studies. Allergy. 2018;73:37–49.CrossRef Yepes-Nunes JJ, Brozek JL, Fiocchi A, Pawankar R, Cuello-Garcia C, Zhang Y, et al. Vitamin D supplementation in primary allergy prevention: systematic review of randomized and non-randomized studies. Allergy. 2018;73:37–49.CrossRef
15.
go back to reference Kim YH, Kim KW, Kim MJ, Sol IS, Yoon SH, Ahn HS, et al. Vitamin D levels in allergic rhinitis: a systematic review and meta-analysis. Ped Allergy Immunol. 2016;27:580–90.CrossRef Kim YH, Kim KW, Kim MJ, Sol IS, Yoon SH, Ahn HS, et al. Vitamin D levels in allergic rhinitis: a systematic review and meta-analysis. Ped Allergy Immunol. 2016;27:580–90.CrossRef
16.
go back to reference Aryan Z, Rezaei N, Camargo CA. Vitamin status, aeroallergen sensitization, and allergic rhinitis: a systematic review and meta-analysis. Int Rev Immunol. 2017;36:41–53.CrossRef Aryan Z, Rezaei N, Camargo CA. Vitamin status, aeroallergen sensitization, and allergic rhinitis: a systematic review and meta-analysis. Int Rev Immunol. 2017;36:41–53.CrossRef
17.
go back to reference Ariano R. Efficacy of a novel food supplement in the relief of the signs and symptoms of seasonal allergic rhinitis and in the reduction of the consumption of anti-allergic drugs. Acta Biomed. 2015;86(1):53–8.PubMed Ariano R. Efficacy of a novel food supplement in the relief of the signs and symptoms of seasonal allergic rhinitis and in the reduction of the consumption of anti-allergic drugs. Acta Biomed. 2015;86(1):53–8.PubMed
18.
go back to reference Marseglia GL, Licari A, Ciprandi G. A polycentric, randomized, double blind, parallel-group, placebo-controlled study on Lertal®, a multicomponent nutraceutical, as add-on treatment in children with allergic rhinoconjunctivitis: phase I during active treatment. J Biol Reg Homeost Agents. 2019; (in press). Marseglia GL, Licari A, Ciprandi G. A polycentric, randomized, double blind, parallel-group, placebo-controlled study on Lertal®, a multicomponent nutraceutical, as add-on treatment in children with allergic rhinoconjunctivitis: phase I during active treatment. J Biol Reg Homeost Agents. 2019; (in press).
19.
go back to reference Wirchow JC, Backer V, Kuna P, Prieto L, Nolte H, Villesen HH, et al. Efficacy of a house dust mite sublingual allergen immunotherapy tablet in adults with allergic asthma. A randomized clinical trial. JAMA. 2016;315:1715–25.CrossRef Wirchow JC, Backer V, Kuna P, Prieto L, Nolte H, Villesen HH, et al. Efficacy of a house dust mite sublingual allergen immunotherapy tablet in adults with allergic asthma. A randomized clinical trial. JAMA. 2016;315:1715–25.CrossRef
20.
go back to reference Guilbert TW, Morgan WJ, Zeiger RS, Mauger DT, Boehmer SJ, Szefler SJ, et al. Long-term inhaled corticosteroids in preschool children at high risk for asthma. N Engl J Med. 2006;354:1985–97.CrossRef Guilbert TW, Morgan WJ, Zeiger RS, Mauger DT, Boehmer SJ, Szefler SJ, et al. Long-term inhaled corticosteroids in preschool children at high risk for asthma. N Engl J Med. 2006;354:1985–97.CrossRef
21.
go back to reference Portnoy JM, Dinakar C. Review of cetirizine hydrochloride for the treatment of allergic disorders. Expert Opin Pharmacother. 2004;5(1):125–35.CrossRef Portnoy JM, Dinakar C. Review of cetirizine hydrochloride for the treatment of allergic disorders. Expert Opin Pharmacother. 2004;5(1):125–35.CrossRef
22.
go back to reference Tonelli M, Bacci E, Dente FL, Bartoli ML, Cianchetti S, Di Franco A, et al. Predictors of symptom recurrence after low-dose inhaled corticosteroid cessation in mild persistent asthma. Resp Med. 2006;100:622–9.CrossRef Tonelli M, Bacci E, Dente FL, Bartoli ML, Cianchetti S, Di Franco A, et al. Predictors of symptom recurrence after low-dose inhaled corticosteroid cessation in mild persistent asthma. Resp Med. 2006;100:622–9.CrossRef
23.
go back to reference Mosbech H, Deckelmann R, de Blay F, Pastorello EA, Trebas-Pietras E, Andres LP, et al. Standardized quality (SQ) house dust mite sublingual immunotherapy tablet (ALK) reduces inhaled corticosteroid use while maintaining asthma control: a randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol. 2014;134:568–75.e7.CrossRef Mosbech H, Deckelmann R, de Blay F, Pastorello EA, Trebas-Pietras E, Andres LP, et al. Standardized quality (SQ) house dust mite sublingual immunotherapy tablet (ALK) reduces inhaled corticosteroid use while maintaining asthma control: a randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol. 2014;134:568–75.e7.CrossRef
24.
go back to reference Valovirta E, Petersen TH, Piotrowska T, Laursen MK, Andersen JS, Sorensen HF, et al. Results from the 5-year SQ grass sublingual immnutherapy tablet asthma prevention (GAP) trial in children with grass pollen allergy. J Allergy Clin Immunol. 2018;141:529–38.CrossRef Valovirta E, Petersen TH, Piotrowska T, Laursen MK, Andersen JS, Sorensen HF, et al. Results from the 5-year SQ grass sublingual immnutherapy tablet asthma prevention (GAP) trial in children with grass pollen allergy. J Allergy Clin Immunol. 2018;141:529–38.CrossRef
25.
go back to reference Wjst M. We are still confused but on a higher level. Allergy. 2019; (in press). Wjst M. We are still confused but on a higher level. Allergy. 2019; (in press).
26.
go back to reference Litonjua AA. Vitamin D and childhood asthma: causation and contribution to disease activity. Curr Opin Allergy Clin Immunol. 2019;19:126–31.CrossRef Litonjua AA. Vitamin D and childhood asthma: causation and contribution to disease activity. Curr Opin Allergy Clin Immunol. 2019;19:126–31.CrossRef
Metadata
Title
A polycentric, randomized, parallel-group, study on Lertal®, a multicomponent nutraceutical, as preventive treatment in children with allergic rhinoconjunctivitis: phase II
Authors
Gianluigi Marseglia
Amelia Licari
Salvatore Leonardi
Maria Papale
Anna Maria Zicari
Laura Schiavi
Giorgio Ciprandi
Italian Study Group on Pediatric Allergic Rhinoconjunctivitis
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2019
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/s13052-019-0678-y

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