Combination treatment using the COX-2 inhibitor meloxicam and an anti-allergic in pollinosis

The value of combination therapies that aim to affect both immediate and delayed inflammatory reactions is well known in the treatment of pollinosis. Use of a selective cyclooxygenase-2 (COX-2) inhibitor such as meloxicam is a new approach, however. COX-2 inhibitors target the delayed reaction, which plays a major role in chronic nature of this allergic reaction through activation of the arachidonate cascade and the production of prostaglandins. In this study, four treatment regimens were compared for effectiveness in relieving the symptoms of pollinosis: (i) an anti-allergic alone; (ii) an anti-allergic plus a conventional non-steroidal anti-inflammatory drug; (iii) an anti-allergic plus a selective COX-2 inhibitor; and (iv) an anti-allergic plus an oral steroid. Use of a COX-2 inhibitor plus an anti-allergic produced significantly more relief for most symptoms. The significance of this is as yet unclear, but it is hoped that these results will further our understanding of chronic inflammation.