Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fluticasone propionate was compared with beclomethasone dipropionate for the treatment of allergic rhinitis in a multicenter, double-blind, randomized, placebo-controlled study during the mountain cedar (Juniperus ashei) pollination season in central Texas. Adults (n = 313) with moderate to severe symptoms were treated with fluticasone propionate aqueous nasal spray 200 micrograms once a day or beclomethasone dipropionate aqueous nasal spray 168 micrograms twice a day or placebo for 2 weeks. Fluticasone propionate administered once daily and beclomethasone dipropionate administered twice daily were equally effective as assessed by clinician- and patient-rated scores for nasal obstruction, rhinorrhea, sneezing, and nasal itching throughout the treatment and follow-up periods. Both regimens were more effective than placebo. Adverse events were related to topical administration and were similar in frequency and nature in all three treatment groups. Fluticasone propionate and beclomethasone dipropionate displayed a similar safety profile that did not differ from placebo. We conclude that fluticasone propionate aqueous nasal spray administered as 200 micrograms once daily in the morning is as safe and effective as beclomethasone dipropionate aqueous nasal spray administered as 168 micrograms twice daily for seasonal allergic rhinitis.
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PMID:Fluticasone propionate given once daily is as effective for seasonal allergic rhinitis as beclomethasone dipropionate given twice daily. 152 13

Rush immunotherapy (RIT) was administered on an outpatient basis to 11 patients. Of these, nine had asthma and four were steroid-dependent. All patients received extracts containing a mixture of antigens to which they were prick-sensitive. FEV1s were greater than 80% predicted before starting RIT. Four patients each required a 1 week steroid "burst" to accomplish this. A series of 8 subcutaneous injections were given starting with 0.3 mL of 1:100,000 (wt/vol) and ending with 0.10 mL of 1:100 (wt/vol) 1.5 days later. A dose of 0.15 mL of 1:100 was given weekly after that. All patients but one completed the RIT. Four had sore arms, four had pruritus and/or sneezing, four developed wheezing, and one experienced anaphylaxis with hypotension. Systemic reactions tended to occur at the higher doses and usually more than 30 minutes after a previous injection. Subsequent weekly injections were tolerated without reactions by seven of the patients. Rush immunotherapy is an effective method for administering a high dose of allergen in a very short time period. Due to the risk of systemic reactions it needs to be given under carefully controlled conditions.
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PMID:Incidence of systemic reactions during rush immunotherapy. 161 25

This double-blind, double-dummy, parallel-group study was undertaken in 40 patients with seasonal allergic rhinoconjunctivitis during the 1990 hay fever season. The patients were randomized and treated for seven days with either 120 mg terfenadine or 10 mg loratadine, each drug taken once daily in the morning. The severity of nasal congestion, rhinorrhea, sneezing, nasopharyngeal itching, and itchy, watery, red eyes was evaluated before and at the end of treatment. The global severity of symptoms was ranked daily by the patient on a diary card. Both treatment groups experienced a significant improvement of symptoms after treatment (p < 0.01), without any significant difference between the two study drugs. Terfenadine and loratadine significantly improved symptom severity by 69 and 55% compared with the baseline values, respectively. Headache and fatigue were reported in three loratadine-treated patients, and sedation in one patient. No side effects were observed in patients receiving terfenadine. This study confirmed that terfenadine 120 mg once daily is a safe and effective treatment for hay fever.
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PMID:Comparative effects of terfenadine and loratadine in the treatment of hay fever. 166 95

