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Published in: Allergy, Asthma & Clinical Immunology 1/2014

Open Access 01-12-2014 | Research

Reasons for prescribing second generation antihistamines to treat allergic rhinitis in real-life conditions and patient response

Authors: Pascal Demoly, Anca Mirela Chiriac, Benoît Berge, Michel Rostin

Published in: Allergy, Asthma & Clinical Immunology | Issue 1/2014

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Abstract

Background

Second generation H1 antihistamines (H1A) are currently recommended as first choice medications for allergic rhinitis and rhinoconjunctivitis. However, little is known about what influences the choice of prescription of one second generation (H1A) as opposed to another in real-life conditions.

Objective

The aim of the study was to identify the main criteria determining the choice of a second generation H1A by allergy specialists in mainland France.

Methods

Consecutive patients suffering from allergic rhinitis or rhinoconjunctivitis were included and followed prospectively for 30 days from the prescription of a second generation H1A in monotherapy. Patients were asked to fill in auto-questionnaires at baseline, daily during the first 10 days of the new treatment, and at the end of follow-up. Data on efficacy, tolerance, safety, rate and type of response to treatment, as well as patient satisfaction were recorded and analyzed.

Results

1,080 patients were included between March 2011 and October 2012, mostly suffering from moderate to severe rhinitis (82.0%). The most frequently cited reason for choosing a specific H1A was the expected efficacy (85.3%). The mean time to nasal and ocular recovery was 6 days and 78.2% of patients responded to treatment within this interval. The presence of conjunctivitis was significantly associated with a more rapid response. At the end of follow-up, the satisfaction rate was higher for patients who were switched from a previous treatment (87.5%), compared to those receiving their first treatment (78.8%).

