Comparison of intranasal corticosteroids and antihistamines in allergic rhinitis: A review of randomized, controlled trials

American Journal of Respiratory Medicine

Volumn 2, Issue 1, 2003, Pages 55-65

  Nielsen, Lars P ^a,b   Dahl, Ronald ^b  

^a AARHUS UNIVERSITY   (Denmark)

^b AARHUS UNIVERSITY HOSPITAL   (Denmark)

Author keywords

[No Author keywords available]

Indexed keywords

ACRIVASTINE; ANTIFUNGAL AGENT; ANTIINFECTIVE AGENT; ASTEMIZOLE; AZELASTINE; BECLOMETASONE DIPROPIONATE; BUDESONIDE; CETIRIZINE; CHLORPHENIRAMINE; CORTICOSTEROID; DIPHENHYDRAMINE; EBASTINE; FEXOFENADINE; FLUNISOLIDE; FLUTICASONE PROPIONATE; HISTAMINE H1 RECEPTOR ANTAGONIST; LEVOCABASTINE; LORATADINE; MACROLIDE; MIZOLASTINE; MOMETASONE FUROATE; PIPERAZINE DERIVATIVE; PIPERIDINE DERIVATIVE; PLACEBO; PROMETHAZINE; TERFENADINE; TRIAMCINOLONE ACETONIDE; TRIPROLIDINE;

ALLERGIC RHINITIS; ANTICHOLINERGIC EFFECT; CATARACT; CENTRAL NERVOUS SYSTEM DISEASE; CLINICAL TRIAL; COMPARATIVE STUDY; CONJUNCTIVITIS; COST EFFECTIVENESS ANALYSIS; DATA ANALYSIS; DISEASE ASSOCIATION; DOSE RESPONSE; DRUG CHOICE; DRUG EFFECT; DRUG EFFICACY; DRUG FATALITY; DRUG METABOLISM; DRUG POTENTIATION; DRUG SAFETY; DRY NOSE; GLAUCOMA; GROWTH INHIBITION; HEART DISEASE; HUMAN; PRIORITY JOURNAL; REVIEW; SEDATION; SKIN ATROPHY; STRUCTURE ACTIVITY RELATION; TASTE DISORDER; TORSADE DES POINTES; TREATMENT OUTCOME; WEIGHT GAIN;

EID: 0041854732     PISSN: 11756365     EISSN: None     Source Type: Journal    
DOI: 10.1007/BF03256639     Document Type: Review

References (146)

1. International Rhinitis Management Working Group International Consensus Report on the Diagnosis and Management of Rhinitis. Allergy 1994; 49 Suppl 9: 5-34
2. Sibbald B, Rink E, D'Souza M. Is the prevalence of atopy increasing? Br J Gen Pract 1990; 40: 338-40
3. Åberg N, Sundell J, Eriksson B, et al. Prevalence of allergic diseases in schoolchildren in relation to family history, upper respiratory tract infections and residential characteristics. Allergy 1996; 51: 232-7
4. Bousquet J, Bullinger M, Fayol C, et al. Assessment of the quality of life in patients with perennial allergic rhinitis with the French version of the SF-36 Health Status Questionnaire. J Allergy Clin Immunol 1994; 94: 182-8
5. Juniper EF, Guyatt GH, Dolovich J. Assessment of quality of life in adolescents with allergic rhinoconjunctivitis: development and testing of a questionnaire for clinical trials. J Allergy Clin Immunol 1994 Feb; 93 (2): 413-23
6. Simons FE. Learning impairment and allergic rhinitis. Allergy Asthma Proc 1996 Jul; 17 (4): 185-9
7. Spector SL. Overview of comorbid associations of allergic rhinitis. J Allergy Clin Immunol 1997 Feb; 99 (2): S773-90
8. Mygind N. Local effect of intranasal beclomethasone dipropionate aerosol in hay fever. BMJ 1973 Nov 24; 4 (890): 464-6
9. Holmberg K, Pipkorn U, Bake B, et al. Effects of topical treatment with H1 and H2 antagonists on clinical symptoms and nasal vascular reactions in patients with allergic rhinitis. Allergy 1989 May; 44 (4): 281-7
10. Wang D, Clement P, Smitz J. Effect of H1 and H2 antagonists on nasal symptoms and mediator release in atopic patients after nasal allergen challenge during the pollen season. Acta Otolaryngol 1996 Jan; 116 (1): 91-6
11. Andersson M, Nolte H, Baumgarten C, et al. Suppressive effect of loratadine on allergen-induced histamine release in the nose. Allergy 1991 Oct; 46 (7): 540-6
12. Bousquet J, Lebel B, Chanal I, et al. Antiallergic activity of H1-receptor antagonists assessed by nasal challenge. J Allergy Clin Immunol 1988 Nov; 82 (5 Pt 1): 881-7
