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Review Article| Volume 19, ISSUE 6, P1278-1293, November 1997

A review of loratadine in the treatment of patients with allergic bronchial asthma

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      Abstract

      Patients with seasonal or allergic bronchial asthma experience an immediate allergic response caused by allergen-specific immunoglobulin E—mediated histamine release. The release of histamine and other chemical mediators may trigger airway hyperresponsiveness and exaggerated bronchoconstriction, characteristic features of allergic bronchial asthma. Traditional antihistamines have demonstrated only moderate activity of short duration against this disease. In contrast, loratadine, a potent, nonsedating, histamine-l—receptor antagonist with activity in seasonal and perennial allergic rhinitis, has demonstrated effective control of asthma symptoms, improved pulmonary function, and long duration of action in patients with allergic bronchial asthma. This review summarizes preclinical evidence for the antiallergic activity of loratadine and the results of clinical studies with oral loratadine in patients with allergic bronchial asthma.

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      References

        • Kroll VM
        • Nothofer B
        • Werdermann K
        Allergic bronchial asthma treated with loratadine.
        Fortschr Med. 1993; 111 (In German): 76-78
        • Ryhal BT
        • Fletcher MP
        The second-generation antihistamines. What makes them different?.
        Postgrad Med. 1991; 89: 87-99
        • Busse WW
        Role of antihistamines in allergic disease.
        Ann Allergy Asthma Immunol. 1994; 72: 371-375
        • Rafferty P
        • Holgate ST
        Histamine and its antagonists in asthma.
        J Allergy Clin Immunol. 1989; 84: 141-151
        • Holgate ST
        • Finnerty JP
        Antihistamines in asthma.
        J Allergy Clin Immunol. 1989; 83 (pt 2): 537-547
        • Akagi K
        • Townley RG
        Spontaneous histamine release and histamine content in normal subjects and subjects with asthma.
        J Allergy Clin Immunol. 1989; 83: 742-749
        • Hargreave FE
        • O'Byrne PM
        • Ramsdale EH
        Mediators, airway responsiveness, and asthma.
        J Allergy Clin Immunol. 1985; 76 (pt 2): 272-276
        • Holgate ST
        • Beasley R
        • Twentyman OP
        The pathogenesis and significance of bronchial hyper-responsiveness in airways disease.
        Clin Sci. 1987; 73: 561-572
        • Bousquet J
        • Czarlewski W
        • Danzig MR
        Antiallergic properties of loratadine: A review.
        Adv Ther. 1995; 12: 283-298
        • Flint KC
        • Leung KB
        • Hudspith BN
        • et al.
        Bronchoalveolar mast cells in extrinsic asthma: A mechanism for the initiation of antigen specific bronchoconstriction.
        BMJ. 1985; 291: 923-926
        • Leung KB
        • Flint KC
        • Brostoff J
        • et al.
        Some properties of mast cells obtained by human bronchoalveolar lavage.
        Agents Actions. 1986; 18: 110-112
        • Simon RA
        • Stevenson DD
        • Arroyave CM
        • et al.
        The relationship of plasma histamine to the activity of bronchial asthma.
        J Allergy Clin Immunol. 1977; 60: 312-316
        • Bruce C
        • Weatherstone R
        • Seaton A
        • et al.
        Histamine levels in plasma, blood, and urine in severe asthma, and the effect of corticosteroid treatment.
        Thorax. 1976; 31: 724-729
        • Dabelic M
        • Neumann Y
        Protection of histamine-induced bronchial obstruction by loratadine.
        Allergologie. 1994; 17 (In German): 143-147
        • Holgate ST
        • Emanuel MB
        • Howarth PH
        Astemizole and other H1-antihistaminic drug treatment of asthma.
        J Allergy Clin Immunol. 1985; 76 (pt 2): 375-380
        • Chan TB
        • Shelton DM
        • Eiser NM
        Effect of an oral H1-receptor antagonist, terfenadine, on antigen-induced asthma.
