Perennial Allergic Rhinitis In Children Research Articles

Possibilities of combined nasal drugs in symptomatic therapy of allergic rhinitis in adolescent children

This article provides an overview of current views on the problem of allergic rhinitis (AR) in children. Modern data on the epidemiology of AR and the main comorbid conditions are highlighted. It has been noted that adolescence is the peak incidence of AR. Despite the similar clinical manifestations of AR in adolescent children, it should be borne in mind that patients in this age group represent a unique population with needs and perceptions of problems that are different from those of adults and young children. Mental perception of the symptoms of the disease is more often more pronounced in adolescents than in other age groups. This manifests itself in a large negative impact on both sleep and rest patterns, as well as on learning activity and exam results. The work of a doctor with patients of this age group requires the most rationalized approach. Based on the data of the latest consensus documents, the role of I and II generation antihistamines, intranasal antihistamines and intranasal glucocorticosteroids was assessed. The possibilities of symptomatic therapy of symptomatic moderate and severe AR with the help of nasal sprays based on a fixed combination of intranasal glucocorticosteroids and antihistamines have been evaluated in more detail. The available data from clinical studies of the use of a nasal spray based on a fixed combination of mometasone furoate and olopatadine are reviewed. Based on the above material, it was concluded that nasal sprays of a fixed combination of mometasone furoate and olopatadine are effective means of starting therapy for moderate to severe seasonal and perennial AR in children over 12 years of age. Such combination drugs can reduce the severity of AR symptoms with a relatively low risk of developing adverse events.

COMPARISON OF CLINICAL EFFICACY AND SAFETY BETWEEN CHILDREN AND ADULTS BEFORE AND 1 YEAR AFTER MITE SUBLINGUAL IMMUNOTHERAPY FOR PERENNIAL ALLERGIC RHINITIS

We studied clinical efficacy and safety after 1 year of mite sublingual immunotherapy (SLIT) for perennial allergic rhinitis in children, compared with adults. We compared 121 children under 15 yeas old (81 male, aged 5-14 years, a median of 12 years) and 77 adults (36 male, aged 15-65 years, a median of 26 years) treated with mite SLIT tablet (10000 Japanese Allergy Unit). The clinical efficacy before and 1 year after SLIT was evaluated by assessing symptom scores by Japanese rhino-conjunctivitis quality of life questionnaire (JRQLQ No1) and visual analog scale (VAS). Combined medication was also compared. Adverse events of SLIT were checked at every visit. All items of JRQLQ No1 scores and VAS after 1 year of mite SLIT, except eye symptoms in adults by JRQLQ No1, were significantly improved in both children and adults. Comparing children and adults, there were no differences in symptoms before and after 1 year. Combined medication score showed a similar result. Adverse events were observed in 57.9% of children and 58.4% of adults, but there were no serious adverse reactions. There was no difference between children and adults in efficacy and safety of mite SLIT, and both group showed significant improvement of symptoms.

A trial of adding Lactobacillus johnsonii EM1 to levocetirizine for treatment of perennial allergic rhinitis in children aged 7–12 years

BackgroundSupplementary consumption of probiotics may temporarily alter the intestinal microflora of infants and children, thereby preventing and treating allergic disorders. ObjectiveTo compare the clinical efficacy of levocetirizine with that of levocetirizine plus Lactobacillus johnsonii EM1 (Lj EM1) for treating perennial allergic rhinitis (PAR) in children. MethodsSixty-three children aged 7–12years fulfilled the entry criteria for the study and had moderate to severe PAR of at least 1year's duration. The treatment followed a randomized, open-label crossover design: all subjects were randomized to 2 crossover treatment regimens of levocetirizine with Lj EM1 (group 1) or levocetirizine alone (group 2) for 12weeks; subsequently, treatments were reversed for a further 12weeks. The effects of the 2 regimens were compared using the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and the total symptom score (TSS) from diary cards. The parameters evaluated were nasal peak expiratory flow rate (nPEFR), FVC, FEV1, serum immunoglobulin E (IgE), mite-specific IgE, eosinophilic cationic protein (ECP), resistin, blood eosinophils, eosinophil percentage in nasal smears, IL-4, IL-10, interferon-γ (IFN-γ), and transforming growth factor-β (TGF-β). ResultsAfter the first 12weeks of treatment, TSS in both groups had improved progressively compared with that in the run-in period. Both groups had improved TSS at weeks 4, 8, and 12 (P<0.05), and group 1 was more efficacious than group 2at week 4 (P=0.014), week 8 (P=0.011), and week 12 (P<0.009). During the second 12-week period, group 2 showed continual and progressive improvement, while group 1 did not. The PRQLQ scores were significantly decreased in both groups (P<0.05), but there was no statistically significant difference between the 2 groups (P=0.446). The eosinophil percentage in nasal smears decreased in both groups compared with that in the run-in period, and significant differences were detected in groups 2 and 1at 16 and 24weeks of treatment, respectively (P<0.05). Both groups showed significant improvement in nPEFR at weeks 4, 8, 12, 16, and 24 (P<0.01), and the treatment for group 1 appeared to be more efficacious than that for group 2at weeks 12, 16, and 20 (P<0.05). FVC and FEV1 were improved in both groups at weeks 8 through 24 (P<0.05), but there was no significant difference between the 2 groups. In cytokine measurements, IFN-γ and IL-10 increased significantly and IL-4 decreased significantly in both groups, while elevation of TGF-β was seen only in group 1 at 12weeks (P<0.001). However, the difference in TGF-β disappeared after 24weeks treatment. There was no difference in serum resistin levels. No serious adverse events were recorded in either treatment group. ConclusionThe 24-week, 2-phase, crossover treatment program showed that levocetirizine plus Lj EM1 was more effective for PAR than levocetirizine and that this difference persisted for at least 3months after discontinuation of Lj EM1.

