Single-dose desloratadine and montelukast and allergen-induced late airway responses

Eur Respir J. 2009 Jun;33(6):1302-8. doi: 10.1183/09031936.00169008. Epub 2009 Jan 22.

Abstract

Montelukast and desloratadine synergistically inhibit the allergen-induced early asthmatic response. Montelukast also suppresses the allergen-induced late asthmatic response, but there are no reports on the effect of desloratadine or the combination on the allergen-induced late asthmatic response. Atopic asthmatics (n = 10) completed a multicentric randomised double-blind crossover study comparing single-dose placebo, 5 mg desloratadine, 10 mg montelukast and the combination administered 2 h prior to allergen inhalation challenge. Methacholine challenges were performed 24 h before and after allergen challenge. Exhaled nitric oxide measurements and sputum inflammatory cell counts were also carried out. All active treatments significantly decreased the late asthmatic response area under the curve. Combination therapy provided the greatest inhibition compared to desloratadine and montelukast. Montelukast was nonsignificantly better than desloratadine but not as effective as the combination. There was a trend towards a decrease in airway responsiveness following montelukast and combination. Montelukast, but not desloratadine or the combination, decreased exhaled NO levels 24 h after allergen. The allergen-induced increase in sputum eosinophil numbers was significantly suppressed at 7 h with desloratadine and combination therapy, and at 24 h with montelukast and combination therapy. Single-dose co-administration of desloratadine and montelukast 2 h prior to allergen inhalation clinically abolished the late asthmatic response and eosinophil recruitment.

Trial registration: ClinicalTrials.gov NCT00424580.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Acetates / administration & dosage
  • Acetates / immunology
  • Acetates / therapeutic use*
  • Adult
  • Allergens / immunology
  • Analysis of Variance
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / immunology
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / immunology
  • Bronchial Provocation Tests
  • Cross-Over Studies
  • Double-Blind Method
  • Drug Therapy, Combination
  • Eosinophils
  • Female
  • Histamine H1 Antagonists, Non-Sedating / therapeutic use*
  • Humans
  • Leukotriene Antagonists / administration & dosage
  • Leukotriene Antagonists / immunology
  • Leukotriene Antagonists / therapeutic use*
  • Loratadine / administration & dosage
  • Loratadine / analogs & derivatives*
  • Loratadine / immunology
  • Loratadine / therapeutic use
  • Male
  • Methacholine Chloride
  • Middle Aged
  • Nitric Oxide / metabolism
  • Placebos
  • Quinolines / administration & dosage
  • Quinolines / immunology
  • Quinolines / therapeutic use*
  • Respiratory Function Tests
  • Sputum / cytology
  • Treatment Outcome

Substances

  • Acetates
  • Allergens
  • Anti-Asthmatic Agents
  • Histamine H1 Antagonists, Non-Sedating
  • Leukotriene Antagonists
  • Placebos
  • Quinolines
  • Methacholine Chloride
  • Nitric Oxide
  • Loratadine
  • desloratadine
  • montelukast

Associated data

  • ClinicalTrials.gov/NCT00424580