To Evaluate Adenosine Monophosphate and Allergen Challenge in Allergic Rhinitis

Allergic Rhinitis Clinical Trial

Official title:

A Placebo Controlled Trial to Evaluate The Effects of Levocetirizine on Nasal Allergen Challenge And Adenosine Monophosphate Challenge In Patients With Intermittent and Persistent Allergic Rhinitis

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00679250
• Other study ID #: GRAY09
• Secondary ID: 2004-000683-27
• Status: Completed
• Phase: Phase 4
• Start date: November 2005
• Est. completion date: December 2006

Study information

• Verified date: April 2019
• Source: University of Dundee
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Allergic rhinitis is a common condition characterize by inflammation of the upper airways. Third generation antihistamines have been demonstrated effective in the treatment of this condition. Allergen challenge can be use to assess the effects of drugs in allergic rhinitis, adenosine monophosphate may also be used as a means to investigate these effects but as yet its effects have yet to be compared to allergen challenge. We intend to compare the effects of levocetirizine at a single dose of 5mg on allergen and AMP challenge compared to placebo in a double blind cross-over study. The study will include 20 patients with allergic rhinitis. Each patient will have allergen and AMP challenge on placebo and active treatment. The primary outcome variable will be the change in concentration of AMP/Allergen required to produce a 20% drop in nasal flow as manifest by peak nasal inspiratory flow. A 1 doubling dose change in concentration of challenge medium to cause a 20% drop in nasal flow will be deemed significant. We will also measure time to recovery after both challenges. AMP challenge is a safe alternative to allergen challenge and does not have the risk of anaphylaxis.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 25
• Est. completion date: December 2006
• Est. primary completion date: December 2006
• Accepts healthy volunteers: No
• Gender: All
• Age group: 16 Years to 75 Years

Eligibility

Inclusion Criteria:

• Male or female 16-75

• Patients with persistent rhinitis must be skin prick positive to house dust mite with perennial symptoms

• Patients with seasonal rhinitis should be skin prick positive to grass/tree pollen with seasonal symptoms

• Concomitant asthma is permitted in those with rhinitis if FEV1 >60%

• No recent exacerbations of asthma or chest infections if asthmatic

• Able to perform all of the techniques necessary to carry out challenge testing

• Must be compliant to study medication

• Must give informed consent

Exclusion Criteria:

• Male or female outwith the above age range

• Negative skin prick testing

• Patients with concomitant asthma with FEV1 less than 60% predicted

• Patients with asthma with recent chest infection or exacerbation

• Pregnant females, those at risk of becoming pregnant or breast feeding. Females must be on adequate contraception for the whole study period

Related Conditions & MeSH terms

• Allergic Rhinitis
• Rhinitis
• Rhinitis, Allergic

Intervention

Drug:
• levocetirizine
5 mg once nightly before visit
• placebo to levocetirizine
1 tablet once nightly before visit

Locations

Country	Name	City	State
United Kingdom	Ninewells Hospital and Medical School (Tayside NHS Trust, University of Dundee)	Dundee	Angus
United Kingdom	Perth Royal Infirmary	Perth	Perthshire

Sponsors (1)

Lead Sponsor	Collaborator
Brian J Lipworth

Country where clinical trial is conducted

United Kingdom, 

References & Publications (8)

Bousquet J, Van Cauwenberge P, Khaltaev N; Aria Workshop Group; World Health Organization. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001 Nov;108(5 Suppl):S147-334. Review. — View Citation

Clough GF, Boutsiouki P, Church MK. Comparison of the effects of levocetirizine and loratadine on histamine-induced wheal, flare, and itch in human skin. Allergy. 2001 Oct;56(10):985-8. — View Citation

Lee DK, Gray RD, Wilson AM, Robb FM, Soutar PC, Lipworth BJ. Single and short-term dosing effects of levocetirizine on adenosine monophosphate bronchoprovocation in atopic asthma. Br J Clin Pharmacol. 2004 Jul;58(1):34-9. — View Citation

Terada N, Hamano N, Kim WJ, Hirai K, Nakajima T, Yamada H, Kawasaki H, Yamashita T, Kishi H, Nomura T, Numata T, Yoshie O, Konno A. The kinetics of allergen-induced eotaxin level in nasal lavage fluid: its key role in eosinophil recruitment in nasal mucosa. Am J Respir Crit Care Med. 2001 Aug 15;164(4):575-9. — View Citation

Togias A. Rhinitis and asthma: evidence for respiratory system integration. J Allergy Clin Immunol. 2003 Jun;111(6):1171-83; quiz 1184. Review. — View Citation

Vaidyanathan S, Nair A, Barnes ML, Meldrum K, Lipworth BJ. Effect of levocetirizine on nasal provocation testing with adenosine monophosphate compared with allergen challenge in allergic rhinitis. Clin Exp Allergy. 2009 Mar;39(3):409-16. doi: 10.1111/j.13 — View Citation

Wang DY, Hanotte F, De Vos C, Clement P. Effect of cetirizine, levocetirizine, and dextrocetirizine on histamine-induced nasal response in healthy adult volunteers. Allergy. 2001 Apr;56(4):339-43. — View Citation

Wilson AM, Sims EJ, Orr LC, Robb F, Lipworth BJ. An evaluation of short-term corticosteroid response in perennial allergic rhinitis using histamine and adenosine monophosphate nasal challenge. Br J Clin Pharmacol. 2003 Apr;55(4):354-9. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Provocative concentration of AMP or Allergen required to cause a 20% drop in Peak Nasal Inspiratory Flow.		1 hour
Secondary	Recovery Time Profile after nasal AMP and Allergen challenge		1 hour