13. Campbell A, Michel FB, Bremard-Oury C, et al. Overview of allergic mechanisms: ebastine has More than an antihistamine effect. Drugs 1996; 52 Suppl. 1: 15-9
14. Ciprandi G, Pronzato C, Ricca V, et al. Terfenadine exerts antiallergic activity reducing ICAM-1 expression on nasal epithelial cells in patients with pollen allergy. Clin Exp Allergy 1995 Sep; 25 (9): 871-8
15. Ciprandi G, Buscaglia S, Pesce G, et al. Cetirizine reduces inflammatory cell recruitment and ICAM-1 (or CD54) expression on conjunctival epithelium in both early- and late-phase reactions after allergen-specific challenge. J Allergy Clin Immunol 1995 Feb; 95 (2): 612-21
16. Ciprandi G, Pronzato C, Ricca V, et al. Loratadine treatment of rhinitis due to pollen allergy reduces epithelial ICAM-1 expression. Clin Exp Allergy 1997 Oct; 27 (10): 1175-83
17. Fadel R, Herpin-Richard N, Rihoux JP, et al. Inhibitory effect of cetirizine 2HCl on eosinophil migration in vivo. Clin Allergy 1987 Jul; 17 (4): 373-9
18. Naclerio RM, Kagey-Sobotka A, Lichtenstein LM, et al. Terfenadine, an H1 antihistamine, inhibits histamine release in vivo in the human. Am Rev Respir Dis 1990 Jul; 142 (1): 167-71
19. Jacobi HH, Skov PS, Poulsen LK, et al. Histamine and tryptase in nasal lavage fluid after allergen challenge: effect of 1 week of pretreatment with intranasal azelastine or systemic cetirizine. J Allergy Clin Immunol 1999; 103: 768-72
20. Bronsky EA, Dockhorn RJ, Meltzer EO, et al. Fluticasone propionate aqueous nasal spray compared with terfenadine tablets in the treatment of seasonal allergic rhinitis. J Allergy Clin Immunol 1996 Apr; 97 (4): 915-21
21. Klementsson H. Andersson M, Pipkorn U. Allergen-induced increase in nonspecific nasal reactivity is blocked by antihistamines without a clear-cut relationship to eosinophil influx. J Allergy Clin Immunol 1990 Oct; 86 (4 Pt 1): 466-72
22. Roquet A, Rand J, Hallden G, et al. Effect of loratadine on anti-IgE induced inflammation, histamine release and leucocyte recruitment in skin of atopics. Allergy 1995; 50: 414-20
23. Bentley AM, Walker S, Hanotte F, et al. A comparison of the effects of oral cetirizine and inhaled beclomethasone on early and late asthmatic responses to allergen and the associated increase in airways hyperresponsiveness. Clin Exp Allergy 1996; 26: 909-17
24. Brogden RN, McTavish D. Acrivastine: a review of its pharmacological properties and therapeutic efficacy in allergic rhinitis. urticaria and related disorders. Drugs 1991 Jun; 41 (6): 927-40
25. Campoli-Richards DM, Buckley MM, Fitton A. Cetirizine: a review of its pharmacological properties and clinical potential in allergic rhinitis, pollen-induced asthma, and chronic urticaria. Drugs 1990 Nov; 40 (5): 762-81
26. Leynadier F, Bousquet J, Murrieta M, et al. Efficacy and safety of mizolastine in seasonal allergic rhinitis. The Rhinase Study Group. Ann Allergy Asthma Immunol 1996 Feb; 76 (2): 163-8
27. Pelaez A. Clinical efficacy of ebastine in the treatment and prevention of seasonal allergic rhinitis. Drugs 1996; 52 Suppl. 1: 35-8
28. Richards DM, Brogden RN, Heel RC, et al. Astemizole: a review of its pharmacodynamic properties and therapeutic efficacy. Drugs 1984 Jul; 28 (1): 38-61
29. Simpson K, Jarvis B. Fexofenadine: a review of its use in the management of seasonal allergic rhinitis and chronic idiopathic urticaria. Drugs 2000 Feb; 59 (2): 301-21
30. Sorkin EM, Heel RC. Terfenadine: a review of its pharmacodynamic properties and therapeutic efficacy. Drugs 1985 Jan; 29 (1): 34-56
31. Haria M, Fitton A, Peters DH. Loratadine: a reappraisal of its pharmacological properties and therapeutic use in allergic disorders. Drugs 1994; 48: 617-37
