Abstract | BACKGROUND:
Asthma and allergic rhinitis are manifestations of a single unified allergic airway, for which the best treatment is uncertain. OBJECTIVE: To compare the anti-inflammatory efficacy in the unified allergic airway of combined oral mediator antagonism and combined topical steroid. METHODS: RESULTS: Seventeen patients completed per protocol. For PC20 and exhaled nitric oxide, only combined topical steroid produced improvements (P < 0.005) from placebo baseline. Combined steroid was superior by a 0.93 (95% CI 0.14-0.93, P < 0.05) doubling dilution difference for PC20 and a 0.99 (95% CI 0.9-15.1, P < 0.01) doubling difference for exhaled nitric oxide. Both treatments attenuated eosinophils and eosinophilic cationic protein, and reduced nasal symptoms (P < 0.05). Only steroid improved nasal nitric oxide (P=0.05) and asthma symptoms (P < 0.05). Neither treatment affected lung or nasal function tests. CONCLUSION: Combined topical steroid and combined mediator antagonism both attenuated systemic inflammation in the unified allergic airway, but only the former reduced bronchial and nasal inflammatory markers. The relevance of this to exacerbations and airway remodelling needs to be defined.
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Authors | M L Barnes, D Menzies, T C Fardon, P Burns, A M Wilson, B J Lipworth |
Journal | Allergy
(Allergy)
Vol. 62
Issue 1
Pg. 73-80
(Jan 2007)
ISSN: 0105-4538 [Print] Denmark |
PMID | 17156345
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Acetates
- Anti-Allergic Agents
- Anti-Asthmatic Agents
- Cyclopropanes
- Quinolines
- Sulfides
- Beclomethasone
- montelukast
- Cetirizine
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Topics |
- Acetates
(administration & dosage)
- Administration, Topical
- Adolescent
- Adult
- Aged
- Anti-Allergic Agents
(administration & dosage)
- Anti-Asthmatic Agents
(administration & dosage)
- Asthma
(drug therapy)
- Beclomethasone
(administration & dosage)
- Cetirizine
(administration & dosage)
- Cross-Over Studies
- Cyclopropanes
- Double-Blind Method
- Drug Administration Routes
- Drug Administration Schedule
- Drug Therapy, Combination
- Female
- Humans
- Male
- Middle Aged
- Quinolines
(administration & dosage)
- Rhinitis, Allergic, Perennial
(drug therapy)
- Sulfides
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