Management of persistent allergic rhinitis: evidence-based treatment with levocetirizine
Management of persistent allergic rhinitis: evidence-based treatment with levocetirizine
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发表时间：
2005-12
影响因子：
2.8
通讯作者：
J. Mullol;C. Bachert;J. Bousquet
中科院分区：
文献类型：
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作者：
J. Mullol;C. Bachert;J. Bousquet
过敏性鼻炎 (AR) 是一个严重的健康问题，会严重损害生活质量 (QoL)。以前的AR分类包括季节性变应性鼻炎（SAR）和常年性变应性鼻炎（PAR），不能充分反映AR的临床病程和表现。过敏性鼻炎及其对哮喘的影响 (ARIA) 分类基于症状的持续时间及其严重程度。持续性 AR (PER) 的持续时间超过 4 天/周且连续超过 4 周，根据生活质量受损和症状严重程度，可能表现为轻度或中度至重度疾病。口服抗组胺药是 AR 的标准治疗选择。新的第二代抗组胺药起效迅速，对 AR 症状非常有效，有些甚至可以缓解鼻塞。左西替利嗪是一种有效的组胺 H1 受体拮抗剂，已证明对 SAR 和 PAR 均有效，并且是持续性 AR 中研究最充分的治疗选择。 Xyzal 持续性鼻炎试验 (XPERT™) 对 551 名 PER 患者进行了研究，结果表明，左西替利嗪（与安慰剂相比，每天 5 毫克）早在第一周和研究的 6 个月内就显着改善了鼻部症状，治疗 6 周后鼻塞症状显着改善。左西替利嗪还改善了生活质量，耐受性良好，并节省了大量的社会和雇主成本。因此，左西替利嗪是第一个使用 ARIA 分类进行测试的 PER 标准治疗药物，能够迅速缓解短期和长期症状，提高患者的生活质量，并为雇主和社会带来经济效益。
Allergic rhinitis (AR) is a major health problem that can significantly impair quality of life (QoL). The former classification of AR comprises seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR), which do not adequately reflect the clinical course and presentation of AR. The Allergic Rhinitis and its Impact on Asthma (ARIA) classification is based on the duration of symptoms and their severity. Persistent AR (PER) is experienced for periods longer than 4 days/week and for more than 4 consecutive weeks, and may feature mild or moderate-to-severe disease based on the impairment of QoL and symptom severity. Oral antihistamines are a standard treatment option in AR. New second generation antihistamines have a rapid onset of action, are highly effective on AR symptoms, and some were even shown to relieve nasal congestion. Levocetirizine is a potent histamine H1-receptor antagonist with proven efficacy in both SAR and PAR, and it is the best studied therapeutic option in persistent AR. The Xyzal in Persistent Rhinitis Trial (XPERT™) studied 551 patients with PER, showing that levocetirizine (5 mg/day compared with placebo) significantly improved nasal symptoms as early as the first week and for the 6 months of study, with significant improvement in nasal congestion after 6 weeks of treatment. Levocetirizine also improved QoL, was well tolerated, and produced substantial societal and employer cost savings. Thus, levocetirizine is the first tested standard treatment for PER using ARIA classification, and shows prompt short-term and long-term relief of symptoms, improves patients' QoL, and provides economic benefits to employers and the society.