32. Ciprandi G, Ricca V, Tosca M, et al. Continuous antihistamine treatment controls allergic inflammation and reduces respiratory morbidity in children with mite allergy. Allergy 1999; 54 (4): 358-65
33. ETAC study group. Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomized, placebo-controlled trial: first results of ETAC. Pediatr Allergy Immumol 1998; 9: 116-24
34. Simons FE, Simons KJ. The pharmacology and use of H1-receptor-antagonist drugS. N Engl J Med 1994; 330 (23): 1663-70
35. Renwick AG. The metabolism of antihistamines and drug interactions: the role of cytochrome P450 enzymes. Clin Exp Allergy 1999; 3: 116-24
36. Simons FE, Kesselman MS, Giddins NG, et al. Astemizole-induced torsade de pointes [letter]. Lancet 1988 Sep 10; 11 (8611): 624
37. Barbey JT, Anderson M, Ciprandi G, et al. Cardiovascular safety of second-generation antihistamines. Am J Rhinol 1999; 13 (3): 235-43
38. Crane JK, Shih HT. Syncope and cardiac arrhythmia due to an interaction between itraconazole and terfenadine. Am J Med 1993; 95 (4): 445-6
39. Rankin AC. Non-sedating antihistamines and cardiac arrhythmia. Lancet 1997 Oct 18; 350 (9085): 1115-6
40. Woosley RL, Sale M. QT interval: a measure of drug action. Am J Cardiol 1993; 72 (6): 36B-43B
41. Van Cauwenberge P, Bachert C, Passalacqua G, et al. Consensus statement on the treatment of allergic rhinitis. European Academy of Allergology and Clinical Immunology. Allergy 2000 Feb; 55 (2): 116-34
42. Chervinsky P, Georgitis J, Banov C, et al. Once daily loratudine versus astemizole once daily. Ann Allergy 1994 Aug; 73 (2): 109-13
43. Wihl JA, Petersen BN, Petersen LN, et al. Effect of the nonsedative H1-receptor antagonist astemizole in perennial allergic and nonallergic rhinitis. J Allergy Clin Immunol 1985 Jun; 75 (6): 720-7
44. Raemakers JG, O'Hanlon JF. Acrivastine, terfenadine and diphenhydramine effects on driving performance as a function of dose and time after dosing. Eur J Clin Pharmacol 1994; 47: 261-6
45. Falliers CJ, Brandon ML, Buchman E, et al. Double-blind comparison of cetirizine and placebo in the treatment of seasonal rhinitis. Ann Allergy 1991 Mar; 66 (3): 257-62
46. McNeely W, Wiseman LR. Intranasal azelastine: a review of its efficacy in the management of allergic rhinitis. Drugs 1998 Jul; 56 (1): 91-114
47. Noble S, McTavish D. Levocabastine: an update of its pharmacology, clinical efficacy and tolerability in the topical treatment of allergic rhinitis and conjunctivitis. Drugs 1995 Dec; 50 (6): 1032-49
48. Rombaut N, Bhatti JZ, Curran S, et al. Effects of topical administration of levocabastine on psychomotor and cognitive function. Ann Allergy 1991; 67 (1): 75-9
49. Wang D, Clement P, Smitz J, et al. The activity of recent anti-allergic drugs in the treatment of seasonal allergic rhinitis. Acta Otorhinolaryngol Belg 1996; 50 (1): 25-32
50. Mygind N, Lund V. Topical corticosteroid therapy of rhinitis. Clin Immunother 1996; 5: 122-36
51. Beato M. Gene regulation by steroid hormones. Cell 1989; 56 (3): 335-44
52. Cato AC, Wade E. Molecular mechanisms of antiinflammatory action of glucocorticoids. Bioessays 1996; 18 (5): 371-8
53. Kagoshima M, Wilcke T, Ito K, et al. Glucocorticoid-mediated transrepression is regulated by histone acetylation and DNA methylation. Eur J Pharmacol 2001 Oct; 429 (1-3): 327-34
54. Godthelp T, Holm AF, Blom H, et al. The effect of fluticasone propionate aqueous nasal spray on nasal mucosal inflammation in perennial allergic rhinitis. Allergy 1995; 50 (23 Suppl.): 21-4
