Efficacy and Safety of Diethylcarbamazine in Treatment of Allergic Rhinitis: A Double Blind Randomised Controlled Trial
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ORIGINAL ARTICLE
Efficacy and Safety of Diethylcarbamazine in Treatment of Allergic Rhinitis: A Double Blind Randomised Controlled Trial S. Mohana Karthikeyan1
•
G. N. Nikisha1
Received: 2 October 2020 / Accepted: 24 October 2020 Ó Association of Otolaryngologists of India 2020
Abstract There are many evidences showing diethylcarbamazine as a potential drug for the treatment of allergic rhinitis. This study evaluated the effectiveness of diethylcarbamazine in the treatment of allergic rhinitis and compared it with montelukast and levocetirizine. This parallel double-blind randomized clinical trial was done in allergic rhinitis patients. Seven hundred and twelve participants who met the inclusion criteria and provided informed written consent were randomized and divided into 2 equal groups. Diethylcarbamazine 300 mg/day orally in divided doses was given to group A, and montelukast 10 mg and levocetirizine 5 mg/day orally at night for 21 days was given to group B. Primary outcomes were the change in symptoms, absolute eosinophil count, serum total IgE, phadiatop and response in skin prick from baseline to 21 days and 3 months after treatment. Secondary outcome was to compare it with montelukast and levocetirizine. The mean (SD) age of the patients was 33 (10.6) years, with 374 (52.5%) males and 338 (47.5%) females. There was statistically significant improvement in all the parameters in both groups. Improvement was better with diethylcarbamazine compared to montelukast and levocetirizine and the effects were sustained for 3 months in diethylcarbamazine group. The findings suggest that diethylcarbamazine is effective in the treatment of allergic rhinitis. It
& G. N. Nikisha [email protected] S. Mohana Karthikeyan [email protected] 1
Department of ENT and Head and Neck Surgery, Karpaga Vinayaka Institute of Medical Sciences and Research Center, Chinna Kolambakkam, Madurantagam, Tamil Nadu 603308, India
gives better control and is cost-effective than montelukast and levocetirizine. Trial Registration: https://www.ctri.nic.in Identifier: CTRI/2020/03/024145 registered on 20-03-2020. Keywords Allergic rhinitis Allergens Inhalation allergen challenge Skin prick test Therapeutics
Introduction Allergic rhinitis is one of the most common but underdiagnosed disease of the nasal mucosa worldwide which persists throughout life. It is present in 0.8 and 39.7% of the world population (depending on location). It is characterised by symptoms like sneezing, itching, rhinorrhoea and nasal congestion [1]. It is mediated by early and late hypersensitivity responses and IgE mediated activation of mast cells in the nasal mucosa. This leads to mediator release and acute inflammatory reaction. T helper-2 cells and eosinophils also contribute to the pathology. Interleukin-17 and interleukin-33 also play a role in the inflammatory and immune response to allergen [2–4]. Allergic rhinitis is diagnosed based on history, nasal symptoms, nasal examination, and investigations like skin prick test and serum total and specific Ig
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