CLINICAL EFFICIENCY AND ANTI-INFLAMMATORY ACTIVITYOF THERAPY IN CHILDREN WITH PERENNIAL ALLERGICRHINITIS

Background. Intranasal corticosteroids and nonsedating antihistamines are the drug classes most often prescribed to treat allergic rhinitis (AR). Treatment guidelines recommend a combination of these agents for moderate to severe AR. Objective: To compare the efficacy of mometasone furoate (MF) nasal spray plus desloratadine (DL) with that of monotherapy with the individual agents in 6-16 years old patients with perennial AR. Methods. A prospective, randomized, open label, parallel group study of the efficiency of MF nasal spray plus DL and of monotherapy with MF or DL in children with persistent allergic rhinitis aged 6-16 in a 12week period was conducted. The efficacy of therapy was evaluated by level of markers of an allergic inflammation, indicators of a bronchial hyperresponsiveness and by dynamics of clinical symptoms. Results. Combined therapy (DL+MF) restores balance of cytokines: increase the Тh1 activity and decrease the Т2 activity. Combined therapy found to be effective in the majority of AR patients. Сnclusion. Combined therapy with MF and DL in the treatment of perennial AR in children has clinical advan60

Olopatadine hydrochloride in children: efficacy and safety for perennial allergic rhinitis

Objective:The efficacy of antihistamines in perennial allergic rhinitis in children has been evaluated in studies using active comparators, whereas placebo-controlled studies are very few. A randomized, multicenter, double-blind, parallel-group clinical study was carried out to evaluate the dose–response relationship and superiority of olopatadine hydrochloride over placebo in children aged 7 to 16 years with perennial allergic rhinitis.Methods:Subjects received twice daily treatment for two weeks with either olopatadine 2.5 mg, 5 mg or placebo after a one-week observation period. Efficacy was assessed based on the diary card score the subject (or guardian) recorded.Results:Of the 302 subjects randomized, two were excluded from analysis: one did not receive treatment; the other was not monitored for efficacy parameters. The remaining 300 subjects (97 in the placebo group, 103 in the olopatadine 2.5-mg group and 100 in the olopatadine 5-mg group) constituted the full analysis set (FAS) for the efficacy analysis. As a primary endpoint, the total three nasal symptom score (for sneezing, rhinorrhea and nasal congestion) at final assessment was compared with baseline or the score obtained in the observation period. The change from baseline was then tested using analysis of covariance (ANCOVA) with the baseline score as covariate. Williams’ test was applied to the least squares means estimated from this ANCOVA model for each treatment group, resulting in showing the monotonicity Williams’ test assumed. The total three nasal symptom score significantly improved in the 5-mg group compared with the placebo group (p = 0.019). In contrast, the 2.5-mg group did not differ statistically from the placebo group. Adverse events occurred in 33.7% (33/98 subjects) in the placebo group, 35.9% (37/103 subjects) in the 2.5-mg group and 35.0% (35/100 subjects) in the 5-mg group. There were no serious or severe adverse events.Conclusions:Olopatadine hydrochloride 5 mg twice daily is an effective and safe treatment for perennial allergic rhinitis in children.

Prevalence of Seasonal and Perennial Allergic Rhinitis in Children and Adults

Prevalence of Seasonal and Perennial Allergic Rhinitis in Children and Adults

Topical treatment for perennial allergic rhinitis in children

Topical treatment for perennial allergic rhinitis in children

Mometasone furoate nasal spray improves symptoms of perennial allergic rhinitis in children and adults in Peru

Mometasone furoate nasal spray improves symptoms of perennial allergic rhinitis in children and adults in Peru

Efficacy and safety of levocetirizine on symptoms and health-related quality of life of children with perennial allergic rhinitis: a double-blind, placebo-controlled randomized clinical trial

