Use of cetirizine in patients with allergic rhinitis and conjunctivitis


DOI: https://dx.doi.org/10.18565/therapy.2024.2.49-55

Bolieva L.Z., Kabisova F.A., Kasabieva M.K.

1) North Ossetian State Medical Academy of the Ministry of Healthcare of Russia, Vladikavkaz; 2) State Center for Forensic Medical and Forensic Expertise, Saint Petersburg
Abstract. Antihistamine drugs have been used in the treatment of allergic diseases for over 70 years. The first H1-antihistamines of the 2nd generation were synthesized in 1980s. These medicines in therapeutic doses are selectively interacting with H1-histamine receptors, they are well tolerated, have virtually no sedative effect, their duration of action is 24 hours. According to clinical recommendations, currently it is non-sedating 2nd generation antihistamine remedies that are considered to be drugs of choice for the treatment of allergic diseases, in particular allergic rhinitis and conjunctivitis. According to clinical studies and real clinical practice, one of the most studied drugs in this group is cetirizine, the experience of clinical use of which is more than 30 years. Article summarizes the available data on the efficacy and safety of this drug in patients with seasonal and year-round rhinitis and conjunctivitis.

Literature


1. Powell K. Histamine receptors. xPharm: The Comprehensive Pharmacology Reference. 2007; 1–2.


https://doi.org/10.1016/B978-008055232-3.60127-8.


2. Tatarkiewicz J., Rzodkiewicz P., Zochowska M. et al. New antihistamines – perspectives in the treatment of some allergic and inflammatory disorders. Arch Med Sci. 2019; 15(2): 537–53.


https://doi.org/10.5114/aoms.2017.68534. PMID: 30899308. PMCID: PMC6425212.


3. Быстрова Е.Ю., Дворникова К.А., Платонова О.Н., Ноздрачев А.Д. Модулирующая роль гистамина в нейроиммунных взаимодействиях. Молекулярная медицина. 2021; 19(3): 17–26. (Bystrova E.Yu., Dvornikova K.A., Platonova O.N., Nozdrachev A.D. The modulating role of histamine in neuroimmune interactions. Molekulyarnaya meditsina = Molecular Medicine. 2021; 19(3): 17–26 (In Russ.).)


https://doi.org/10.29296/24999490-2021-03-03. EDN: IJSDWN.


4. Leurs R., Church M.K., Taglialatela M. H1-antihistamines: Inverse agonism, anti-inflammatory actions and cardiac effects. Clin Exp Allergy. 2002; 32(4): 489–98.


https://doi.org/10.1046/j.0954-7894.2002.01314.x. PMID: 11972592.


5. Church M.K., Church D.S. Pharmacology of antihistamines. Indian J Dermatol. 2013; 58(3): 219–24.


https://doi.org/10.4103/0019-5154.110832. PMID: 23723474.


6. Емельянов А.В. Клиническое применение Н1-антигистаминных препаратов. Медицинский совет. 2016; (4): 74–81. (Emelyanov A.V. Clinical use of H1-antihistamines. Meditsinskiy sovet = Medical Council. 2016; (4): 74–81 (In Russ.).) EDN: VSLKNL.


7. Клинические рекомендации. Аллергический ринит. Российская ассоциация аллергологов и клинических иммунологов, Национальная медицинская ассоциация оториноларингологов, Союз педиатров России. Рубрикатор клинических рекомендаций Минздрава России. 2020. ID: 261. Доступ: https://cr.minzdrav.gov.ru/schema/261_1 (дата обращения: 11.01.2024). (Clinical guidelines. Allergic rhinitis. Russian Association of Allergists and Clinical Immunologists, National Medical Association of Otorhinolaryngologists, Union of Pediatricians of Russia. Rubricator of clinical guidelines of the Ministry of Healthcare of Russia. 2020. ID: 261. URL: https://cr.minzdrav.gov.ru/schema/261_1 (date of access: 11.01.2024) (In Russ.).)


8. Tillement J-P., Testa B., Bree F. Compared pharmacological characteristics in humans of racemic cetirizine and levocetirizine, two histamine H1-receptor antagonists. Biochem Pharmacol. 2003; 66(7): 1123–26.


https://doi.org/10.1016/s0006-2952(03)00558-6. PMID: 14505791.


