Evaluation of cetirizine in patients with allergic rhinitis and perennial asthma

Background: Cetirizine, a highly specific H-1 receptor antagonist with modest sedation and anticholinergic effects at the higher doses required for bronchodilation, may be useful for treating concomitant allergy and symptoms of asthma. Objective: This study evaluated the effectiveness of cetirizine compared with placebo in patients with allergic rhinitis and concomitant symptomatic mild to moderate perennial asthma. Methods: Twenty-eight patients (13 females and 15 males) aged 13 to 59 years having allergic rhinitis and mild to moderate perennial asthma were treated for 26 weeks with 20 mg cetirizine or placebo. Daily diary entries of symptoms, medications taken and peak expiratory flow rate measurements (morning and evening), biweekly pulmonary function tests, and monthly global evaluations by investigators were performed. Results: Cetirizine treatment significantly reduced baseline severity of several symptoms of rhinitis (itchy nose, nasal congestion, and watery eyes), and asthma (chest tightness, wheezing, shortness of breath, and nocturnal asthma). Although not statistically significant, cetirizine also reduced other symptoms of rhinitis (sneezing, itchy eyes, postnasal drip, and runny nose) and asthma (cough and sputum production), reduced albuterol use, and increased mean peak expiratory flow rates compared with placebo. No differences between treatment groups were noted for patient satisfaction, patient and physician global assessments of asthma management, pulmonary function, and methacholine challenge tests. Of two cetirizine patients with adverse events, one event, moderate drowsiness, was considered to be related to study drug. Conclusions: Cetirizine reduced symptoms of rhinitis as well as symptoms of asthma in patients with allergic rhinitis and concomitant perennial asthma.