55. Holm AF, Fokkens WJ, Godthelp T, et al. Effect of 3 months' nasal steroid therapy on nasal T cells and Langerhans cells in patients suffering from allergic rhinitis. Allergy 1995 Mar; 50 (3): 204-9
56. Holt PG, Thomas JA. Steroids inhibit uptake and/or processing but not presentation of antigen by airway dendritic cells. Immunology 1997; 91 (1): 145-50
57. Gomez E, Clague JE, Gatland D, et al. Effect of topical corticosteroids on seasonally induced increases in nasal mast cells. BMJ 1988 Jun 4; 296 (6636): 1572-3
58. Pipkorn U, Enerback L. Nasal mucosal mast cells and histamine in hay fever: effect of topical glucocorticoid treatment. Int Arch Allergy Appl Immunol 1987; 84 (2): 123-8
59. Bascom R, Wachs M, Naclerio R, et al. Basophil influx occurs after nasal antigen challenge: effects of topical corticosteroid pretreatment. J Allergy Clin Immunol 1988; 81: 580-9
60. Pipkorn U, Proud D, Lichtenstein LM, et al. Inhibition of mediator release in allergic rhinitis by pretreatment with topical glucocorticosteroids. N Engl J Med 1987 Jun 11; 316 (24): 1506-10
61. Nielsen LP, Bjerke T, Christensen MB, et al. Eosinophil markers in seasonal allergic rhinitis: intranasal fluticasone propionate inhibits local and systemic increases during the pollen season. Allergy 1998 Aug; 53 (8): 778-85
62. Schleimer RP, Bochner BS. The effects of glucocorticoids on human eosinophils. J Allergy Clin Immunol 1994; 94: 1202-13
63. Rolfe FG, Hughes JM, Armour CL, et al. Inhibition of interleukin-5 gene expression by dexamethasone. Immunology 1992; 77: 494-9
64. Robinson D, Hamid Q, Ying S, et al. Prednisolone treatment in asthma is associated with modulation of bronchoalveolar lavage cell interleukin-4, interleukin-5 and interferon-gamma cytokine gene expression. Am Rev Respir Dis 1993; 148: 401-6
65. Weido AJ, Reece LM, Alam R, et al. Intranasal fluticasone propionate inhibits recovery of chemokines and other cytokines in nasal secretions in allergen-induced rhinitis. Ann Allergy Asthma Immunol 1996 Nov; 77 (5): 407-15
66. Rak S, Jacobson MR, Sudderick RM, et al. Influence of prolonged treatment with topical corticosteroid (fluticasone propionate) on early and late phase nasal responses and cellular infiltration in the nasal mucosa after allergen challenge. Clin Exp Allergy 1994 Oct; 24 (10): 930-9
67. Naclerio RM, Adkinson NFJ, Creticos PS, et al. Intranasal steroids inhibit seasonal increases in ragweed-specific immunoglobulin E antibodies. J Allergy Clin Immunol 1993 Nov; 92 (5): 717-21
68. Pullerits T, Praks L, Sjostrand M, et al. An intranasal glucocorticoid inhibits the increase of specific IgE initiated during birch pollen season. J Allergy Clin Immunol 1997 Nov; 100 (5): 601-5
69. Edwards TB. Effectiveness and safety of beclomethasone dipropionate, an intranasal corticosteroid, in the treatment of patients with allergic rhinitis. Clin Ther 1995 Nov; 17 (6): 1032-41
70. Brogden RN, McTavish D. Budesonide: an updated review of its pharmacological properties, and therapeutic efficacy in asthma and rhinitis. Drugs 1992; 44 (3): 375-407
71. Pakes GE, Brogden RN, Heel RD, et al. Flunisolide: a review of its pharmacological properties and therapeutic efficacy in rhinitis. Drugs 1980 Jun; 19 (6): 397-411
72. Wiseman LR, Benfield P. Intranasal fluticasone propionate: a reappraisal of its pharmacology and clinical efficacy in the treatment of rhinitis. Drugs 1997; 53 (5): 885-907
73. Onrust SV, Lamb HM. Mometasone furoate: a review of its intranasal use in allergic rhinitis. Drugs 1998 Oct; 56 (4): 725-45
74. Jeal W, Faulds D. Triamcinolone acetonide: a review of its pharmacological properties and therapeutic efficacy in the management of allergic rhinitis. Drugs 1997 Feb; 53 (2): 257-80
