fluticasone and fexofenadine

In Japan, oral antihistamines are frequently used as the initial treatment for seasonal allergic rhinitis (SAR), and intranasal steroids are added when nasal symptoms worsen. This study aimed to evaluate whether starting treatment with fluticasone propionate nasal spray (FP) from the beginning of pollinosis symptoms and adding fexofenadine hydrochloride tablet (FEX) when SAR is aggravated could achieve improved amelioration of nasal symptoms throughout the pollen season in comparison with a treatment that involves starting with FEX and later adding FP.. In this pragmatic, randomized, open-label, parallel-group trial, 51 Japanese cedar pollinosis patients (age, 16-85 years) were randomly divided and administered FP 100 mcg twice daily as an initial drug with FEX 60 mg twice daily as an additional drug and the same treatment in the reverse order. Nasal symptoms were evaluated in a daily dairy using a 4-point scale. The primary outcome was area under curve of the line representing the daily total nasal symptom score in the pollen season on a graph.. Initial treatment with FP was significantly (P = 0.0015) more effective than initial treatment with FEX in improving the primary outcome. The average daily total nasal symptom score in the initial treatment with FP group was better than that in the initial treatment with FEX group throughout the pollen season.. Initiating treatment with FP and adding FEX might lead to improved outcomes for nasal symptoms in comparison with the same drugs administered in the reverse order.

Topics: Adult; Androstadienes; Anti-Allergic Agents; Female; Fluticasone; Humans; Male; Middle Aged; Nasal Sprays; Pollen; Rhinitis, Allergic, Seasonal; Tablets; Terfenadine; Treatment Outcome

Owing to high prevalence of arterial hypertension (AH) and allergic rhinitis (AR), these diseases frequently coexist. The study aimed to assess whether improvement of AR by conventional treatment can improve blood pressure (BP) control in this population. Sixty-eight subjects of both sexes aged 35-60 years with AR and AH were randomized into two groups to receive in addition to their antihypertensive medications: treatment group (n=34) Fluticasone nasal 50 microg/spray b.i.d. and Fenoxifenadine 180 mg tablets q.d., and control group (n=34) 0.9% NaCl nasal drops b.i.d. Office BP and AR severity (using the Relative Quality of Life Questionnaire (RQLQ)) and high-sensitive C-reactive protein (hs-CRP) were measured at study entry and after 8 weeks in both groups, without changing of antihypertensive medications. In Treatment group an improvement in RQLQ, significant reduction of systolic BP (SBP) (DSBP 7.4 +/- 4.3 mm Hg, P=0.006) and reduction of hs-CRP level (DCRP 2.05 +/- 1.08; P=0.028) were observed, whereas diastolic BP (DBP) remained unchanged (DDBP 0.9 +/- 1.7 mm Hg, P=0.7). There was a significant correlation between DRQLQ and DSBP (r=0.86; P=0.019) and between DCRP and DSBP (r=0.56; P=0.027). No statistically significant changes of RQLQ, BP and CRP were observed in the control group. In patients with coincidence of AH and AR, medications meant to improve AR attenuate low-grade systemic inflammation and can lower SBP, but not DBP.

Topics: Adult; Analysis of Variance; Androstadienes; Anti-Allergic Agents; Antihypertensive Agents; Biomarkers; Blood Pressure; C-Reactive Protein; Female; Fluticasone; Humans; Hypertension; Male; Middle Aged; Quality of Life; Rhinitis, Allergic, Perennial; Severity of Illness Index; Sodium Chloride; Surveys and Questionnaires; Terfenadine; Treatment Outcome

