Background and objective: Allergic rhinitis and urticaria are common allergic disorders that may affect approximately 15% of people at some time in their lives. Antihistamines are the most widely used therapeutic interventions for these disorders but the newer generation agents have differing pharmacokinetic characteristics that may result in different patient satisfaction and preferences. The objective of this study was to investigate patients’ and physicians’ satisfaction with their current antihistamine treatment for allergic disease.
Methods: In an observational study, physicians in nine European countries completed questionnaires evaluating 7274 patients treated with an oral antihistamine. The satisfaction of patients and physicians with the efficacy and tolerability of treatment was rated on a visual analogue scale. In addition, the proportion of patients satisfied with treatment (overall satisfaction) and willing to continue treatment with the same antihistamine were assessed. Safety and tolerability data were also gathered.
Results: The results of this study indicate that modern antihistamines are generally considered effective and well tolerated by patients. In general, levocetirizine scored significantly higher in terms of perception of efficacy, tolerability and overall satisfaction. In terms of tolerability, three-quarters of patients were ‘very satisfied’ and a further fifth were moderately satisfied with levocetirizine and almost all (95%) were happy to continue treatment. Overall, the most commonly reported adverse event in this study was somnolence, a well known effect of antihistamines. The rate of somnolence in the levocetirizine group (3.8%) was similar to that for fexofenadine (both doses) and desloratadine, two products which are considered to be nonsedating antihistamines, and significantly less than half the rate for cetirizine.
Conclusion: Levocetirizine is considered an effective and well tolerated option for treating allergic disease by patients and physicians alike, particularly when the best available effectiveness and tolerability are required.
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
This study was sponsored and performed by UCB SA, Belgium. The authors take full responsibility for the content of the article but thank Veeda Clinical Research SA for their collaboration in data entry, statistical analysis and their assistance in report writing. The authors also thank Caudex Medical (supported by UCB SA) for their assistance in preparing the initial draft of the manuscript and collating the comments of authors and other named contributors. Christine De Vos, Krassimir Mitchev, Marie-Etienne Pinelli and Rossen Boev are employees of UCB. Marie-Paule is an employee of Veeda Clinical Research SA.
ISAAC. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet 1998 Apr 25; 351(9111): 1225–32CrossRefGoogle Scholar
Mosges R, Klimek L. Today’s allergic rhinitis patients are different: new factors that may play a role. Allergy 2007: 62: 969–75PubMedCrossRefGoogle Scholar
Maurer M, Zuberbier T. Undertreatment of rhinitis symptoms in Europe: findings from a cross-sectional questionnaire survey. Allergy 2007: 62: 1057–63PubMedCrossRefGoogle Scholar
Pfaar O, Wrede H, Barth C, et al. Levocetirizine in patients with chronic idiopathic urticaria: results of a multicenter clinical practice study. Int J Clin Pharmacol Ther 2006 Apr; 44(4): 191–2PubMedGoogle Scholar
Schoenwetter WF, Dupclay Jr L, Appajosyula S, et al. Economic impact and quality-of-life burden of allergic rhinitis. Curr Med Res Opin 2004 Mar; 20(3): 305–17PubMedCrossRefGoogle Scholar
Burge HA, Rogers CA. Outdoor allergens. Environ Health Perspect 2000 Aug; 108Suppl. 4: 653–9PubMedGoogle Scholar
Nash DB, Sullivan SD, Mackowiak J. Optimizing quality of care and cost effectiveness in treating allergic rhinitis in a managed care setting. Am J Manag Care 2000 Jan; 6(1 Suppl.): S3–15; quiz S19-20PubMedGoogle Scholar
Day JH, Horak F, Briscoe MP, et al. The role of allergen challenge chambers in the evaluation of anti-allergic medication: an international consensus paper. Clin Exp Allergy Rev 2006; 6: 31–59CrossRefGoogle Scholar
Bousquet J, Lund VJ, van Cauwenberge P, et al. Implementation of guidelines for seasonal allergic rhinitis: a randomized controlled trial. Allergy 2003 Aug; 58: 733–41PubMedCrossRefGoogle Scholar
Kapp A, Wedi B. Chronic urticaria: clinical aspects and focus on a new antihistamine, levocetirizine. J Drugs Dermatol 2004 Nov–Dec; 3(6): 632–9PubMedGoogle Scholar
Holgate ST, Canonica GW, Simons FE, et al. Consensus Group on New-Generation Antihistamines (CONGA): present status and recommendations. Clin Exp Allergy 2003 Sep; 33: 1305–24PubMedCrossRefGoogle Scholar
Bauchau V, Durham SR. Epidemiological characterization of the intermittent and persistent types of allergic rhinitis. Allergy 2005 Mar; 60: 350–3PubMedCrossRefGoogle Scholar
Demoly P, Allaert FA, Lecasble M, et al. Validation of the classification of ARIA (Allergic Rhinitis and its Impact on Asthma). Allergy 2003 Jul; 58: 672–5PubMedCrossRefGoogle Scholar
Yates C. Parameters for the treatment of urticaria and angioedema. J Am Acad Nurse Pract 2002 Nov; 14(11): 478–83PubMedCrossRefGoogle Scholar
Kozel MA, Sabroe RA. Chronic urticaria: aetiology, management and current and future treatment options. Drugs 2004; 64(22): 2515–36PubMedCrossRefGoogle Scholar
Jorissen M, Bertrand B, Stiels B, et al. Levocetirizine as treatment for symptoms of seasonal allergic rhinitis. B-ENT 2006; 2: 55–62PubMedGoogle Scholar
Klimek L, Hundorf I. Levocetirizine in allergic diseases: an open multicentre practice study of efficacy and tolerability. Allergologie 2002; 25: S1–7Google Scholar
Klimek L, Wrede H, Schott BC, et al. Patients’ perception of the value of levocetirizine in allergic diseases: a multicentre observational study in Germany. Clin Drug Investig 2005; 25(9): 609–14PubMedCrossRefGoogle Scholar
Kapp A, Pichler WJ. Levocetirizine is an effective treatment in patients suffering from chronic idiopathic urticaria: a randomized, double-blind, placebo-controlled, parallel, multicenter study. Int J Dermatol 2006 Apr; 45: 469–74PubMedCrossRefGoogle Scholar
Devalia JL, De Vos C, Hanotte F, et al. A randomized, double-blind, crossover comparison among cetirizine, levocetirizine, and UCB 28557 on histamine-induced cutaneous responses in healthy adult volunteers. Allergy 2004 Jan; 56: 50–7CrossRefGoogle Scholar
Grant JA, Riethuisen JM, Moulaert B, et al. A double-blind, randomized, single-dose, crossover comparison of levocetirizine with ebastine, fexofenadine, loratadine, mizolastine, and placebo: suppression of histamine-induced wheal-and-flare response during 24 hours in healthy male subjects. Ann Allergy Asthma Immunol 2002 Feb; 88(2): 190–7PubMedCrossRefGoogle Scholar
Purohit A, Melac M, Pauli G, et al. Twenty-four-hour activity and consistency of activity of levocetirizine and desloratadine in the skin. Br J Clin Pharmacol 2003 Oct; 56(4): 388–94PubMedCrossRefGoogle Scholar
Bachert C, Bousquet J, Canonica GW, et al. Levocetirizine improves quality of life and reduces costs in long-term management of persistent allergic rhinitis. J Allergy Clin Immunol 2004 Oct; 114(4): 838–44PubMedCrossRefGoogle Scholar