Eduardo Urdaneta

Effect of cetirizine on symptom severity and quality of life in perennial allergic rhinitis.

The effect of cetirizine on quality of life (QOL) in subjects with perennial allergic rhinitis (PAR) has been previously evaluated using generic instruments. While generic QOL tools are used across various conditions, disease-specific instruments evaluate the impact of treatment on areas that are affected by that particular condition. This study evaluated the effect of cetirizine on symptom severity and health-related QOL, using a disease-specific instrument, in adults with PAR. This randomized, double-blind, placebo-controlled study was conducted at 15 U.S. centers outside the pollen allergy season. After a 1-week placebo run-in period, qualified subjects aged 18-65 years with PAR were randomized to once-daily cetirizine 10 mg (n = 158) or placebo (n = 163) for 4 weeks. Change from baseline in total symptom severity complex (TSSC) and overall Rhinitis Quality of Life Questionnaire (RQLQ) scores were primary efficacy end points. Cetirizine produced significantly greater improvements in mean TSSC for each treatment week (p < 0.05) and for the entire 4-week treatment period (p = 0.005) compared with placebo. After 4 weeks, cetirizine-treated subjects reported significantly greater overall improvement in RQLQ scores compared with placebo-treated subjects (p = 0.004). After 1 week, cetirizine produced significant improvements in the nasal symptoms, practical problems, and activities RQLQ domain scores compared with placebo (p < 0.05). After 4 weeks, cetirizine-treated subjects reported significant reductions in these RQLQ domain scores and in emotion domain scores compared with placebo-treated subjects (p < 0.05). Cetirizine 10 mg daily produced significant improvements in symptom severity and allergic rhinitis-related QOL compared with placebo in adults with PAR.

Treatment with Inhaled Mometasone Furoate Reduces Short-Acting β2 Agonist Claims and Increases Adherence Compared to Fluticasone Propionate in Asthma Patients

OBJECTIVES Differences between mometasone furoate (MF), administered once daily, and fluticasone propionate (FP), administered twice daily, dosing regimens may affect adherence and short-acting β(2) agonist (SABA) use. The objective of this analysis was to compare asthma control outcomes in matched cohorts of MF- and FP-treated asthma patients stratified by SABA claims. METHODS A retrospective pharmacy claims database analysis identified matched cohorts of asthma patients (aged 12-65 years) who initiated treatment with MF or FP. Patients with none, one to four, five to eight, or more than eight SABA preindex claims were stratified to categories A, B, C, and D, respectively. Bivariate analyses compared postindex SABA canister claims, adherence, and exacerbations; multivariate analyses compared postindex SABA canister claims. RESULTS Matched patients in categories A (n = 2517 per cohort) and B (n = 2329 per cohort) were analyzed; insufficient sample sizes were identified for categories C and D. Postindex bivariate analyses indicated that MF cohorts had fewer SABA claims compared to FP cohorts (category A, 0.80 vs. 1.17 [P < 0.0001]; category B, 1.39 vs. 1.58 [P < 0.0001]), better adherence to the index drug (category A, 24% vs. 15% [P < 0.0001]; category B, 27% vs. 15% [P < 0.0001]), and fewer exacerbations (category A, 0.17 vs. 0.19 [P = 0.011]; category B, 0.17 vs. 0.21 [P = 0.008]). Multivariate analyses indicated that MF cohorts had fewer postindex SABA claims compared to FP cohorts in categories A and B (P < 0.0001). CONCLUSIONS Data for SABA claims, treatment adherence, and exacerbations suggest that, compared to twice-daily FP, once-daily MF may provide better asthma control.