The efficacy and safety of cetirizine were evaluated in 419 patients with seasonal allergic rhinitis. Using a 4-way, double-blind randomization schedule, patients were given a 1-week course of once daily cetirizine (5, 10, or 20 mg) or placebo. Patient and physician efficacy ratings corresponded, indicating superiority of cetirizine to placebo (P less than .05) in reducing symptom severity scores for sneezing, rhinorrhea, ocular pruritus, nasal pruritus, watering of the eyes, and redness of the eyes. All cetirizine doses achieved higher efficacy ratings (72.7%, 79.2%, and 75.7%, respectively) than placebo (52.9%; P less than .05) by the physician's global assessment. Cetirizine was well tolerated, with sedation being the most common adverse experience, increasing in frequency at higher doses. A dose-response relationship was evident for selected symptoms, and the once daily 5-mg dose was found to be an effective minimum dose.
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PMID:Double-blind comparison of cetirizine and placebo in the treatment of seasonal rhinitis. 167 94

In a double-blind, parallel-group study to compare the efficacy of 120 mg terfenadine taken orally once daily with that of the conventional regimen of 60 mg terfenadine taken twice daily, 30 patients with perennial allergic rhinitis were enrolled. Groups of 15 patients were treated for 7 days with either 60 mg terfenadine twice daily, morning and evening, or 120 mg terfenadine once daily in the morning and placebo in the evening. The physician detected marked to total relief of symptoms (sneezing, rhinorrhoea, nasal pruritus and nasal obstruction) at similar rates (60% and 66%) in the two groups and patients in both groups reported a reduction in symptoms. The incidence of reported side-effects (sedation and mild headache) was low and not significantly different using either regimen. The results indicate that the new once-daily regimen of terfenadine was as effective and as well tolerated as the twice-daily regimen for the treatment of perennial allergic rhinitis.
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PMID:Comparison of terfenadine once daily with terfenadine twice daily for the treatment of perennial allergic rhinitis. 167 1

Second-generation H1 receptor antagonists (cetirizine, terfenadine, astemizole, loratadine, azelastine, and acrivastine) offer several important advantages over the older first-generation antihistamines. They are substantially less sedating and have little or no anticholinergic activity. Many of them are effective for 12 to 24 hours, thereby increasing compliance. In addition to acting as competitive inhibitors of histamine, several seem to have other antiallergic mechanisms as well. They are all absorbed well when taken orally. Many studies demonstrate their effectiveness compared with placebo in the treatment of seasonal and perennial rhinitis and chronic urticaria, and several studies suggest that they have a role in the treatment of bronchial asthma. A number of multicenter, double-blind, placebo-controlled studies comparing the effectiveness of terfenadine, 60 mg bid, with chlorpheniramine, 8 mg bid, in seasonal allergic rhinitis demonstrate that both drugs are approximately equally potent in reducing the symptoms of sneezing, rhinorrhea, and nasal itching and are statistically significantly better than placebo. Ocular symptoms were reduced somewhat less but still significantly. No differences from placebo were recorded in their effect on nasal congestion. The effectiveness of cetirizine, 10 mg once daily, compared with astemizole, 10 mg once daily, was measured in double-blind, placebo-controlled studies of patients with seasonal allergic rhinitis. These studies also demonstrate statistically significant benefit from the study drugs compared with placebo in relieving all nasal symptoms except congestion. Both drugs also relieved ocular pruritus. Fewer studies have assessed azelastine, acrivastine, and loratadine, but all have been shown to provide significant relief of seasonal allergic rhinitis compared with placebo.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparative efficacy of H1 antihistamines. 168 23

The aim of the study was to compare the efficacy and side-effects of oral antihistamine and nasal glucocorticoid therapy in seasonal allergic rhinitis. In a double-blind, double-dummy, group-comparative study, 60 birch and grass pollen allergic patients were treated with either loratadine (10 mg daily) or beclomethasone dipropionate (BDP) (100 micrograms in each nostril twice daily) during a 3 weeks' study period. Grading of 4 nasal and 3 non-nasal symptoms was performed at 4 weekly visits, and patients recorded daily symptoms and possible adverse experiences in a diary. Patients treated with BDP showed significantly less nasal blockage than those receiving loratadine (P less than 0.05), but there was no difference (P greater than 0.05) in other nasal symptoms (sneezing, itching and discharge). Patients treated with loratadine showed a statistically significantly greater relief in eye symptoms as compared with BDP (P less than 0.05). The side-effects caused by the 2 treatments were few and insignificant. We conclude that loratadine and intranasal BDP were effective in the treatment of seasonal allergic rhinitis, but the spectrum of individual symptoms controlled was different for the 2 drugs.
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PMID:Efficacy of an oral antihistamine, loratadine, as compared with a nasal steroid spray, beclomethasone dipropionate, in seasonal allergic rhinitis. 168 45