We previously showed that H1-antihistamines may shift the PC20 (provocation concentration that caused a decrease in forced expiratory volume in 1 second of 20%) threshold to adenosine monophosphate (AMP) challenge but may paradoxically prolong recovery.. To measure AMP recovery using a constant predetermined AMP PC20 and to evaluate whether fexofenadine use confers add-on effects to treatment with either fluticasone propionate alone or combined fluticasone propionate-salmeterol.. Fourteen atopic patients with mild-to-moderate asthma (forced expiratory volume in 1 second of 76%) completed a double-blind, randomized, crossover study consisting of 3-week treatment blocks of either fluticasone propionate-salmeterol, 250 microg twice daily, or fluticasone propionate alone, 250 microg twice daily, in conjunction with either fexofenadine, 180 mg once daily, or matched placebo. Recovery after a predetermined AMP PC20 challenge was measured (primary outcome), along with exhaled nitric oxide levels, plasma eosinophil cationic protein levels, peripheral eosinophil counts, pulmonary function, diary card outcomes, and quality of life (all secondary outcomes).. There were no differences in any of the primary or secondary outcomes when fexofenadine was added to treatment with either fluticasone propionate-salmeterol or fluticasone propionate alone. The mean AMP recovery time was 25.0 vs 23.4 minutes for fexofenadine and placebo, respectively, as add-on to fluticasone-salmeterol and 22.5 vs 23.9 minutes, respectively, as add-on to fluticasone alone.. Fexofenadine did not affect recovery to a fixed dose of AMP challenge or any other surrogate inflammatory markers when given as add-on therapy to corticosteroid-treatedatopic asthmatic patients.

Topics: Adenosine Monophosphate; Administration, Inhalation; Adolescent; Adrenal Cortex Hormones; Adult; Albuterol; Androstadienes; Anti-Allergic Agents; Asthma; Biomarkers; Bronchial Provocation Tests; Drug Therapy, Combination; Eosinophil Cationic Protein; Eosinophils; Female; Fluticasone; Humans; Hypersensitivity, Immediate; Inflammation; Male; Nitric Oxide; Respiratory Function Tests; Salmeterol Xinafoate; Terfenadine; Treatment Outcome

The aim of the study was to examine the level of sICAM-1 in serum of patients suffering from allergic rhinitis treated with fexofenadine or fluticasone. The study was performed after two weeks' duration of the pollen season. Thirty -eight patients sensitized to grass pollen were participated in this study: 15 patients were treated for 10 days with oral fexofenadine (dose: 120 mg/d), 13 patients were treated with intranasal fluticasone (dose: 200 mcg/d), 10 patients were given oral placebo. Blood sample were collected both in the first and the last day of the treatment. The efficacy was evaluated with the use of symptom score. sICAM-1 level in serum was measured with ELISA method.. Mean sICAM-1 level in serum was: in group treated with fexofenadine- 224,5 ng/ml before treatment, 228 ng/ml - after treatment; in group treated with fluticasone- 212 ng/ml before treatment, 214 ng/ml- after treatment; in placebo group- 226 ng/ml before treatment, 229 ng/ml- after treatment. There was no difference in statistical analysis between sICAM-1 values. (p > 0.05). In 7 patients treated with fexofenadine serum levels of sICAM-1 significantly decreased from 212 ng/ml to 185 ng/ml (p < 0.05), the same decrease was observed in 7 patients treated with fluticasone: from 233 ng/ml to 209 ng/ml (p < 0.01), and in 6 patients from placebo group: from 219 ng/ml to 205 ng/ml (p < 0.01). However in the rest of patient's level of sICAM-1 significantly increased after treatment. Patients treated with fexofenadine showed significant improvements of clinical symptoms (mean symptom score before treatment: 11, 3, after treatment-5, 3) and symptoms evaluated during laryngological examination (mean symptom score before treatment: 9, 5, after treatment- 5, 5). Significant improvement of clinical symptoms was also observed in patients treated with fluticasone (mean symptom score before treatment: 10, 7, after treatment 3, 6) and symptoms evaluated during laryngological examination (mean symptom score before treatment: 9, 2, after treatment- 5, 0). No changes were noticed in placebo group (mean clinical symptom score before treatment: 9, 0, after treatment 10, 3 and mean laryngological symptom score before treatment: 7, 5, after treatment 7, 7).

