Miseda-cetirizina

Nagoya J Med Sci. 2008 Aug;70(3-4):97-106.

Evaluation of cetirizine hydrochloride-based therapeutic strategy for chronic urticaria.

Sugiura K, Hirai S, Suzuki T, Usuda T, Kondo T, Azumi T, Masaki S, Yokoi T, Nitta Y, Kamiya S, Ando K, Mori T, Tomita Y.

Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.

We investigated the suitability of cetirizine HCl (cetirizine) for the initial treatment of chronic urticaria. A secondary aim was to identify the optimal alternative treatments when switching from this drug to other drugs in patients who are dissatisfied with cetirizine. We started cetirizine at a once-daily dose of 10 mg for 2 weeks and then, depending on the course of symptoms in individual patients, it was either continued, titrated to a higher dose, or switched to other drugs (antihistamines including H2 blockers) for a further 2 weeks. Degrees of patient satisfaction and ratings by physicians were analyzed, as were adverse events. At 2 weeks after the start of treatment, among 74 patients included in the final evaluation 55 (74.3%) expressed satisfaction with cetirizine therapy. Those not satisfied included five (6.7%) who felt drowsy after taking the drug and 14 (18.9%) in whom the drug had not demonstrated adequate efficacy. After optimizing the treatment on a per-patient basis, including switching from cetirizine to other drugs, the percentage satisfied with treatment at 4 weeks was 83.7% (62/74). In the group of patients who were satisfied with the therapy at 2 weeks, attending physicians confirmed that wheals and scratches were significantly alleviated at 2 and 4 weeks, respectively. Adverse effects were mild and uncommon. Cetirizine as an initial treatment for chronic urticaria appears effective and safe. For patients in whom cetirizine fails to satisfactorily alleviate symptoms as well as those who complain of drowsiness, switching to other antihistamine drugs may be an effective strategy.

The effect of cetirizine on IFN-gamma and IL-10 production in children with allergic rhinitis.

Uğuz A, Sanlioğlu S, Yüzbey S, Coşkun M, Yeğin O.

Division of Immunology and Allergy, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey.

Cetirizine, one of the most commonly used antihistamines for the treatment of allergic diseases, possesses some anti-inflammatory properties. Despite its common use, the effect of cetirizine on the production of cytokines from peripheral blood mononuclear cells (PBMCs) needs further clarification. The aim of this study was to investigate whether cetirizine changes interleukin (IL)-10, (IF)-gamma and IL-4 production from PBMCs in children with allergic rhinitis. Thirteen children with allergic rhinitis sensitized to house dust mite (HDM) were treated with cetirizine for four weeks. Blood samples were drawn just prior to the treatment, on the last day of the treatment and two weeks following the cessation of treatment The cytokine production from PBMCs was tested in the presence or absence of HDM allergen and measured by ELISA assay. An augmentation in IL-10 production was observed in PBMCs at the 4th week of cetirizine treatment (p<0.05). Furthermore, a significant increase in IFN-gamma production was observed following the therapy. IL-4 release did not change at all time points tested. In addition, IFN-gamma/IL-4 ratio increased following cetirizine treatment. Cetirizine induced a shift in the human Th1/Th2 cytokine balance toward a Th1 type response by increasing IFN-gamma production and augmenting suppressor cytokine release (IL-10). We concluded that apart from its known antihistaminic properties, cetirizine may modulate allergic inflammation while the patients are on regular treatment schedules.

Ann Otol Rhinol Laryngol. 2004 Dec;113(12):941-5.

Effects of cetirizine on substance P release in patients with perennial allergic rhinitis.

Shirasaki H, Watanabe K, Kanaizumi E, Sato J, Konno N, Narita S, Himi T.

Department of Otolaryngology, Sapporo Medical University, School of Medicine, Sapporo, Japan.

To evaluate the effect of cetirizine hydrochloride on substance P release in allergic rhinitis, we performed a single-blind placebo-controlled study of 14 patients with perennial allergic rhinitis (7 treated with cetirizine and 7 with placebo). After an initial nasal allergen challenge with lavages, the subjects received treatment with placebo or cetirizine hydrochloride (10 mg by mouth daily) for 1 week, followed by the second nasal allergen challenge with lavages. The levels of albumin, histamine, and substance P in nasal lavages before and after allergen challenge were quantified by enzyme-linked immunosorbent assay. Pretreatment of subjects with cetirizine reduced the level of substance P induced by antigen challenge, but did not significantly reduce levels of histamine. These results suggest that cetirizine may reduce nasal neurogenic inflammation by modulating the release of substance P in allergic rhinitis.