Seasonal allergic rhinitis is very common. Failure to control the disease with mono-therapy leads to dual therapy treatment with less compliance and reduced quality of life. A prostaglandin receptor antagonist (ONO-4053) showed some efficacy in controlling allergic rhinitis in animal models. The authors conducted a double-blinded placebo controlled study including an arm assessing leukotriene receptor antagonist (LTRA) panlukast in adults over a two-week period. Stringent inclusion and exclusion criteria were applied. Outcomes were assessed utilising three questionnaires focusing on symptoms and safety profile.

Two hundred patients were enrolled in the study (39 placebo, 83 panlukast, 78 ONO-4053), the three groups were roughly similar in age, sex, rast score and baseline symptomatic scores. ONO-4053 was found to be more effective than LTRA, which in turn was more effective than placebo in controlling patient symptoms. However, changes from baseline in both panlukast and ONO-4053 did not reach statistical significance.

Interestingly, adverse effects (mild and reversible) were noted in all three groups (15.4% of placebo group, 18.1% in panlukast and 17.9% in ONO-4053). The authors concluded that ONO-4053 has the potential for treating seasonal AR with good safety profile and better effect than panlukast. The findings of this study are interesting even though under-powered as the authors mentioned. Importantly the authors did not assess severity of symptoms using VAS and there was no information about follow-up beyond two weeks.

A randomized controlled phase II clinical trial comparing ONO-4053, a novel DP1 antagonist, with a leukotriene receptor antagonist panlukast in patients with seasonal allergic rhinitis.
Okubo K, Hashiguchi K, Takeda T, et al.
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Hassan Mohammed

Cumberland Infirmary, Carlisle, UK.

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