This randomized study examined the efficacy and safety of levocetirizine in pediatric patients with perennial allergic rhinitis. Health-related quality of life (HRQL) was also investigated, which is particularly relevant in children because of the effects of rhinitis on learning, social activities, and comorbidity. To evaluate the effect of levocetirizine on the Total 4 Symptoms Score, the 50% response rate, the Pediatric Rhinitis Quality of Life Questionnaire (PRQLQ), and investigators' global evaluation of symptom improvement. Double-blind, placebo-controlled, randomized, multicenter trial of levocetirizine, 5 mg once daily for 4 weeks, in 306 children with perennial allergic rhinitis aged 6 to 12 years. There were 154 children in the levocetirizine arm and 152 in the placebo group who completed daily diary cards, and the PRQLQ and investigators' global evaluations were conducted at 3 visits. The levocetirizine group showed a significant improvement in 2-week and 4-week Total 4 Symptoms Score compared with placebo (P = .001 and P = .008, respectively). The 50% response rate for the first 2 weeks was 12.3% for the levocetirizine group compared with 3.9% for the placebo group (P = .01). The investigators' global evaluation also favored levocetirizine, because 57.1% of the children in the levocetirizine group were considered markedly or moderately improved compared with 44.7% in the placebo group. Levocetirizine also provided a significantly greater HRQL improvement than placebo at 2 weeks (P = .01), and the frequency of adverse events did not differ significantly from those seen in the placebo group. The study confirmed the efficacy of levocetirizine in relieving symptoms of perennial allergic rhinitis in children between 6 and 12 years of age. A HRQL benefit greater than placebo was shown. The treatment was well tolerated.

Features of mometasone furoate nasal spray and its utility in the management of allergic rhinitis

Mometasone furoate aqueous nasal spray (NS; Nasonex®, Schering Corporation), is a synthetic corticosteroid approved for the prophylaxis and treatment of seasonal allergic rhinitis (SAR) and the treatment of perennial allergic rhinitis (PAR) in patients ≥ 12 years of age, and for the treatment of SAR and PAR in children as young as 2 years of age. Studies demonstrate that mometasone furoate NS is a potent, clinically effective and well-tolerated intranasal corticosteroid with negligible systemic activity and which offers the convenience of once-daily dosing.

Features of mometasone furoate nasal spray and its utility in the management of allergic rhinitis

Mometasone furoate aqueous nasal spray (NS; Nasonex®, Schering Corporation), is a synthetic corticosteroid approved for the prophylaxis and treatment of seasonal allergic rhinitis (SAR) and the treatment of perennial allergic rhinitis (PAR) in patients ≥ 12 years of age, and for the treatment of SAR and PAR in children as young as 2 years of age. Studies demonstrate that mometasone furoate NS is a potent, clinically effective and well-tolerated intranasal corticosteroid with negligible systemic activity and which offers the convenience of once-daily dosing.

Intranasal azelastine in the treatment of perennial allergic rhinitis in children

Twenty-five patients (5-15 years old) with perennial allergic rhinitis (PAR) for at least one year were treated with intranasal azelastine. The study was conducted in two separate occasions. In the first study, in a special prepared room, the patients underwent Active Anterior Rhinomanometry (AAR). Twenty minutes later, after 2 drops of saline installed in each nostril, the Total Nasal Resistance (TNR) and Total Nasal Conductance (TNC) were measured. This was followed by the intranasal application of azelastine (0.14 mg/nostril ) and the TNR and TNC were measured at 15,30,60,90 and 120 minutes. At the end of this period, a topical vasoconstrictor (fenoxazoline 0.05%) was instilled and TNR and TNC measured after 15 and 30 minutes. The patients were discharged with a prescription of intranasal azelastine, same dose, for 14 days, with diary cards. Clinical evaluation and clinical score were performed at days 3,7 and 14. There were no changes in TNR and TNC after the acute and prolonged (14 days) use of azelastine, which was observed after the use of fenoxazoline. Clinical scores (physician and patient), according to the diary card, were significant for itching and sneezing after 7 days of treatment. Intranasal azelastine is useful for the therapeutic management of PAR, mainly in those for whom nasal blockage is not important.

Perennial allergic rhinitis in children - relieved by triamcinolone

Perennial allergic rhinitis in children - relieved by triamcinolone

78. Flunisolide aerosol treatment of perennial allergic rhinitis in children

78. Flunisolide aerosol treatment of perennial allergic rhinitis in children

Beclomethasone dipropionate aerosol in treatment of perennial allergic rhinitis in children.

Forty-four children with perennial allergic rhinitis who had failed to respond to conventional therapy, including sodium cromoglycate insufflation and hyposensitization, were treated with beclomethasone aerosol given intranasally. The study was conducted in a double-blind manner, the patients being allocated active drug or placebo for a 3-week period, followed by a 1-week rest period. The treatments were then crossed over for a period of 3 weeks. After this all children were put on active drug and followed-up at monthly intervals for a period of 3 months. Results were graded as either success of failure, and success had to be an unequivocal vote for the active drug by the patient, parent, and doctor. An overall success rate of 77% was obtained and no untoward or toxic effect was noted in any child. Tetracosactrin tests in 5 children remained normal at the end of the study period. We found intranasal beclomethasone dipropionate to be the most effective drug we have used for treating perennial allergic rhinitis in children.