A double-blind, placebo-controlled clinical trial was undertaken for two weeks to evaluate three dosing schedules for administration of cetirizine in patients with seasonal allergic rhinitis. Average severity scores from the patients' ratings for sneezing and nasal itching were significantly reduced in all three cetirizine groups (10 mg QAM or QHS and 5 mg BID), compared with placebo. The effectiveness of cetirizine in once-daily dosing schedules indicates that significant antihistaminic activity is delivered over a full 24 hours. The possibility for flexibility in dosing combined with its relatively short half-life and low incidence of adverse effects make cetirizine an important second-generation H1-antihistamine for the management of seasonal allergic rhinitis.
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PMID:Cetirizine therapy for seasonal allergic rhinitis: alternative dosage schedules. 168 22

Histamine, which is stored mainly in mast cells and basophils, is a prominent contributor to allergic disease. Elevations in plasma or tissue histamine levels have been noted during anaphylaxis and experimental allergic responses of the skin, nose, and airways. Of the four cardinal signs of asthma (bronchospasm, edema, inflammation, and mucus secretion), histamine is capable of mediating the first two through its H1 receptor and mucus secretion through its H2 receptor. Of the five cardinal signs of allergic rhinitis (pruritus, mucosal edema, sneezing, mucus secretion, and late-phase inflammatory reactions), histamine is capable of mediating the first three through its H1 receptor. In the nose, mucus secretion can be reflexively mediated by H1 and possibly also by H2 receptors. In the skin the cardinal features of urticaria (vasodilation, vascular permeability, and pruritus) can be mediated by stimulation of the H1 receptor. In anaphylaxis histamine H1-receptor stimulation can mediate vascular permeability, smooth muscle contraction, and tachycardia, whereas H2-receptor stimulation can mediate mucus secretion. Stimulation of both receptors can mediate vasodilation and reduce peripheral vascular resistance. Thus although histamine is only one of many mediators of allergic disease, it plays a primary role in allergic rhinitis, urticaria, anaphylaxis, and to a lesser degree, asthma.
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PMID:The role of histamine in allergic diseases. 169 87

Allergic rhinitis is characterized by a profuse rhinorrhea in addition to paroxysms of sneezing, nasal congestion, and pruritus. To define better the sources of nasal secretion produced during rhinitis, nasal allergen challenges were performed on nine atopic subjects with seasonal rhinitis. A single dose of allergen was sprayed into one side of the nose, and nasal lavages were collected bilaterally for 7 hours. Nasal lavages were assayed for protein (total protein, albumin, lactoferrin, and lysozyme) and mediator (histamine and prostaglandin D2) content. Protein concentrations increased and remained elevated above baseline levels in both ipsilateral and contralateral secretions for up to 3 hours after allergen challenge. The proportion of albumin relative to total protein (the albumin percent) increased on the ipsilateral side, whereas the relative proportions of lactoferrin and lysozyme (the lactoferrin percent and lysozyme percent) increased on the contralateral side. Prostaglandin D2, but not histamine, increased selectively on the ipsilateral side. These data suggest that the ipsilateral protein secretory response is due to allergen-induced mast cell mediator release causing increased vascular permeability, whereas the contralateral protein secretory response is primarily a reflex-induced glandular secretion.
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PMID:The pathophysiology of rhinitis. V. Sources of protein in allergen-induced nasal secretions. 171 3


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