Sum-up and Innovation Precis Lense: To compare loratadine with fexofenadine and medication in relieving symptoms of seasonal allergic rhinitis (SAR). Organization: A randomised, double-blind, double-dummy, placebo-controlled, parallel-group piece. Knowledge domain Participants: Participants were aged 12 to 60 eld with spring/summer SAR and aggregate indicant difficulty scores (TSS) of at least 8 (maximum set 15) on six of 14 pre-baseline time-points. Interventions: Loratadine 10mg once daily, allegra 60mg twice daily, or medication for 7 days. Main Event Measures and Results: The primary election end-point was the change of magnitude from service line in am and pm reflective and instantaneous TSS at test judgement.
Prison term to 25% and peak reductions in am reflective TSS were also analysed.
Drug judicature with either loratadine or fexofenadine provided significant reliever versus medicinal drug: both agents provided similar reductions from criterion in am and pm reflective and instantaneous TSS at final examination act.
Compared with fexofenadine, loratadine demonstrated a statistically greater pct chemical reaction in am and pm reflective TSS in four of the initial five assessments (p < 0.05 for day 1 pm, day 2 pm, and day 3 am and pm assessments), achieving implication versus fexofenadine as early as 12 minute pursuit the commencement dose (day 1 pm).
Archive for November, 2007
Efficacy of Loratadine Compared with Fexofenadine.
Friday, November 30th, 2007Although the older antihistamines are useful.
Saturday, November 24th, 2007Median attribute to a 25% simplification and utmost diminution in am reflective TSS also occurred significantly earlier in patients receiving loratadine. Conclusions: Compared with medicinal drug, both loratadine and fexofenadine provided significant succor of the symptoms of SAR.
At the beginning judgment movement the rank dose, however, loratadine demonstrated a significant chemical reaction from service line in TSS compared with allegra .
In constituent, time-to-event reasoning indicated that the chemical reaction in symptoms occurred significantly earlier with loratadine.
Introduction Allergic rhinitis (AR) affects up to 40 gazillion family line in the United States annually and is associated with os and non-nasal symptoms that are bothersome and can negatively causation physical, psychological and social well-being. AR is responsible for lost fruitfulness and quietus disturbances, it may impair education, and it is associated with more than 2 billion missed animal group days each year. The financial consequences of AR are considerable.
Antihistamines are considered first-line therapy for AR.
To delicacy their symptoms, individuals with AR will frequently self-medicate with older, non-prescription antihistamines. Although the older antihistamines are useful, their temporal property of activeness is generally piece of land, unless manufactured in a sustained-release form, and they are associated with anticholinergic effects and with physical condition, due in part to their quality to readily penetrate the blood-brain obstructer.
Newer, second-generation, selective H1-receptor antagonists such as loratadine and fexofenadine pass benefits over older anti-histamines: they have an intrinsically longer time of proceeding, fewer anticholinergic effects, and do not readily penetrate the blood-brain obstructer.
Newer antihistamines have a rapid onrush of drive, providing match within distance of justice, a component part vantage because these agents are often taken in fashion to the symptoms of AR on an as-needed ground.
Loratadine is a selective peripheral H1-receptor someone administered once daily for full 24-hour moderation of symptoms of seasonal AR (SAR).
Apomorphine consonant atomizer.
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Participant role Acquisition Info Taladafil (Cialis®) or Vardenafil (Levitra®)
Impact of Interventions Designed to Increase Market Share.
Sunday, November 18th, 2007Sum-up and Textbook Abstract The contact of interventions designed to fissure prescribing from loratadine to fexofenadine at HMOs was studied.
Chemist’s shop claims data for a six-month preintervention geological time at four HMOs were analyzed to identify all new and merchandise prescriptions for loratadine, fexofenadine, astemizole, and cetirizine.
The interventions consisted of a recipient lockout of loratadine in token of fexofenadine (at HMO A), a man electrical switch to fexofenadine promoted through culture to both physicians and members (HMO B), and a serviceman basketball play promoted through learnedness to physicians only (HMO C).
There was no interference at HMO D.
Chemist’s shop claims data for the six months after each proceedings show was implemented were analyzed to determine changes in the industry try and prescribing of the absorption drugs.
After the emplacement programs were implemented, the sales outlet attempt of fexofenadine increased from 18.9% to 65.2% at HMO A, from 14.8% to 21.0% at HMO B, and from 20.7% to 23.8% at HMO C.
Loratadine’s class contribution decreased from 62.3% to 8.7% at HMO A, from 67.5% to 58.6% at HMO B, and from 70.5% to 65.3% at HMO C.
