Lower Symptom Severity Scores in Cetirizine-Treated Patients with Moderate/Severe Seasonal Allergic Rhinitis

Abstract

Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines define moderate/severe allergic rhinitis as causing ≥1 of the following: abnormal sleep; impairment of daily activities, sport, leisure; abnormal work and school; and troublesome symptoms. To retrospectively assess the efficacy of cetirizine 10mg daily for moderate/severe seasonal allergic rhinitis (SAR), symptom relief was evaluated in patients with SAR-related quality-of-life impairments that are consistent with ARIA guidelines. Data from patients with moderate/severe impairment in any of the domains of 1) activity, 2) sleep, 3) nasal symptoms, and 4) eye symptoms from the Rhinitis Quality of Life Questionnaire (RQLQ) were evaluated. Patients with any of these four baseline RQLQ domain scores ≥3 (0=not troubled, 3=moderately troubled, 6=extremely troubled) were identified in two 2-week RCTs. Total symptom severity score (TSSC) was sum of sneezing, runny nose, itchy nose, postnasal drip, watery eyes, and itchy eyes scores (0=none to 3=severe). Mean 2-week TSSC was compared between cetirizine 10mg and placebo patients who had baseline RQLQ scores consistent with ARIA-defined moderate/severe SAR. Of patients treated in two RCTs, 95% of cetirizine (598/632) and 93% of placebo patients (585/628) had baseline RQLQ scores consistent with ARIA-defined moderate/severe SAR. Of these patients with moderate/severe SAR, cetirizine-treated patients demonstrated significantly lower mean TSSC over 2 weeks than placebo-treated patients (differences= -1.7 and -1.5, respectively; P<0.001 in both studies). A retrospective analysis of data from two 2-week RCTs demonstrates that cetirizine 10mg daily effectively relieves symptoms of moderate/severe SAR based on RQLQ domain scores that are consistent with ARIA guidelines.