Desloratadine treatment for intermittent and persistent allergic rhinitis: a review

Allergic rhinitis (AR) has a high prevalence and substantial impact on quality of life (QoL). The traditional classification of AR as either seasonal or perennial is being superseded in many countries by the ARIA (Allergic Rhinitis and its Impact on Asthma) definitions, in which the term intermittent AR denotes the presence of symptoms for <4 days a week or <4 weeks, and the term persistent AR denotes the presence of symptoms for >4 days a week for >4 weeks. These definitions, particularly that of persistent AR, may better reflect the true pattern of AR as it is experienced by patients. Desloratadine has been approved by the European Medicines Evaluation Agency for the treatment of intermittent and persistent AR, as defined by the ARIA classification.

The purpose of this review was to assess data concerning desloratadine in relation to the ARIA definitions of intermittent and persistent AR.

Relevant clinical studies and information on treatment guidelines were identified through searches of the English-language literature indexed on MEDLINE through May 2007. Search terms included intermittent AR, persistent AR, seasonal AR, perennial AR, and desloratadine.

Desloratadine has been found to be effective and well tolerated in studies in subjects with symptoms of AR analogous to/consistent with the ARIA definitions of intermittent and persistent disease. In a 2-week, randomized, double-blind, placebo-controlled study in subjects with a > or =2-year history of intermittent AR, desloratadine was associated with greater reductions relative to placebo in congestion scores (P < 0.05) and total symptom scores (TSS) (P <0.01). In a 4-week, multicenter, randomized, double-blind, placebo-controlled study in subjects with a > or =2-year history of perennial AR, desloratadine had greater efficacy than placebo in terms of reductions in TSS as early as day 2 (P > or = 0.02), as well as reductions in nasal and nonnasal symptom scores (P > or =0.04). A 4-week, randomized, double-blind, placebo-controlled study assessing QoL found that desloratadine improved QoL scores to a greater extent than placebo in subjects with a > or =2-year history of perennial AR (P = 0.009).

According to the ARIA guidelines, second-generation antihistamines are a cornerstone of pharmacologic therapy for AR. Desloratadine is effective in the treatment of AR across all classifications of disease, either seasonal/perennial or intermittent/persistent.