Topics: Adolescent; Adult; Androstadienes; Anti-Allergic Agents; Female; Fluticasone; Humans; Intercellular Adhesion Molecule-1; Male; Rhinitis, Allergic, Seasonal; Terfenadine; Treatment Outcome

One approach to treating allergic rhinoconjunctivitis is the concomitant use of an intranasal spray such as fluticasone propionate to alleviate nasal symptoms and a topical or systemic agent to relieve ocular symptoms. It has not yet been determined whether a topical or systemic agent is more effective for the latter purpose.. This study compared the efficacy of combined use of fluticasone and olopatadine with combined use of fluticasone and fexofenadine in the treatment of the signs and symptoms of allergic rhinoconjunctivitis.. This 2-site, randomized, double-masked, placebo-controlled, parallel-group study employed the conjunctival allergen challenge (CAC) model, a standardized method of inducing ocular and nasal signs and symptoms of allergic rhinoconjunctivitis. At visit 1, subjects underwent CAC to determine the dose of allergen required to elicit a positive reaction. The allergen dose was confirmed at visit 2, and, according to a randomization schedule, subjects were dispensed fluticasone, olopatadine, and placebo pill; fluticasone, fexofenadine, and tear substitute; or placebo nasal spray, placebo pill, and tear substitute. CAC took place at visit 3, after patients had used the assigned medications for 2 weeks. Study medication was instilled 2 hours before CAC, after which allergic signs and symptoms were graded on standardized scales. The primary efficacy variables were ocular itching, ocular redness, and overall nasal symptoms.. Eighty subjects completed the study: 30 received fluticasone and olopatadine, 30 fluticasone and fexofenadine, and 20 placebo. Women constituted 63.8% of the study population and men 36.3%; 91.3% were white, 3.8% black, 2.5% Hispanic, 1.3% Asian, and 1.3% other. Concomitant use of fluticasone and olopatadine produced significantly greater improvements in ocular itching at 3 and 7 minutes after CAC compared with fluticasone and fexofenadine (P < 0.05). There were no significant differences in redness scores between groups; however, concomitant use of fluticasone and olopatadine produced significantly greater improvements in redness at 2 time points in each of the 3 vessel beds (ciliary, conjunctival, and episcleral) compared with placebo, and fluticasone and fexofenadine produced significantly greater improvement in redness at 1 time point in I vessel bed compared with placebo (both comparisons, P < 0.05). The 2 treatments had similar effects on total nasal symptom efficacy scores.. In this study, concomitant use of the topical agents fluticasone and olopatadine was more effective than concomitant use of fluticasone plus fexofenadine for overall treatment of the signs and symptoms of induced allergic rhinoconjunctivitis.

Topics: Administration, Intranasal; Administration, Topical; Adult; Allergens; Androstadienes; Anti-Allergic Agents; Anti-Inflammatory Agents; Conjunctivitis, Allergic; Dibenzoxepins; Double-Blind Method; Drug Therapy, Combination; Female; Fluticasone; Histamine H1 Antagonists; Humans; Male; Olopatadine Hydrochloride; Ophthalmic Solutions; Rhinitis, Allergic, Perennial; Terfenadine; Treatment Outcome

Topics: Acetates; Adult; Anti-Allergic Agents; Cetirizine; Cryptomeria; Cyclopropanes; Drug Therapy, Combination; Female; Fluticasone; Humans; Leukocyte Count; Leukotriene Antagonists; Male; Mast Cells; Middle Aged; Nasal Cavity; Nasal Sprays; Neutrophils; Quinolines; Rhinitis, Allergic, Seasonal; Sulfides; Terfenadine; Treatment Outcome

Topics: Administration, Oral; Administration, Topical; Adult; Androstadienes; Anti-Allergic Agents; Dermatitis, Atopic; Drug Therapy, Combination; Fluticasone; Food Hypersensitivity; Humans; Hypersensitivity, Immediate; Male; Shiitake Mushrooms; Terfenadine