75. Aubier M, Levy J, Clerici C, et al. Different effects of nasal and bronchial glucocorticosteroid administration on bronchial hyperresponsiveness in patients with allergic rhinitis. Am Rev Respir Dis 1992 Jul; 146 (1): 122-6
76. Corren J, Adinoff AD, Buchmeier AD, et al. Nasal beclomethasone prevents the seasonal increase in bronchial responsiveness in patients with allergic rhinitis and asthma. J Allergy Clin Immunol 1992 Aug; 90 (2): 250-6
77. Foresi A, Pelucchi A, Gherson G, et al. Once daily intranasal fluticasone propionate (200 micrograms) reduces nasal symptoms and inflammation but also attenuates the increase in bronchial responsiveness during the pollen season in allergic rhinitis. J Allergy Clin Immunol 1996 Aug; 98 (2): 274-82
78. Reed CE, Marcoux JP, Welsh PW. Effects of topical nasal treatment on asthma symptoms. J Allergy Clin Immunol 1988 May; 81 (5 Pt 2): 1042-7
79. Wood RA, Eggleston PA. The effects of intranasal steroids on nasal and pulmonary responses to cat exposure. Am J Respir Crit Care Med 1995 Feb; 151 (2 Pt 1): 315-20
80. Henriksen J, Wenzel A. Effects of intranasally administered corticosteroid (budesonide) on nasal obstruction, mouth breathing and asthma. Am Rev Respir Dis 1984; 130: 1014-8
81. Berkowitz RB, Bernstein DI, LaForce C, et al. Onset of action of mometasone furoate nasal spray (NASONEX) in seasonal allergic rhinitis. Allergy 1999 Jan; 54 (1): 64-9
82. Lumry WR. A review of the preclinical and clinical data of newer intranasal steroids used in the treatment of allergic rhinitis. J Allergy Clin Immunol 1999 Oct; 104 (4 Pt 1): S150-8
83. Selner JC, Weber RW, Richmond GW, et al. Onset of action of aqueous beclomethasone dipropionate nasal spray in seasonal allergic rhinitis. Clin Ther 1995 Nov; 17 (6): 1099-109
84. Day JH, Briscoe MP, Rafeiro E, et al. Onset of action of intranasal budesonide (Rhinocort aqua) in seasonal allergic rhinitis studied in a controlled exposure model. J Allergy Clin Immunol 2000 Mar; 105 (3): 489-94
85. Holm AF, Fokkens WJ, Godthelp T, et al. A 1-year placebo-controlled study of intranasal fluticasone propionate aqueous nasal spray in patients with perennial allergic rhinitis: a safety and biopsy study. Clin Otolaryngol 1998 Feb; 23 (1): 69-73
86. Banov CH, Woehler TR, LaForce CF, et al. Once daily intranasal fluticasone propionate is effective for perennial allergic rhinitis. Ann Allergy 1994 Sep; 73 (3): 240-6
87. Bhatia M, Campbell LM, Ross JR, et al. Intranasal budesonide once daily in seasonal allergic rhinitis. Curr Med Res Opin 1991; 12 (5): 287-95
88. Drouin M, Yang WH, Bertrand B, et al. Once daily mometasone furoate aqueous nasal spray is as effective as twice daily beclomethasone dipropionate for treating perennial allergic rhinitis patients. Ann Allergy Asthma Immunol 1996 Aug; 77 (2): 153-60
89. Munch E, Gomez G, Harris C, et al. An open comparison of dosage frequencies of beclomethasone dipropionate in seasonal allergic rhinitis. Clin Allergy 1981 May; 11 (3): 303-9
90. Nathan RA, Bronsky EA, Fireman P, et al. Once daily fluticasone propionate aqueous nasal spray is an effective treatment for seasonal allergic rhinitis. Ann Allergy 1991 Sep; 67 (3): 332-8
91. Dolovich J, O'Connor M, Stepner N, et al. Double-blind comparison of intranasal fluticasone propionate, 200 micrograms, once daily with 200 micrograms twice daily in the treatment of patients with severe seasonal allergic rhinitis to ragweed. Ann Allergy 1994 May; 72 (5): 435-40
92. Toft A, Wihl JA, Toxman J, et al. Double-blind comparison between beclomethasone dipropionate as aerosol and as powder in patients with nasal polyposis. Clin Allergy 1982 Jul; 12 (4): 391-401