Mometasone furoate vs fluticasone propionate with salmeterol: multivariate analysis of resource use and asthma-related charges

Abstract Objective: Although current National Asthma Education and Prevention Program (NAEPP) guidelines indicate low-dose inhaled corticosteroid (ICS) monotherapy as the preferred treatment for patients with mild persistent asthma, many patients receive ICS and long-acting β2-agonist (LABA) combinations. The objective of the current study was to evaluate asthma-related charges in patients with mild asthma who began treatment with mometasone furoate (MF) versus those who began treatment with a fluticasone propionate/salmeterol (FPS) combination. Research design and methods: This retrospective administrative claims database analysis collected data from the 365-day periods before (preindex period) and after (postindex period) the study index date from patients with mild asthma aged 12 to 65 years who began treatment with MF or FPS. Asthma-related inpatient, outpatient, pharmaceutical, and total charges; exacerbations; short-acting β2-agonist (SABA) canister claims; and adherence to therapy were assessed. Matched cohorts of MF and FPS patients were compared using multivariate generalized linear regression models. Results: Among matched MF (n = 4094) and FPS (n = 4094) cohorts, MF patients had significantly lower postindex asthma-related total charges (

Randomized, placebo-controlled study of cetirizine and loratadine in children with seasonal allergic rhinitis

2136 vs

Mometasone furoate versus beclomethasone dipropionate: effectiveness in patients with mild asthma.

2315, respectively; P = 0.0003), lower pharmaceutical charges (

Incidence of Exacerbations and Hospitalizations Is Reduced and Time to Exacerbations Is Prolonged with Mometasone Furoate Dry Powder Inhaler Versus Beclomethasone Dipropionate Hydrofluoroalkane Aerosol in Patients with Mild Asthma

727 vs

A Multivariate Outcomes Analysis of Mometasone Furoate versus Fluticasone Propionate Outcomes in Mild Persistent Asthmatics with Prior Asthma Medication Use

925, respectively; P < 0.0001), fewer exacerbations (0.14 vs 0.16, respectively; P = 0.0306), fewer SABA canister claims (0.9 vs 1.0, respectively; P < 0.0001), and greater adherence measured by prescription fills (3.0 vs 2.8, respectively; P < 0.0001). Asthma-related inpatient charges, outpatient charges, and adherence measured by percent of days covered were not significantly different between treatment cohorts. Limitations included a lack of additional ICS and ICS/LABA therapies, a lack of pediatric patients, and the general limitations associated with retrospective database analyses (e.g., no patient records). Conclusions: These data suggest that MF may be more cost-effective than FPS for the treatment of mild asthma. To effectively and efficiently manage asthma, it is important for clinicians to follow current NAEPP guidelines, which indicate ICS monotherapy as preferred treatment for mild persistent asthma.

Cetirizine Improves Both Ocular and Nasal Allergy Symptoms in Subjects with Perennial Allergic Rhinitis

BACKGROUND Pharmacologic treatment is a mainstay of allergy therapy and many caregivers use over-the-counter antihistamines for the treatment of seasonal allergic rhinitis (SAR) symptoms in children. OBJECTIVE To assess the efficacy and safety of cetirizine 10 mg syrup versus loratadine 10 mg syrup versus placebo syrup in a randomized double-blind study of children, ages 6-11 years, with SAR. METHODS This randomized, double-blind, parallel-group, placebo-controlled study was conducted at 71 U.S. centers during the spring tree and grass pollen season. After a 1-week placebo run-in period, qualified subjects were randomized to once-daily cetirizine 10 mg (n = 231), loratadine 10 mg (n = 221), and placebo (n = 231) for 2 weeks. The primary efficacy end point was change from baseline in the subjects mean reflective total symptom severity complex (TSSC) score over 14 days. RESULTS Children treated with cetirizine experienced significantly greater TSSC score reductions versus children treated with placebo over 14 days (least square mean change, -2.1 versus -1.6; p = 0.006). The differences in TSSC score improvement over 14 days between the cetirizine versus loratadine groups (-2.1 versus -1.8; p = 0.124) and between the loratadine versus placebo groups (-1.8 versus -1.6; p = 0.230) were not statistically significant. Predominant adverse events in the cetirizine, loratadine, and placebo groups were headache (3.5, 3.6, and 3.1%, respectively) and pharyngitis (3.5, 2.7, and 3.5%, respectively). Somnolence was reported in three subjects (1.3%) treated with cetirizine and in none of the other subjects. CONCLUSION Cetirizine 10 mg was statistically significantly more efficacious than placebo in the treatment of SAR symptoms in children ages 6-11 years. Symptom improvement was not significantly different between the loratadine 10 mg and placebo groups.