Onset and Duration of the Effects of Three Antihistamines in Current Use – Astemizole,Loratadine and Terfenadine Forte – Studied during Prolonged,Controlled Allergen Challenges in Volunteers

Abstract

In a three-way, double-blind, crossover study the onset of action and effects at the end of the dosing interval of 10 mg/day astemizole, 10 mg/day loratadine and 120 mg/day terfenadine forte given for 3 days to six atopic volunteers were assessed using the Vienna challenge chamber (VCC). With each treatment, two long-term pollen challenges were performed in the VCC: the first to assess the onset of action started 1 h before the first dose and lasted continuously for 5 h; the second to assess the effects at the end of dosing took place 21 h after the last of the three doses and lasted 3 h. All three drug treatments initiated 1 h after the beginning of challenge with grass pollen reversed the adverse effects of challenge on the subjective symptoms (runny, blocked or itchy nose, sneezing, itchy eyes, tears) and the objective parameters (nasal secretions, nasal resistance, nasal flow, flow increase, nasal peak flow) within 1 − 3 h. The mean time to onset of action was 107 min for astemizole, 117 min after treatment for loratadine and 153 min for terfenadine forte.

During the second allergen challenge, 21 − 24 h after intake, astemizole consistently provided better protection for all parameters than did loratadine or terfenadine forte; however the differences were not statistically significant.

In einer doppelblinden Dreiwege-Crossover-Studie wurden der Wirkungsbeginn und die Effekte am Ende des Dosierungsintervalls von 10 mg/Tag Astemizol, 10 mg/Tag Loratadin und 120 mg/Tag Terfenadin forte beurteilt. Die drei Medikamente wurden für die Dauer von 3 Tagen an sechs allergische Freiwillige verabreicht. Für die Beurteilung wurde die “Wiener Provokations-Kammer” benutzt. Mit jeder Behandlung wurden zwei langzeitige Pollenexpositionen in der Wiener-Kammer durchgeführt. Die erste Exposition, die 1 h vor Verabreichung der ersten Dosis begonnen wurde, diente der Abklärung des Wirkungsbeginns und wurde ununterbrochen über 5 h fortgeführt, wohingegen die zweite zur Abklärung der Effekte am Ende der Dosierung, 21 h nach der letzten der drei Dosen vorgenommen wurde und 3 h dauerte. Mit alien drei medikamentösen Behandlungen, die 1 h nach Beginn der Provokation mit Graspollen eingeleitet wurden, konnten die klinisch erfaßbaren Wirkungen der Provokation auf die subjektiven Symptome (laufende, verstopfte oder juckende Nase, Nießreiz, juckende Augen, tränende Augen) aufgehoben werden. Die objektiven Parameter (Sekretproduktion der Nase, Nasenwiderstand, Nasendurchfluß, Durchflußzunahme, Nasen-Peakflow) zeigten nach 1 − 3 h eine Verbesserung. Die mittlere Zeit bis zum Wirkungsbeginn betrug für Astemizol 107 min, für Loratadin 117 min nach der Behandlung und für Terfenadin forte 153 min. Während der zweiten Allergenexposition, 21–24 h nach der Einnahme, stellte Astemizol für alle Parameter gleichbleibend einen besseren Schutz bereit als Loratadin oder Terfenadin forte. Die Unterschiede waren jedoch nicht statistisch signifikant.

Keywords

ASTEMIZOLE LORATADINE TERFENADINE ANTIHISTAMINES HAY FEVER SEASONAL NASAL ALLERGY VIENNA CHALLENGE CHAMBER ALLERGEN CHALLENGE

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