        Br J Dis Chest. 1986; 80: 375-384
        • Rafferty P
        • Beasley R
        • Holgate ST
        The contribution of histamine to immediate bronchoconstriction provoked by inhaled allergen and adenosine 5′ monophosphate in atopic asthma.
        Am Rev Respir Dis. 1987; 136: 369-373
        • Kersten W
        The value of antihistamines in the treatment of bronchial asthma.
        Allergologie. 1994; 17 (In German): 148-153
        • Berthon B
        • Taudou G
        • Combettes L
        • et al.
        In vitro inhibition, by loratadine and descarboxyethoxyloratadine, of histamine from human basophils, and of histamine release and intracellular calcium fluxes in rat basophilic leukemia cells (RBL-2H3).
        Biochem Pharmacol. 1994; 47: 789-794
        • Simons FE
        The antiallergic effects of antihistamines (H1-receptor antagonists).
        J Allergy Clin Immunol. 1992; 90 (pt 2): 705-715
        • Kreutner W
        • Chapman RW
        • Gulbenkian A
        • et al.
        Antiallergic activity of loratadine, a nonsedating antihistamine.
        Allergy. 1987; 42: 57-63
        • Pistelli A
        • Di Bello MG
        • Raspanti S
        • et al.
        New pharmacological profiles of loratadine: Effects on platelet aggregation and histamine release from repository cells.
        Agents Actions. 1993; 38 (Special issue II): C200-C202
        • Tasaka K
        • Kamei C
        • Akagi M
        • et al.
        Effect of loratadine on immediate and delayed type hypersensitivity reactions.
        Arzneimittelforschung. 1995; 45: 796-804
        • Letari O
        • Miozzo A
        • Folco G
        • et al.
        Effects of loratadine on cytosolic Ca2+ levels and leukotriene release: Novel mechanisms of action independent of the anti-histamine activity.
        Eur J Pharmacol. 1994; 266: 219-227
        • El-Batrawi FA
        • Aggour SA
        • Mortada SA
        • et al.
        Effect of loratadine on guinea pig mast cells: A pharmacological and histological study.
        Med J Cairo Univ. 1990; 62: 519-530
        • Sherwood JE
        • Hutt DA
        • Kreutner W
        • et al.
        A magnetic resonance imaging evaluation of histamine-mediated allergic response in the guinea pig nasopharynx.
        J Allergy Clin Immunol. 1993; 92: 435-441
        • Emery DL
        • Siegel MI
        • Cuss FM
        • et al.
        Loratadine inhibits mediator release from dispersed human lung mast cells.
        Clin Exp Allergy. 1990; 20 (Abstract): 40
        • Kleine-Tebbe J
        • Josties C
        • Frank G
        • et al.
        Inhibition of IgE- and non-IgE—mediated histamine release from human basophil leukocytes in vitro by a histamine H1-antagonist, desethoxycarbonyl-loratadine.
        J Allergy Clin Immunol. 1994; 93: 494-500
        • Marone G
        • Patella V
        • Casolaro V
        • et al.
        Inhibition of mediator release from human mast cells by loratadine.
        J Allergy Clin Immunol. 1994; 93 (Abstract): 258
        • Miadonna A
        • Milazzo N
        • Lorini M
        • et al.
        Inhibitory effect of the H1 antagonist loratadine on histamine release from human basophils.
        Int Arch Allergy Immunol. 1994; 105: 12-17
        • Ramachers U
        • Amon U
        • Wolff HH
        Direct effects of second-generation H1-receptor antagonists on the activation of human basophils.
        Agents Actions. 1994; 41: C45-C46
        • Vignola AM
        • Crampette L
        • Mondain M
        • et al.
        Inhibitory activity of loratadine and descarboethoxyloratadine on expression of ICAM-1 and HLA-DR by nasal epithelial cells.
        Allergy. 1995; 50: 200-203
        • Molet S
        • Gossett P
        • Czarlewski W
        • et al.
        Inhibition by loratadine of histamine-induced activation of human endothelial cells.
        Am J Respir Crit Care Med. 1995; 151 (Abstract): A380
        • Czarlewski W
        • Chanal I
        • Michel FB
        • et al.
