China
Africa
Explore chapters and articles related to this topic
The Pharmacotherapy of Rhinitis and Asthma
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Amanda Grippen Goddard, Harold S. Nelson, Rohit Katial, Flavia Hoyte
Two intranasal antihistamines preparations are available (azelastine and olopatadine). Their onset of action is within 15 to 30 minutes. In comparison studies they have proven of equal or occasionally slightly superior efficacy to the second-generation oral antihistamines (Wallace and Dykewicz 2008). Intranasal antihistamines are equally effective but faster in onset of action as compared with intranasal corticosteroids (Kaliner et al. 2009). In one study comparing intranasal azelastine to intranasal fluticasone, intranasal fluticasone was superior to reducing rhinorrhea, but intranasal azelastine showed comparable efficacy for all other nasal and ocular symptoms. Additionally, compared to baseline ocular symptoms, there was a larger percentage (53.0%) of patients on intranasal azelastine as opposed to intranasal fluticasone (39.6%) that exhibited a 50% reduction in reflective total ocular symptom score by day 14 of treatment (Carr et al. 2012b). The use of intranasal antihistamines in combination with intranasal corticosteroids demonstrates additional symptom reduction and improved quality of life as compared to intranasal antihistamine monotherapy (Brozek et al. 2017). Intranasal antihistamines may have greater efficacy for nasal congestion than oral antihistamines (Brozek et al. 2017). Azelastine is associated with taste perversion and somnolence in some patients (Bousquet et al. 2008), while these symptoms are less frequent with olopatadine (Lieberman et al. 2011).
Expression of Cell Adhesion Molecules in Allergic Disorders of the Eye
Published in Bruce S. Bochner, Adhesion Molecules in Allergic Disease, 2020
Giorgio Walter Canonica, Antonio Scordamaglia, Francesca Paolieri, Nicolò Fiorino, Giovanni Passalacqua, Giorgio Ciprandi
Deflazacort, a new systemic corticosteroid, reduces ICAM-1 in the early as well in the late phase of the allergic response induced by allergen-specific challenge (20). Further studies on topical antihistamines (such as azelastine and levocabastine) have demonstrated their antiallergic activity (Table 4).
Respiratory disorders
Published in Anne Lee, Sally Inch, David Finnigan, Therapeutics in Pregnancy and Lactation, 2019
In principle, it is preferable to choose an intranasal antihistamine such as azelastine since this would produce lower maternal blood concentrations. However, intranasal use is less effective than oral administration against symptoms affecting the eyes and is probably less effective than intranasal steroids against nasal symptoms.
Azelastine a potent antihistamine agent, as hypolipidemic and modulator for aortic calcification in diabetic hyperlipidemic rats model
Published in Archives of Physiology and Biochemistry, 2022
Mohamed M. Elseweidy, Gehad M. Elnagar, Marwa M. Elsawy, Nabila Zein
The relationship between increased histamine levels and the progression of atherosclerosis was previously demonstrated in patients with allergy (Liu et al.2016). A previous study in confirm showed that histamine downregulated low-density lipoprotein receptors (LDL-R) in liver and reduced plasma HDL-c levels (Herink and Ito 2018). The latter was mediated by H1-receptor signalling. Conversely, fexofenadine (a histamine H1-receptor antagonist) increased HDL-c levels in experimental rats (Haas et al., 2018). Haas et al. (2018) showed that certain antihistamine agents attenuated atherosclerosis in-apo E-/- mice fed a high-fat diet (Haas et al., 2018). A previous report in addition indicated that histamine can mediate smooth muscle cell proliferation, neointimal changes and atherosclerosis promotion (Wang et al.2017). Among the selective H1 antagonists, azelastine is a well-known anti-allergic agent that inhibits the release of histamine from mast cells in the presence of antigen and non-antigen stimuli (Williams et al.2010). Azelastine has been shown to increase hepatic mRNA expression and protein levels of apolipoprotein A (apo A) (Haas et al., 2018). These findings have encouraged us to test azelastine as a possible inhibitor of aortic calcification in diabetic hyperlipidemic rats.
Comorbid allergic rhinitis and asthma: important clinical considerations
Published in Expert Review of Clinical Immunology, 2022
E Nappi, G Paoletti, L Malvezzi, S Ferri, F Racca, M R Messina, F Puggioni, E Heffler, G W Canonica
Fixed combinations of INCS and INAH combine the high efficacy of the former and the rapidness of the latter and are indeed more effective than INCS or INAH alone [11]. On the other hand, combined INCS and oral anti-histamine (OAH) treatment does not appear to be superior to INCS alone [104,105]. INCS-INAH combinations should be considered for patients who do not achieve a desirable disease control with INCS alone or prefer to treat their symptoms on demand [11]. The fluticasone-azelastine combination was the first entry in the market and gained success due to its high efficacy and rapidness in alleviating symptoms, requiring approximately 5–15 minutes to achieve a significant reduction in symptoms [112]. Subsequently, mometasone-olopatadine combinations have been recently developed and proved to be highly effective and to have a quick onset of action, in the range of 10–15 minutes [105–117]. It appeared that the latter combination had an improved clinically meaningful impact on symptom reduction than the fluticasone-azelastine combination, but without reaching statistical significance [115]. Mometasone-olopatadine combination is a promising new tool for allergic rhinitis treatment and may provide an added benefit for these patients. Future studies specifically aimed at comparing the efficacy, onset of action, and safety of fixed INCS-INAH combinations are needed.
Current therapeutical strategies for allergic rhinitis
Published in Expert Opinion on Pharmacotherapy, 2019
Ludger Klimek, Annette Sperl, Sven Becker, Ralph Mösges, Peter Valentin Tomazic
H1 antihistamines are available for both systemic and topical administration [9,10]. Nasal obstruction is probably more effectively treated via the topical route [9]. Topical antihistamines such as azelastine, levocabastine, and olopatadine show rapid effects (within approximately 15 min) and are therefore particularly useful in cases of acute onset of symptoms [9,11]. In the direct comparison of their efficacy with that of nasal GCS, no clear recommendations can be made [12]. While some studies attribute better efficacy to nasal GCSs [13], other studies have shown equal efficacy for both therapeutic approaches [14].