Efficacy of montelukast and desloratadine combination in allergic rhinitis

Abstract

Allergic rhinitis represents a global health problem affecting 10 to 25% of the population worldwide. The complications i.e. sinusitis, nasal polyps, middle ear and lower respiratory tract infections increase the importance of allergic rhinitis. Besides treatment costs, due to wage loss and decrease in productive capacity it has a huge negative impact on community. It may also seriously affect quality of life. Despite recent developments in its treatment modalities, several studies have indicated that the prevalence of allergic rhinitis is increasing. New knowledge on the mechanisms underlying allergic inflammation of the airways has resulted in better therapeutic strategies for allergic rhinitis. Montelukast and desloratadine has powerful effects on allergic rhinitis. Since studies demonstrate that both products have better pharmacodynamic and pharmacokinetic profiles, and having side effects similar to placebo, they are better options for this sub-group. The concomitant use of both drugs is believed to provide a better control on the symptoms of allergic rhinitis. The combination therapy possibly provides a more potential reduction in early and late allergic and inflammatory response to histamine and histamine like mediators during allergen inhalation. Including a fixed dose combination of montolukast-desloratadine to the treatment strategy seems to be a more rational and cost effective approach in these groups of patients.

Keywords

• Montelukast, desloratadine, allergic rhinitis

Alerjik rinitte montelukast ve desloratadin kombinasyonunun etkinliği

Öz

Alerjik rinit dünya nüfusunun %10-25'ini etkileyen önemli bir sağlık sorunudur. Sinüzit, nazal polipozis, orta kulak ve alt solunum yolu enfeksiyonlarına da yol açabilmesi alerjik rinitin önemini artırmaktadır. Tedavi maliyetlerinin yanı sıra hastalığın yol açtığı işgücü kaybı ve üretkenlikteki azalma nedeniyle, bu hastalığın toplumsal maliyeti çok büyük ölçüdedir. Yaşam kalitesine etkisi ise beklenenin çok üzerindedir. Son yıllarda alerjik rinit tedavisinde yeni gelişmeler sağlanmasına rağmen, araştırmalar hastalığın sıklığında artış olduğunu göstermektedir. Hava yolu enflamasyonunun altında yatan mekanizmalara ilişkin son yıllarda ortaya çıkan gelişmeler, alerjik rinit tedavisinde yeni stratejiler geliştirilmesini sağlamıştır. Montekulast ve desloratadin alerjik rinit tedavisinde kullanılan güçlü etken maddelerdir. Farmakodinamik ve farmakokinetik profillerinin çok iyi olmaları ve yan etkilerinin plaseboya benzer olması gibi nedenlerle aynı sınıftaki etken maddelere göre üstünlükleri bildirilmektedir. Semptom kontrolünün yeterince sağlanamadığı durumlarda her iki ilacın birlikte kullanılmasının alerjik rinitin kontrolünü daha iyi sağlayacağı düşünülmektedir. Kombinasyon tedavisi ile alerjen inhalasyonu sırasında erken ve geç dönemlerde ortaya çıkan histamin ve histamin dışındaki mediatörlerin de, alerjik ve enflamatuvar yanıtları daha güçlü şekilde bastırmak mümkün olabilmektedir. Bu tip hastalarda tedaviye montelukast-desloratadin fiks kombine preparatının günde tek doz eklenmesi rasyonel ve maliyeti azaltan bir yaklaşım tarzı gibi görünmektedir.

Anahtar Kelimeler

• Montelukast, desloratadin, alerjik rinit

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50. Makalenin atıf künyesi: Cingi C, Oğhan F, Ünlü H, Tekat A, Okuyucu Ş. Alerjik rinitte montelukast ve desloratadin kombinasyonunun etkinliği.
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