9. Snyder S.H., Snowman A.M. Receptor effects of cetirizine. Ann Allergy. 1987; 59 (6 Pt 2): 4–8. PMID: 2892448.


10. Ciprandi G., Tosca M.A., Milanese M., Ricca V. Cetirizine reduces cytokines and inflammatory cells in children with perennial allergic rhinitis. Eur Ann Allergy Clin Immunol. 2004; 36(6): 237–40. PMID: 15329007.


11. Isomura T., Kono T., Hindnarch I. et al. Central nervous system effects of the second-generation antihistamines marketed in Japan review of inter-drug differences using the Proportional Impairment Ratio (PIR). PLoS One. 2014; 9(12): e114336.


https://doi.org/10.1371/journal.pone.0114336. PMID: 25501360. PMCID: PMC4264760.


12. Barbey J.T., Anderson M., Ciprandi G. et al. Cardiovascular safety of second-generation antihistamines. Am J Rhinol. 1999; 13(3): 235–43.


https://doi.org/10.2500/105065899781389759. PMID: 10392245.


13. Greisner W.A. Onset of action for the relief of allergic rhinitis symptoms with second-generation antihistamines. Allergy Asthma Proc. 2004; 25(2): 81–83. PMID: 15176489.


14. Wood S.G., John B.A., Chasseaud L.F. et al. The metabolism and pharmacokinetics of 14 C-cetirizine in humans. Ann Allergy. 1987; 59(6 Pt 2): 31–34. PMID: 2892447.


15. Boobis A., Watelet J.B., Whomsley R. et al. Drug interactions. Drug Metab Rev. 2009; 41(3): 486–527.


https://doi.org/10.1080/10837450902891550. PMID: 19601724.


16. Государственный реестр лекарственных средств Минздрава России. Инструкции по медицинскому применению лекарственных препаратов с МНН цетиризин. Доступ: https://grls.rosminzdrav.ru/ (дата обращения: 11.01.2024). (State register of medicines of the Ministry of Healthcare of Russia. Instructions for use of the drugs with INN cetirizine. URL: https://grls.rosminzdrav.ru/ (date of access: 11.01.2024) (In Russ.).)


17. Гущин И.С. Перспективы совершенствования противоаллергического действия Н1-антигистаминных препаратов. Лечащий врач. 2009; (5): 64–67. (Gushchin I.S. Prospects for improving the antiallergic action of H1-antihistamines. Lechashchiy vrach = Attending Physician. 2009; (5): 64–67 (In Russ.).) EDN: PYKRSF.


18. Allegra L., Paupe J., Wieseman H.G. et al. Cetirizine for seasonal allergic rhinitis in children aged 2–6 years. A double-blind comparison with placebo. Pediatr Allergy Immunol. 1993; 4(3): 157–61.


https://doi.org/10.1111/j.1399-3038.1993.tb00085.x. PMID: 8220804.


19. Murray J.J., Nathan R.A., Bronsky E.A. et al. Comprehensive evaluation of cetirizine in the management of seasonal allergic rhinitis: Impact on symptoms, quality of life, productivity, and activity impairment. Allergy Asthma Proc. 2002; 23(6): 391–98. PMID: 12528605.


20. Noonan M.J., Raphael G.D., Nayak A. et al. The health-related quality of life effects of once-daily cetirizine HCl in patients with seasonal allergic rhinitis: A randomized double-blind, placebo-controlled trial. Clin Exp Allergy. 2003; 33(3): 351–58.


https://doi.org/10.1046/j.1365-2222.2003.01596.x. PMID: 12614450.


21. Mansmann H.C. Jr., Altman R.A., Berman B.A. et al. Efficacy and safety of cetirizine therapy in perennial allergic rhinitis. Ann Allergy. 1992; 68(4): 348–53. PMID: 1348405.


22. Bousquet J., Duchateau J., Pignat J.C. et al. Improvement of quality of life by treatment with cetirizine in patients with perennial allergic rhinitis as determined by a French version of the SF-36 questionnaire. J Allergy Clin Immunol. 1996; 98(2): 309–16.


https://doi.org/10.1016/s0091-6749(96)70155-0. PMID: 8757208.