93. Andersson M, Berglund R, Greiff L, et al. A comparison of budesonide nasal dry powder with fluticasone propionate aqueous nasal spray in patients with perennial allergic rhinitis. Rhinology 1995 Mar; 33 (1): 18-21
94. LaForce C. Use of nasal steroids in managing allergic rhinitis. J Allergy Clin Immunol 1999 Mar; 103 (3 Pt 2): S388-94
95. Cervin A, Andersson M. Intranasal steroids and septum perforation: an overlooked complication?. A description of the course of events and a discussion of the causes. Rhinology 1998 Sep; 36 (3): 128-32
96. Soderberg-Warner ML. Nasal septal perforation associated with topical corticosteroid therapy. J Pediatr 1984 Nov; 105 (5): 840-1
97. Pipkorn U, Pukander J, Suonpaa J, et al. Long-term safety of budesonide nasal aerosol: a 5.5-year follow-up study. Clin Allergy 1988 May; 18 (3): 253-9
98. Brown HM, Storey G, Jackson FA. Beclomethasone dipropionate aerosol in treatment of perennial and seasonal rhinitis: a review of five years' experience. Br J Clin Pharmacol 1977; 4 Suppl. 3: 283-6
99. Holm AF, Godthelp T, Fokkens WJ, et al. Long-term effects of corticosteroid nasal spray on nasal inflammatory cells in patients with perennial allergic rhinitis. Clin Exp Allergy 1999 Oct; 29 (10): 1356-66
100. Howland WC. Fluticasone propionate: topical or systemic effects? Clin Exp Allergy 1996 May; 26 Suppl. 3: 18-22
101. Vargas R, Dockhorn RJ, Findlay SR, et al. Effect of fluticasone propionate aqueous nasal spray versus oral prednisone on the hypothalamic-pituitary-adrenal axis. J Allergy Clin Immunol 1998 Aug; 102 (2): 191-7
102. Wilson AW, Sims EJ, McFarlane LC, et al. Effects of intranasal corticosteroids on adrenal, bone, and blood markers of systemic activity in allergic rhinitis. J Allergy Clin Immunol 1998 Oct; 102 (4 Pt 1): 598-604
103. Wolthers OD, Pedersen S. Knemometric assessment of systemic activity of once daily intranasal dry-powder budesonide in children. Allergy 1994 Feb; 49 (2): 96-9
104. Skoner D, Rachelefsky G, Meltzer E, et al. Detection of growth suppression in children during treatment with intranasal beclomethasone dipropionate. Pediatrics 2000; 105: c23
105. Agertoft L, Pedersen S. Short-term lower leg growth rate in children with rhinitis treated with intranasal mometasone furoate and budesonide. J Allergy Clin Immunol 1999 Nov; 104 (5): 948-52
106. Passalacqua G, Albano M, Canonica GW, et al. Inhaled and nasal corticosteroids: safety aspects. Allergy 2000; 55 (1): 16-33
107. Robinson AC, Cherry JR, Daly S. Double-blind cross-over trial comparing beclomethasone dipropionate and terfenadine in perennial rhinitis. Clin Exp Allergy 1989 Sep; 19 (5): 569-73
108. Bunnag C, Jareoncharsri P, Wong EC. A double-blind comparison of nasal budesonide and oral astemizole for the treatment of perennial rhinitis. Allergy 1992 Aug; 47 (4 Pt 1): 313-7
109. Sibbald B, Hilton S, D'Souza M. An open cross-over trial comparing two doses of astemizole and beclomethasone dipropionate in the treatment of perennial rhinitis. Clin Allergy 1986 May; 16 (3): 203-11
110. Beswick KB, Kenyon GS, Cherry JR. A comparative study of beclomethasone dipropionate aqueous nasal spray with terfenadine tablets in seasonal allergic rhinitis. Curr Med Res Opin 1985; 9 (8): 560-7
111. Lancer JM, Jones AS, Stevens JC, et al. A comparison by rhinomanometry of beclomethasone and terfenadine in the treatment of seasonal rhinitis. J Laryngol Otol 1987; 101: 350-4