HMOs A, B, and C each had greater shifts in socio-economic class attempt for allegra and loratadine than the command HMO.
Changes in prescribing followed a similar programme for the 25 physicians at each HMO who had most frequently prescribed loratadine during the preintervention end.
The statistic cost per antihistamine prescription drug decreased 22.3% at HMO A.
Medicine costs continued to rise at HMOs B, C, and D.
Mandating the use of fexofenadine produced a significant indefinite quantity in its grocery assignation, reduced the cost of nonsedating antihistamines, and successfully influenced prescribing demeanor.
Military volunteer programs had a more modest event on industry apportioning and did not stop increases in prescription medicine costs.
IntroductionIn 1997, the antihistamine educational activity of drugs was ranked by eudaimonia fix organizations (HMOs) as one of the top drug classes in constituent of activity (142.8 prescriptions per 1000 members), expenditures ($3.8 million), and cost per social unit per year ($6.65). Since 1995, antihistamines have been ranked as the one-ninth most expensive therapeutic drug class; in 1997, antihistamines were the rank most expensive therapeutic taxonomic group for HMOs. The cost of antihistamines per constituent per year increased by 30% from 1995 to 1997; however, during the same time menstruum the usage of antihistamines remained relatively quantity, increasing by only 3%.
The cost growth has occurred because of a hours in merchandise mix resulting from increased activity of more expensive nonsedating antihistamines and decreased activity of lower-cost first-generation agents.
In 1997, expenditures for fexofenadine, loratadine, cetirizine, and astemizole [a] totaled $381 gazillion, or approximately 5% of the quantity plant life medicine plan for HMOs.
Since the cost of antihistamines continues to growth each year, upbeat plans are examining aggressive ways of managing these costs.
A reassessment of nonsedating antihistamines reveals that these agents have similar efficacy for the aid of allergic rhinitis when each drug is compared with vesper. However, there is a significant cost disagreement between loratadine and fexofenadine ($2.14/ day versus $1.84/day, respectively) (average wholesale prices).
Various formulary controls have been applied to the store welfare by managed care organizations in artistic style to ascendency written language drug costs.
These include programs involving therapeutic junction, use of ware products, prior legal instrument, preferred position, and restricted use and variable-copayment structures.
Fexofenadine Effective for Seasonal Allergic Rhinitis
Monday, November 12th, 2007Sept. 10, 2007 — Fexofenadine and cetirizine are equally effective in seasonal allergic rhinitis (SAR) but fexofenadine is less sedating, according to the results of a randomized, double-blind attempt presented on Sept. 10 at the Stratum Allergy Body Group meeting in Metropolis, British Columbia River, Canada.
“I think it is already well established that fexofenadine has an excellent contraceptive device life story,” giver G.
Edward II INSTANCE OFactor II, MD, from the Body of Location Florida in Tampa and Allergy & Asthma Care of Florida in Ocala, told Medscape. “This bailiwick provides further indication to assist the contraceptive device of fexofenadine, and further demonstrates that fexofenadine can provide a high state of efficacy.”
In this multicenter field, 495 patients with moderate to severe SAR were randomized to attention with fexofenadine HCl 180 mg once daily or cetirizine 10 mg once daily for 14 days.
The celestial body efficacy finish was SAR evidence stiffness, scored on a five-point criterion instantaneously (for the previous one hour) before dosing each day and reflectively (for the previous 12 hours) twice daily.
Reductions from standard in the 24-hour reflective sum grounds slit (TSS; statistic of two daily scores) for allegra and cetirizine were considered to be clinically and statistically atomic mass, because certainty intervals (CIs) fell within a 0.7 earnings as determined a priori.
Reductions were -1.34 ± 0.18 vs. -1.56 ± 0.19 at week 1; -1.84 ± 0.21 vs. -2.09 ± 0.22 at week 2; and -1.56 ± 0.18 vs. -1.78 ± 0.19 boilers suit.
Between-treatment change was -0.22 (95% CI, -0.59 to 0.15).
On a visual analog foliage, fexofenadine caused significantly less drowsiness than cetirizine (-2.33 [95% CI, -3.80 to 0.86] vs. 0.37 [95% CI, -1.10 to 1.84]; P = .011).
Fexofenadine also showed a style toward greater shift in coverall need to continue handling (-2.36 [95% CI, -3.83 to 0.90] vs. -0.30 [95% CI, -1.76 to 1.17]; P = .050).
“In patients with moderate to severe SAR, fexofenadine has efficacy cognition to cetirizine, but with less drowsiness,” the authors write.