23. Berkowitz R.B., Dockhom R., Lockey R. et al. Comparison of efficacy, safety, and skin test inhibition of cetirizine and astemizole. Ann Allergy Asthma Immunol. 1996; 76(4): 363–68.


https://doi.org/10.1016/S1081-1206(10)60039-7. PMID: 8612120.


24. Lockey R.F., Widlitz M.D., Mitchell D.Q. et al. Comparative study of cetirizine and terfenadine versus placebo in the symptomatic management of seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 1996; 76(5): 448–54.


https://doi.org/10.1016/S1081-1206(10)63462-X. PMID: 8630719.


25. Gehanno P., Bremard-Oury C., Zeisser P. Comparison of ebastine to cetirizine in seasonal allergic rhinitis in adults. Ann Allergy Asthma Immunol. 1996; 76(6): 507–12.


https://doi.org/10.1016/S1081-1206(10)63269-3. PMID: 8673684.


26. Meltzer E.O., Weiler J.M., Widlitz M.D. Comparative outdoor study of the efficacy, onset and duration of action, and safety of cetirizine, loratadine, and placebo for seasonal allergic rhinitis. J Allergy Clin Immunol. 1996; 97(2): 617–26.


https://doi.org/10.1016/s0091-6749(96)70307-x. PMID: 8621847.


27. Day J.H., Briscoe M.P., Rafeiro E. et al. Randomized double-blind comparison of cetirizine and fexofenadine after pollen challenge in the environmental exposure unit: Duration of effect in subjects with seasonal allergic rhinitis. Allergy Asthma Proc. 2004; 25(1): 59–68. PMID: 15055564.


28. Day J.H., Briscoe M.P., Rafeiro E. et al. Comparative efficacy of cetirizine and fexofenadine for seasonal allergic rhinitis, 5–12 h postdose, in the environmental exposure unit. Allergy Asthma Proc. 2005; 26(4): 275–82. PMID: 16270720.


29. Horak F., Stubner P., Zieglmayer R. et al. Controlled comparison of the efficacy and safety of cetirizine 10 mg o.d. and fexofenadine 120 mg o.d. in reducing symptoms of seasonal allergic rhinitis. Int Arch Allergy Immunol. 2001; 125(1): 73–79.


https://doi.org/10.1159/000053799. PMID: 11385291.


30. Howarth P.H., Stem M.A., Roi L. et al. Double-blind, placebo-controlled study comparing the efficacy and safety of fexofenadine hydrochloride (120 and 180 mg once daily) and cetirizine in seasonal allergic rhinitis. J Allergy Clin Immunol. 1999; 104(5): 927–33.


https://doi.org/10.1016/s0091-6749(99)70070-9. PMID: 10550734.


31. Hampel F., Ratner P., Mansfield L. et al. Fexofenadine hydrochloride, 180 mg, exhibits equivalent efficacy to cetirizine, 10 mg, with less drowsiness in patients with moderate-to-severe seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2003; 91(4): 354–61.


https://doi.org/10.1016/S1081-1206(10)61682-1. PMID: 14582814.


32. Sabbah A., Daele J., Wade A.G. et al. Comparison of the efficacy, safety, and onset of action of mizolastine, cetirizine, and placebo in the management of seasonal allergic rhinoconjunctivitis. MIZOCET Study Group. Ann Allergy Asthma Immunol. 1999; 83(4): 319–25.


https://doi.org/10.1016/s1081-1206(10)62672-5. PMID: 10541424.


33. Martinez-Cocera C., De Molina M., MartíGuadano E. et al. Rupatadine 10 mg and cetirizine 10 mg in seasonal allergic rhinitis: A randomised, double-blind parallel study. J Investig Allergol Clin Immunol. 2005; 15(1): 22–29. PMID: 15864879.


34. Kuna P., Bachert C., Nowacki Z. et al. Efficacy and safety of bilastine 20 mg compared with cetirizine 10 mg and placebo for the symptomatic treatment of seasonal allergic rhinitis: A randomized, double-blind, parallel-group study. Clin Exp Allergy. 2009; 39(9): 1338–47.


https://doi.org/10.1111/j.1365-2222.2009.03257.x. PMID: 19438584.


35. Lai D.S., Lue K.H., Hsieh J.C. et al. The comparison of the efficacy and safety of cetirizine, oxatomide, ketotifen, and a placebo for the treatment of childhood perennial allergic rhinitis. Ann Allergy Asthma Immunol. 2002; 89(6): 589–98.


https://doi.org/10.1016/S1081-1206(10)62107-2. PMID: 12487225.