        Evaluation of loratadine on conjunctival provocation test with orchard grass pollen extracts.
        J Allergy Clin Immunol. 1993; 91 (Abstract): 197
        • Staquet MJ
        • Reano A
        • Schmitt D
        • et al.
        Loratadine downregulates ICAM-1 induced expression on normal human epidermal cells.
        J Allergy Clin Immunol. 1995; (Abstract): 299
        • Lippert U
        • Kruger-Krasagakes S
        • Moller A
        • et al.
        Loratadine and dexamethasone potently suppress secretion of IL-6 and IL-8 by human mast cells and basophilic cells.
        Proc XV Int Congress Allergol Clin Immunol. 1994; (Abstract): 22
        • Amsellem C
        • Czarlewski W
        • Lagarde M
        • et al.
        Effect of loratadine on leukotriene B4 level in stimulated blood neutrophils from healthy and allergic subjects.
        Allergy. 1995; 26 (Abstract): 77
        • Bayram H
        • Khair OA
        • Devalia JL
        • et al.
        Loratadine attenuates nitrogen dioxide (NO2)-induced release of inflammatory mediators from cultured human bronchial epithelial cells.
        J Allergy Clin Immunol. 1997; 99 (Abstract): S166
        • Dirksen A
        • Engel T
        • Frolund L
        • et al.
        Effect of a non-sedative antihistaminic (loratadine) in moderate asthma.
        Allergy. 1989; 44: 566-571
        • Labrecque M
        • Ghezzo H
        • L'Archeveque J
        • et al.
        Duration of the effect of loratadine and terfenadine administered once a day for one week on cutaneous and inhaled reactivity to histamine.
        Chest. 1993; 103: 777-781
        • Youssef HH
        • Ali NA
        • Farouk AK
        • et al.
        The effects of loratadine in patients with allergic bronchial asthma.
        JAMA Middle East. 1996; 6: 37-42
        • Wessel F
        • Marazzi P
        • Soto-Roman L
        • et al.
        The effect of nonsedating antihistamines loratadine and terfenadine on seasonal allergic rhinitis in patients with controlled bronchial asthma.
        Adv Ther. 1997; 14: 199-209
        • Perrin-Fayolle M
        • Kroll VM
        • Raptopoulou M
        • et al.
        A double-blind study of loratadine and ketotifen in the treatment of patients with seasonal asthma.
        Today's Ther Trends. 1997; 15: 27-40
        • Menardo JL
        • Clavel R
        • Couturier P
        • et al.
        Evaluation of prophylactic treatment with loratadine versus sodium cromoglycate in allergic children with mild to moderate bronchial asthma.
        Allergy. 1993; 48 (Abstract): 31
        • Corren J
        • Aaronson D
        • Beaucher W
        • et al.
        A double blind placebo controlled study of Claritin-D in patients with seasonal allergic rhinitis (SAR) and asthma.
        Ann Allergy Asthma Immunol. 1997; 78 (Abstract): 95
        • Ciprandi G
        • Buscaglia S
        • Catrullo A
        • et al.
        Loratadine in the treatment of cough associated with allergic rhinoconjunctivitis.
        Ann Allergy Asthma Immunol. 1995; 75: 115-120
        • Matthys H
        • Heilbrunner J
        New antihistamines for bronchial asthma: Results from one pilot study with loratadine.
        Allergologie. 1991; 14 (In German): 63-87
        • Rafferty P
        • Holgate ST
        The inhibitory effect of azelastine hydrochloride on histamine- and allergen-induced bronchoconstriction in atopic asthma.
        Clin Exp Allergy. 1989; 19: 315-320
        • Brik A
        • Tashkin DP
        • Gong Jr, H
        • et al.
        Effect of cetirizine, a new histamine H1 antagonist, on airway dynamics and responsiveness to inhaled histamine in mild asthma.
        J Allergy Clin Immunol. 1987; 80: 51-56
        • Haria M
        • Fitton A
        • Peters DH
        Loratadine: A reappraisal of its pharmacological properties and therapeutic use in allergic disorders.
        Drugs. 1994; 48: 617-637
        • Bousquet J
        • Godard P
        • Michel FB
        Antihistamines in the treatment of asthma.
        Eur Respir J. 1992; 5: 1137-1142