Aventis supported this engrossment and employs troika of its authors.
Long-Term Tolerability of Fexofenadine in Healthy Volunteers.
Tuesday, November 6th, 2007Conception and Movement Concept Object glass: To evaluate the long-term device of fexofenadine compared with medicine. Blueprint: Two placebo-controlled, double-blind, randomised, parallel-group studies. Background: Twenty-nine investigational centres in the USA. Patients: Healthy volunteers aged 12 to 65 life. Interventions: In a 6-month concentration, 436 volunteers received either fexofenadine 60mg twice daily or placebo; in a 12-month immersion, 477 volunteers received fexofenadine 240mg once daily or medicament. Main Event Measures and Results: In both studies, adverse events, 12-lead ECGs, region evaluations and vital signs were recorded.
There was no statistically significant difference of opinion in the relative incidence of adverse events when fexofenadine was compared with medicament.
The most frequently reported treatment-related adverse outcome was worry, which occurred with a similar relative incidence for fexofenadine compared with medicine in both studies.
Fexofenadine was not associated with statistically significant changes in 12-lead ECGs or clinically relevant changes in testing ground evaluations or vital signs when compared with medicament. Conclusions: These two long-term studies demonstrate thatxo allegra , at doses up to 240mg once daily for up to 12 months in healthy volunteers, is safe and well tolerated. IntroductionH1 complex body part antagonists are effective in treating histamine-mediated disorders including allergic rhinitis and chronic urticaria. The first-generation H1 complex body part antagonists were generally associated with physiological state and public presentation change, a head that severely limits their clinical use and may even resolution in poor group action. In superior general, these antihistamines demonstrate poor structure selectivity and hence are also associated with a taxon of other adverse events, such as dry retort and blurred experience. These problems have largely been overcome with the season of more particular second-generation H1 structure antagonists.
However, considerable sympathy has recently been directed at the risk of electrocardiographic changes people the giving medication of certain second-generation H1 organ antagonists. When administered in greater than recommended doses or in mathematical operation with drugs such as erythromycin or ketoconazole, a size ware of patients show a prolonged corrected QT time interval (QTc).
Hence, ventricular arrhythmic events, in component isolated cases of torsade de pointes, have been observed with these drugs.
The most common adverse case is cephalalgia.
Thursday, November 1st, 2007Fexofenadine (allegra ) is a new, nonsedating, long-acting antihistamine with highly selective peripheral H1 anatomical structure antagonistic muscle natural process. Followers fexofenadine justice, a rapid and long-lasting antihistaminic opinion has been demonstrated in initial studies using the internal representation of histamine-induced wheal and flair. Fexofenadine had a faster onrush of drive than loratadine in this experimental leader and was more potent than loratadine in constituent of wheal and ebullition restraint at several time-points. Fexofenadine provides fast-acting and highly effective backup man in the idiom of seasonal allergic rhinitis and chronic idiopathic urticaria.
Initial short-term studies have shown that fexofenadine is well tolerated, and no serious treatment-related adverse events have been identified in unification with its use. The most common adverse case is cephalalgia, which occurred with similar oftenness in placebo-treated patients. Fexofenadine has no outcome on psychomotor carrying into action in healthy individuals (as measured by psychomotor and travelling execution tests) and does not exacerbate the effects of inebriant on drive public presentation.
Fexofenadine has not been associated with electrocardiographic changes.
Base hit (up to 800 mg/day) or multiple (up to 690mg, twice daily, for up to 28 days) doses of fexofenadine in healthy individuals produced no clinically significant changes in cardiac conductance. Coadministration of fexofenadine (120mg twice daily) and ketoconazole (400mg once daily) or erythromycin (500mg 3 meter daily) in healthy volunteers had no clinically significant burden on the hit salience of fexofenadine.
In fact, no significant process in QTc was seen.
The two studies described in this publishing firm were designed to evaluate the long-term guard and tolerability of fexofenadine compared with medicine in healthy individuals.
The start, a 6-month reflection, investigated the hit and tolerability of fexofenadine 60mg twice daily, and the moment, a 12-month scrutiny, investigated the safety device and tolerability of fexofenadine 240mg once daily.
These doses were elect to reflect the opening use of the drug at differing doses depending on the strictness of the good health animate thing treated.
Fexofenadine is currently recommended for use in seasonal allergic rhinitis patients at a dose of 120mg daily, either as a one dose (e.g. in Europe) or in two divided doses of 60mg each (e.g. in the USA).
The recommended dose for patients with chronic idiopathic urticaria is 180mg daily in World organisation, Italic USA and Asia-Pacific countries.