Conclusion and clinical relevance

The main reason for choosing a specific second generation H1A was its expected efficacy. Concomitant conjunctivitis is associated with a more rapid response to treatment. Symptom recovery necessitates a mean of 6 days.
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Literature
1.
go back to reference Klossek JM, Annesi-Maesano I, Pribil C, Didier A: [INSTANT: national survey of allergic rhinitis in a French adult population based-sample]. Presse Med. 2009, 38 (9): 1220-1229. 10.1016/j.lpm.2009.05.012.CrossRefPubMed Klossek JM, Annesi-Maesano I, Pribil C, Didier A: [INSTANT: national survey of allergic rhinitis in a French adult population based-sample]. Presse Med. 2009, 38 (9): 1220-1229. 10.1016/j.lpm.2009.05.012.CrossRefPubMed
2.
go back to reference Canonica GW, Bousquet J, Mullol J, Scadding GK, Virchow JC: A survey of the burden of allergic rhinitis in Europe. Allergy. 2007, 62 (Suppl 85): 17-25.CrossRefPubMed Canonica GW, Bousquet J, Mullol J, Scadding GK, Virchow JC: A survey of the burden of allergic rhinitis in Europe. Allergy. 2007, 62 (Suppl 85): 17-25.CrossRefPubMed
3.
go back to reference Ramirez LF, Urbinelli R, Allaert FA, Demoly P: Combining H1-antihistamines and nasal corticosteroids to treat allergic rhinitis in general practice. Allergy. 2011, 66 (11): 1501-1502. 10.1111/j.1398-9995.2011.02682.x.CrossRefPubMed Ramirez LF, Urbinelli R, Allaert FA, Demoly P: Combining H1-antihistamines and nasal corticosteroids to treat allergic rhinitis in general practice. Allergy. 2011, 66 (11): 1501-1502. 10.1111/j.1398-9995.2011.02682.x.CrossRefPubMed
5.
go back to reference Bousquet J, Schunemann HJ, Samolinski B, Demoly P, Baena-Cagnani CE, Bachert C, Bonini S, Boulet LP, Bousquet PJ, Brozek JL, Canonica GW, Casale TB, Cruz AA, Fokkens WJ, Fonseca JA, van Wijk RG, Grouse L, Haahtela T, Khaltaev N, Kuna P, Lockey RF, Lodrup Carlsen KC, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Palkonen S, Papadopoulos NG, Passalacqua G, Pawankar R: Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs. J Allergy Clin Immunol. 2012, 130 (5): 1049-1062. 10.1016/j.jaci.2012.07.053.CrossRefPubMed Bousquet J, Schunemann HJ, Samolinski B, Demoly P, Baena-Cagnani CE, Bachert C, Bonini S, Boulet LP, Bousquet PJ, Brozek JL, Canonica GW, Casale TB, Cruz AA, Fokkens WJ, Fonseca JA, van Wijk RG, Grouse L, Haahtela T, Khaltaev N, Kuna P, Lockey RF, Lodrup Carlsen KC, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Palkonen S, Papadopoulos NG, Passalacqua G, Pawankar R: Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs. J Allergy Clin Immunol. 2012, 130 (5): 1049-1062. 10.1016/j.jaci.2012.07.053.CrossRefPubMed
6.
go back to reference Valovirta E, Myrseth SE, Palkonen S: The voice of the patients: allergic rhinitis is not a trivial disease. Curr Opin Allergy Clin Immunol. 2008, 8 (1): 1-9. 10.1097/ACI.0b013e3282f3f42f.CrossRefPubMed Valovirta E, Myrseth SE, Palkonen S: The voice of the patients: allergic rhinitis is not a trivial disease. Curr Opin Allergy Clin Immunol. 2008, 8 (1): 1-9. 10.1097/ACI.0b013e3282f3f42f.CrossRefPubMed
7.
go back to reference Demoly P, Allaert FA, Lecasble M, Bousquet J: Validation of the classification of ARIA (allergic rhinitis and its impact on asthma). Allergy. 2003, 58 (7): 672-675. 10.1034/j.1398-9995.2003.t01-1-00202.x.CrossRefPubMed Demoly P, Allaert FA, Lecasble M, Bousquet J: Validation of the classification of ARIA (allergic rhinitis and its impact on asthma). Allergy. 2003, 58 (7): 672-675. 10.1034/j.1398-9995.2003.t01-1-00202.x.CrossRefPubMed
9.
go back to reference Juniper EF, Thompson AK, Ferrie PJ, Roberts JN: Development and validation of the mini Rhinoconjunctivitis Quality of Life Questionnaire. Clin Exp Allergy. 2000, 30 (1): 132-140. 10.1046/j.1365-2222.2000.00668.x.CrossRefPubMed Juniper EF, Thompson AK, Ferrie PJ, Roberts JN: Development and validation of the mini Rhinoconjunctivitis Quality of Life Questionnaire. Clin Exp Allergy. 2000, 30 (1): 132-140. 10.1046/j.1365-2222.2000.00668.x.CrossRefPubMed
10.
go back to reference Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991, 14 (6): 540-545.PubMed Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991, 14 (6): 540-545.PubMed
11.
go back to reference Glacy J, Putnam K, Godfrey S, Falzon L, Mauger B, Samson D, Aronson N: Treatments for Seasonal Allergic Rhinitis. 2013, Rockville (MD): Agency for Healthcare Research and Quality (US) Glacy J, Putnam K, Godfrey S, Falzon L, Mauger B, Samson D, Aronson N: Treatments for Seasonal Allergic Rhinitis. 2013, Rockville (MD): Agency for Healthcare Research and Quality (US)
12.
go back to reference Falliers CJ, Brandon ML, Buchman E, Connell JT, Dockhorn R, Leese PT, Miller J, Wasserman SI, Zeterberg JM, Altman R, Love S, Samuels LL: Double-blind comparison of cetirizine and placebo in the treatment of seasonal rhinitis. Ann Allergy. 1991, 66 (3): 257-262.PubMed Falliers CJ, Brandon ML, Buchman E, Connell JT, Dockhorn R, Leese PT, Miller J, Wasserman SI, Zeterberg JM, Altman R, Love S, Samuels LL: Double-blind comparison of cetirizine and placebo in the treatment of seasonal rhinitis. Ann Allergy. 1991, 66 (3): 257-262.PubMed
13.
go back to reference Demoly P, Concas V, Urbinelli R, Allaert FA: Spreading and impact of the World Health Organization's Allergic Rhinitis and its impact on asthma guidelines in everyday medical practice in France. Ernani survey. Clin Exp Allergy. 2008, 38 (11): 1803-1807.PubMed Demoly P, Concas V, Urbinelli R, Allaert FA: Spreading and impact of the World Health Organization's Allergic Rhinitis and its impact on asthma guidelines in everyday medical practice in France. Ernani survey. Clin Exp Allergy. 2008, 38 (11): 1803-1807.PubMed