112. Darnell R, Pecoud A, Richards DH. A double-blind comparison of fluticasone propionate aqueous nasal spray, terfenadine tablets and placebo in the treatment of patients with seasonal allergic rhinitis to grass pollen. Clin Exp Allergy 1994 Dec; 24 (12): 1144-50
113. Van Bavel J, Findlay SR, Hampel FCJ, et al. Intranasal fluticasone propionate is more effective than terfenadine tablets for seasonal allergic rhinitis. Arch Intern Med 1994 Dec 12; 154 (23): 2699-704
114. Frolund L. Efficacy of an oral antihistamine, loratadine, as compared with a nasal steroid spray, beclomethasone dipropionate, in seasonal allergic rhinitis. Clin Otolaryngol 1991 Dec; 16 (6): 527-31
115. Condemi J, Schulz R, Lim J. Triamcinolone acetonide aqueous nasal spray versus loratadine in seasonal allergic rhinitis: efficacy and quality of life. Ann Allergy Asthma Immunol 2000 May; 84: 533-8
116. Schoenwetter W, Lim J. Comparison of intranasal triamcinolone acetonide with oral loratadine for the treatment of patients with seasonal allergic rhinitis. Clin Ther 1995 May; 17 (3): 479-92
117. Gehanno P, Desfougeres JL. Fluticasone propionate aqueous nasal spray compared with oral loratadine in patients with seasonal allergic rhinitis. Allergy 1997 Apr; 52 (4): 445-50
118. Jordana G, Dolovich J, Briscoe MP, et al. Intranasal fluticasone propionate versus loratadine in the treatment of adolescent patients with seasonal allergic rhinitis. J Allergy Clin Immunol 1996 Feb; 97 (2): 588-95
119. Kaszuba SM, Baroody FM, deTineo M, et al. Superiority of an intranasal corticosteroid compared with an oral antihistamine in the as-needed treatment of seasonal allergic rhinitis. Arch Intern Med 2001 Nov 26; 161 (21): 2581-7
120. Salomonsson P, Gottberg L, Heilborn H, et al. Efficacy of an oral antihistamine, astemizole, as compared to a nasal steroid spray in hay fever. Allergy 1988 Apr; 43 (3): 214-8
121. Wood SF. Oral antihistamine or nasal steroid in hay fever: a double-blind double-dummy comparative study of once daily oral astemizole vs twice daily nasal beclomethasone dipropionate. Clin Allergy 1986 May; 16 (3): 195-201
122. Bernstein DI, Creticos PS, Busse WW, et al. Comparison of triamcinolone acetonide nasal inhaler with astemizole in the treatment of ragweed-induced allergic rhinitis. J Allergy Clin Immunol 1996 Mar; 97 (3): 749-55
123. Vervloet D, Charpin D, Desfougeres JL. Intranasal fluticasone once daily compared with once daily cetirizine in the treatment of seasonal allergic rhinitis. Clin Drug Invest 1997; 13: 291-8
124. Davies RJ, Lund VJ, Harten-Ash VJ. The effect of intranasal azelastine and beclomethasone on the symptoms and signs of nasal allergy in patients with perennial allergic rhinitis. Rhinology 1993 Dec; 31 (4): 159-64
125. Stern MA, Wade AG, Ridout SM, et al. Nasal budesonide offers superior symptom relief in perennial allergic rhinitis in comparison to nasal azelastine. Ann Allergy Asthma Immunol 1998 Oct; 81 (4): 354-8
126. van de Heyning PH, van Haesendonck J, Creten W, et al. Effect of topical levocabastine on allergic and non-allergic perennial rhinitis: a double-blind study, levocabastine vs. placebo, followed by an open, prospective, single-blind study on beclomethasone. Allergy 1988 Jul; 43 (5): 386-91
127. Newson-Smith G, Powell M, Baehre M, et al. A placebo controlled study comparing the efficacy of intranasal azelastine and beclomethasone in the treatment of seasonal allergic rhinitis. Eur Arch Otorhinolaryngol 1997; 254 (5): 236-41
128. Pelucchi A, Chiapparino A, Mastropasqua B, et al. Effect of intranasal azelastine and beclomethasone dipropionate on nasal symptoms, nasal cytology, and bronchial responsiveness to methacholine in allergic rhinitis in response to grass pollens. J Allergy Clin Immunol 1995 Feb; 95 (2): 515-23
