ORAL ANTIHISTAMINE DECONGESTANT TREATMENT COMPARED WITH INTRANASAL CORTICOSTEROIDS IN SEASONAL ALLERGIC RHINITIS

This international, multicentre, randomized, double-blind, double-dumm y, parallel-group trial was undertaken to compare the efficacy and tol erability of once-daily astemizole-D (10 mg astemizole plus 240 mg pse udoephedrine) with beclomethasone nasal spray (0.05 mg/ml) two puffs/n ostril administered twice daily in a total of 204 patients with season al allergic rhinitis. Treatment duration was 4 weeks. Although investi gator assessments of symptom severity were generally comparable in the two treatment groups throughout the trial, statistically significant differences in favour of astemizole-D for sneezing and ocular symptoms were apparent at the end of the 4-week treatment period (P < 0.05). P atient diary data support these findings, with significant differences in favour of the antihistamine/decongestant combination reported for ocular symptoms after 2 weeks of treatment (P < 0.05) and non-signific ant trends for sneezing after 2 weeks and ocular symptoms over the ent ire treatment period (P = 0.07). Use of rescue medication for ocular s ymptoms was also significantly lower in the astemizole-D treatment gro up (P < 0.05). A wide range of adverse experiences were reported, howe ver, there were no statistically significant differences in the type o r incidence of those between the two treatment groups. In conclusion, astemizole-D appears to be at least as effective and well tolerated as intranasal beclomethasone in the treatment of seasonal allergic rhini tis, providing at least comparable relief from all nasal symptoms incl uding congestion and significantly greater relief from ocular symptoms than the topical steroid.