Comparative effects of desloratadine versus montelukast on asthma symptoms and use of β2-agonists in patients with seasonal allergic rhinitis and asthma

Background: Asthma and seasonal allergic rhinitis (SAR) are recognized as manifestations of a single airway disease. Desloratadine has demonstrated efficacy in treating SAR symptoms, including nasal obstruction. Methods: Safety and efficacy of desloratadine and montelukast each were assessed in a double-blind, placebo-controlled trial of patients with SAR and symptoms of asthma, who were assigned randomly to once-daily treatment with desloratadine 5 mg, montelukast 10 mg, or placebo for 4 weeks. Change from baseline of AM/PM reflective total asthma symptom severity scores (TASS), FEV1, individual asthma symptom scores, and beta(2)-agonist usage were assessed. Results: Desloratadine and montelukast each were associated with statistically significant reductions from baseline in the mean TASS averaged over the 4-week period (p less than or equal to 0.022 vs. placebo). Individual asthma symptom scores also improved significantly for both therapies (p less than or equal to 0.05). Patients treated with desloratadine or montelukast demonstrated improvement from baseline in FEV1 versus placebo; significant improvement was seen in a subset of patients with baseline FEV1 <80% of predicted normal (both p < 0.05). Both active therapies significantly reduced beta(2)-agonist use (both p < 0.01). Improvements for both therapies were comparable for all efficacy parameters; they were tolerated well with adverse event profiles similar to placebo. Conclusions: Asthma symptoms and beta(2)-agonist were improved significantly in patients with concomitant SAR and asthma treated with desloratadine 5 mg as well as montelukast 10 mg once daily. Both therapies significantly improved FEV1 in a subset of patients with FEV1 < 80% of predicted normal at entry. Improvements in asthma symptoms were comparable for both active treatment groups. Copyright (C) 2003 S. Karger AG, Basel.