129. Dorow P, Aurich R, Petzold U. Efficacy and tolerability of azelastine nasal spray in patients with allergic rhinitis compared to placebo and budesonide. Arzneimittel Forschung 1993 Aug; 43 (8): 909-12
130. Wang D, Smitz J, De Waele M, et al. Effect of topical applications of budesonide and azelastine on nasal symptoms, eosinophil count and mediator release in atopic patients after nasal allergen challenge during the pollen season. Int Arch Allergy Immunol 1997 Oct; 114 (2): 185-92
131. Svensson C, Andersson M, Greiff L, et al. Effects of topical budesonide and levocabastine on nasal symptoms and plasma exudation responses in seasonal allergic rhinitis. Allergy 1998 Apr; 53 (4): 367-74
132. Di Lorenzo G, Gervasi F, Drago A, et al. Comparison of the effects of fluticasone propionate, aqueous nasal spray and levocabastine on inflammatory cells in nasal lavage and clinical activity during the pollen season in seasonal rhinitics. Clin Exp Allergy 1999 Oct; 29 (10): 1367-77
133. Ortolani C, Foresi A, Di Lorenzo G, et al. A double-blind, placebo-controlled comparison of treatment with fluticasone propionate and levocabastine in patients with seasonal allergic rhinitis. FLNCO2 Italian Study Group. Allergy 1999 Nov; 54 (11): 1173-80
134. Weiner JM, Abramson MJ, Puy RM. Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials. BMJ 1998 Dec 12; 317 (7173): 1624-9
135. Juniper EF, Kline PA, Hargreave FE, et al. Comparison of beclomethasone dipropionate aqueous nasal spray, astemizole, and the combination in the prophylactic treatment of ragweed pollen-induced rhinoconjunctivitis. J Allergy Clin Immunol 1989 Mar; 83 (3): 627-33
136. Ratner PH, van Bavel J, Martin BG, et al. A comparison of the efficacy of fluticasone propionate aqueous nasal spray and loratadine, alone and in combination. for the treatment of seasonal allergic rhinitis. J Fam Pract 1998 Aug; 47 (2): 118-25
137. Simpson RJ. Budesonide and terfenadine, separately and in combination, in the treatment of hay fever. Ann Allergy 1994 Dec; 73 (6): 497-502
138. Brooks CD, Francom SF, Peel BG, et al. Spectrum of seasonal allergic rhinitis symptom relief with topical corticoid and oral antihistamine given singly or in combination. Am J Rhinol 1996; 10: 193-9
139. Backhouse CI, Finnamore VP, Gosden CW. Treatment of seasonal allergic rhinitis with flunisolide and terfenadine. J Int Med Res 1986; 14 (1): 35-41
140. Juniper EF, Guyatt GH, Ferrie PJ, et al. First-line treatment of seasonal (ragweed) rhinoconjunctivitis: a randomized management trial comparing a nasal steroid spray and a nonsedating antihistamine. CMAJ 1997 Apr 15; 156 (8): 1123-31
141. Kozma CM, Schulz RM, Sclar DA, et al. A comparison of costs and efficacy of intranasal fluticasone propionate and terfenadine tablets for seasonal allergic rhinitis. Clin Ther 1996 Mar; 18 (2): 334-46
142. Berka C, Chin W. Fluticasone propionate intranasal steroid: cost-effectiveness vs antihistamines [abstract]. J Allergy Clin Immunol 1994; 93: 165
143. Slater JW, Zechnich AD, Haxby DG. Second-generation antihistamines: a comparative review. Drugs 1999 Jan; 57 (1): 31-47
144. Nielsen LP, Mygind N, Dahl R. Intranasal corticosteroids for allergic rhinitis: superior relief? Drugs 2001; 61 (11): 1563-79
145. Bousquet J, Van Cauwenberge P, Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001 Nov; 108 (5 Suppl.): S147-334
146. Dykewicz MS, Fineman S. Executive summary of Joint Task Force Practice Parameters on diagnosis and management of rhinitis. Ann Allergy Asthma Immunol 1998; 81 (5): 463-8