36. Murris-Espin M., Melac M., Charpentier J.C. et al. Comparison of efficacy and safety of cetirizine and ebastine in patients with perennial allergic rhinitis. Ann Allergy Asthma Immunol. 1998; 80(5): 399–403.


https://doi.org/10.1016/S1081-1206(10)62991-2. PMID: 9609610.


37. Nunes C., Ladeira S. Double-blind study of cetirizine and loratadine versus placebo in patients with allergic rhinitis. J Investig Allergol Clin Immunol. 2000; 10(1): 20–23. PMID: 10780795.


38. Fantin S., Maspero J., Bisbal C. et al. A 12-week placebo-controlled study of rupatadine 10 mg once daily compared with cetirizine 10 mg once daily, in the treatment of persistent allergic rhinitis. Allergy. 2008; 63(7): 924–31.


https://doi.org/10.1111/j.1398-9995.2008.01668.x. PMID: 18588560.


39. Skoner D.P., LaForce C.F., Nathan R.A. et al. Effect of cetirizine on symptom severity and quality of life in perennial allergic rhinitis. Allergy Asthma Proc. 2014; 35(4): 338–45.


https://doi.org/10.2500/aap.2014.35.3760. PMID: 24992553.


40. Meier E.J., Torkildsen G.L., Gomes P.J., Jasek M.C. Phase III Trials examining the efficacy of cetirizine ophthalmic solution 0.24% compared to vehicle for the treatment of allergic conjunctivitis in the conjunctival allergen challenge model. Clin Ophthalmol. 2018; (12): 2617–28.


https://doi.org/10.2147/OPTH.S185835. PMID: 30587908. PMCID: PMC6296187.


41. Malhotra R.P., Meier E., Torkildsen G. et al. Safety of cetirizine ophthalmic solution 0.24% for the treatment of allergic conjunctivitis in adult and pediatric subjects. Clin Ophthalmol. 2019; (13): 403–13.


https://doi.org/10.2147/OPTH.S186092. PMID: 30858690. PMCID: PMC6387590.


42. Du Q., Zhou Y. Placebo-controlled assessment of somnolence effect of cetirizine: A meta-analysis. Int Forum Allergy Rhinol. 2016; 6(8): 871–79.


https://doi.org/10.1002/alr.21746. PMID: 26990040.


43. Pasko P., Rodacki T., Domagała-Rodacka R. et al. Second-generation H1-antihistamines interaction with food and alcohol – a systematic review. Biomed Pharmacother. 2017; (93): 27–39.


https://doi.org/10.1016/j.biopha.2017.06.008. PMID: 28622592.


44. Poluzzi E., Diemberger I., De Ridder M. et al. Use of antihistamines and risk of ventricular tachyarrhythmia: A nested case-control study in five European countries from the ARITMO project. Eur J Clin Pharmacol. 2017; 73(11): 1499–510.


https://doi.org/10.1007/s00228-017-2317-0. PMID: 28831527.


45. Golembesky A., Cooney M., Boev R. et al. Safety of cetirizine in pregnancy. J Obstet Gynaecol. 2018; 38(7): 940–45.


https://doi.org/10.1080/01443615.2018.1441271. PMID: 29565188.


About the Autors


Laura Z. Bolieva, MD, Dr. Sci. (Medicine), professor, head of the Department of pharmacology with clinical pharmacology of the North Ossetian State Medical Academy of the Ministry of Healthcare of Russia. Address: 362019, Vladikavkaz, 40 Pushkinskaya St.
E-mail: bolievalz@mail.ru
ORCID: https://orcid.org/0000-0002-1820-7726
Fatima A. Kabisova, MD, PhD (Medicine), psychiatrist at the State Center for Forensic Medical and Forensic Expertise. Address: 191124, Saint Petersburg, 63 Suvorovsky Avenue.
E-mail: regish@mail.ru
Madina K. Kasabieva, MD, postgraduate student of the Department of pharmacology of the North Ossetian State Medical Academy of the Ministry of Healthcare of Russia. Address: 362019, Vladikavkaz, 40 Pushkinskaya St.
E-mail: madinakazbekovna2@gmail.com


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