14.
go back to reference Kuna P, Bachert C, Nowacki Z, van Cauwenberge P, Agache I, Fouquert L, Roger A, Sologuren A, Valiente R: Efficacy and safety of bilastine 20 mg compared with cetirizine 10 mg and placebo for the symptomatic treatment of seasonal allergic rhinitis: a randomized, double-blind, parallel-group study. Clin Exp Allergy. 2009, 39 (9): 1338-1347. 10.1111/j.1365-2222.2009.03257.x.CrossRefPubMed Kuna P, Bachert C, Nowacki Z, van Cauwenberge P, Agache I, Fouquert L, Roger A, Sologuren A, Valiente R: Efficacy and safety of bilastine 20 mg compared with cetirizine 10 mg and placebo for the symptomatic treatment of seasonal allergic rhinitis: a randomized, double-blind, parallel-group study. Clin Exp Allergy. 2009, 39 (9): 1338-1347. 10.1111/j.1365-2222.2009.03257.x.CrossRefPubMed
15.
go back to reference Bachert C, Kuna P, Sanquer F, Ivan P, Dimitrov V, Gorina MM, van de Heyning P, Loureiro A: Comparison of the efficacy and safety of bilastine 20 mg vs desloratadine 5 mg in seasonal allergic rhinitis patients. Allergy. 2009, 64 (1): 158-165. 10.1111/j.1398-9995.2008.01813.x.CrossRefPubMed Bachert C, Kuna P, Sanquer F, Ivan P, Dimitrov V, Gorina MM, van de Heyning P, Loureiro A: Comparison of the efficacy and safety of bilastine 20 mg vs desloratadine 5 mg in seasonal allergic rhinitis patients. Allergy. 2009, 64 (1): 158-165. 10.1111/j.1398-9995.2008.01813.x.CrossRefPubMed
16.
go back to reference Sastre J, Mullol J, Valero A, Valiente R: Efficacy and safety of bilastine 20 mg compared with cetirizine 10 mg and placebo in the treatment of perennial allergic rhinitis. Curr Med Res Opin. 2012, 28 (1): 121-130. 10.1185/03007995.2011.640667.CrossRefPubMed Sastre J, Mullol J, Valero A, Valiente R: Efficacy and safety of bilastine 20 mg compared with cetirizine 10 mg and placebo in the treatment of perennial allergic rhinitis. Curr Med Res Opin. 2012, 28 (1): 121-130. 10.1185/03007995.2011.640667.CrossRefPubMed
17.
go back to reference Noonan MJ, Raphael GD, Nayak A, Greos L, Olufade AO, Leidy NK, Champan D, Kramer B: The health-related quality of life effects of once-daily cetirizine HCl in patients with seasonal allergic rhinitis: a randomized double-blind, placebo-controlled trial. Clin Exp Allergy. 2003, 33 (3): 351-358. 10.1046/j.1365-2222.2003.01596.x.CrossRefPubMed Noonan MJ, Raphael GD, Nayak A, Greos L, Olufade AO, Leidy NK, Champan D, Kramer B: The health-related quality of life effects of once-daily cetirizine HCl in patients with seasonal allergic rhinitis: a randomized double-blind, placebo-controlled trial. Clin Exp Allergy. 2003, 33 (3): 351-358. 10.1046/j.1365-2222.2003.01596.x.CrossRefPubMed
18.
go back to reference Demoly P, Didier A, Blay F, Vervloet D, Devillier P: Taille de l’effet thérapeutique dans les essais cliniques de la rhinite allergique saisonnière. Revue Francaise D Allergologie. 2011, 51 (2): 84-94. 10.1016/j.reval.2011.02.004.CrossRef Demoly P, Didier A, Blay F, Vervloet D, Devillier P: Taille de l’effet thérapeutique dans les essais cliniques de la rhinite allergique saisonnière. Revue Francaise D Allergologie. 2011, 51 (2): 84-94. 10.1016/j.reval.2011.02.004.CrossRef
19.
go back to reference Just J, Gouvis-Echraghi R, Rouve S, Wanin S, Moreau D, Annesi-Maesano I: Two novel, severe asthma phenotypes identified during childhood using a clustering approach. Eur Respir J. 2012, 40 (1): 55-60. 10.1183/09031936.00123411.CrossRefPubMed Just J, Gouvis-Echraghi R, Rouve S, Wanin S, Moreau D, Annesi-Maesano I: Two novel, severe asthma phenotypes identified during childhood using a clustering approach. Eur Respir J. 2012, 40 (1): 55-60. 10.1183/09031936.00123411.CrossRefPubMed
20.
go back to reference Koberlein J, Kothe AC, Schaffert C: Determinants of patient compliance in allergic rhinoconjunctivitis. Curr Opin Allergy Clin Immunol. 2011, 11 (3): 192-199. 10.1097/ACI.0b013e3283466fcb.CrossRefPubMed Koberlein J, Kothe AC, Schaffert C: Determinants of patient compliance in allergic rhinoconjunctivitis. Curr Opin Allergy Clin Immunol. 2011, 11 (3): 192-199. 10.1097/ACI.0b013e3283466fcb.CrossRefPubMed
21.
go back to reference Turner PJ, Kemp AS: Allergic rhinitis in children. J Paediatr Child Health. 2012, 48 (4): 302-310. 10.1111/j.1440-1754.2010.01779.x.CrossRefPubMed Turner PJ, Kemp AS: Allergic rhinitis in children. J Paediatr Child Health. 2012, 48 (4): 302-310. 10.1111/j.1440-1754.2010.01779.x.CrossRefPubMed
22.
go back to reference Marple BF, Fornadley JA, Patel AA, Fineman SM, Fromer L, Krouse JH, Lanier BQ, Penna P: Keys to successful management of patients with allergic rhinitis: focus on patient confidence, compliance, and satisfaction. Otolaryngol Head Neck Surg. 2007, 136 (6 Suppl): S107-S124.CrossRefPubMed Marple BF, Fornadley JA, Patel AA, Fineman SM, Fromer L, Krouse JH, Lanier BQ, Penna P: Keys to successful management of patients with allergic rhinitis: focus on patient confidence, compliance, and satisfaction. Otolaryngol Head Neck Surg. 2007, 136 (6 Suppl): S107-S124.CrossRefPubMed
Metadata
Title
Reasons for prescribing second generation antihistamines to treat allergic rhinitis in real-life conditions and patient response
Authors
Pascal Demoly
Anca Mirela Chiriac
Benoît Berge
Michel Rostin
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Allergy, Asthma & Clinical Immunology / Issue 1/2014
Electronic ISSN: 1710-1492
DOI
https://doi.org/10.1186/1710-1492-10-29

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