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Effectiveness of Second-Generation Antihistamine for the Treatment of Morning Symptoms Observed in Patients with Perennial Allergic Rhinitis: Comparison Study of Bepotastine Besilate versus Olopatadine Hydrochloride

Terumichi Fujikura, Kimihiro Okubo

Objective: The aim of the present study was to examine circadian rhythm-based treatment strategies with the intension of improving the pharmacotherapy for morning symptoms with perennial allergic rhinitis. We investigated the effects of two second generation antihistamines, with different pharmacokinetic parameters, bepotastine besilate and olopatadine hydrochloride, for the treatment of morning symptoms. Methods: Twenty-four subjects with perennial allergic rhinitis were recruited for this study. They were randomly allocated to either a bepotastine group (n=10) or an olopatadine group (n=14). During the 1-hour period after waking up in the morning, the patients counted and recorded the number of sneezes and nose blowing. PNIF was also measured. The study participants took the allocated medicine twice a day. They continued recording their nasal symptoms and PNIF after awakening for 10 to 14 days. Results: In both group, taking bepotastine and olopatadine, the mean sneezing count and the mean nose blowing count were well suppressed. However, a significant change in the nasal congestion score was not observed throughout the study. Especially in olopatadine group, PNIF increased from day 2 onward and a significant increase was observed for the following 10 days. Conclusion: The worsening of nasal symptoms after awakening that is associated with perennial allergic rhinitis has a significant impact on the quality of life of patients. Two second-generation antihistamines, bepotastine besilate and olopatadine hydrochloride, were effective for the treatment of these morning symptoms. The measurement of Peak Nasal Inspiratory Flow (PNIF) value might lead to a favorable self-evaluation of nasal symptom and treatment effects. Some guidance regarding the taking of medicine from Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation the viewpoint of chronotherapy might improve the satisfaction of patients with the results of pharmacotherapy.