Rupatadine and levocetirizine for seasonal allergic rhinitis: a comparative study of efficacy and safety.

OBJECTIVE To determine the better agent among rupatadine fumarate and levocetirizine dihydrochloride for seasonal allergic rhinitis. Although treating and ensuring a decent quality of life to patients is challenging, an increasing understanding of pathomechanisms has revealed the potentiality of new-generation antihistamines in the treatment of seasonal allergic rhinitis. DESIGN A 2-week, single-center, randomized, open, parallel group comparative clinical study between rupatadine and levocetirizine in patients with seasonal allergic rhinitis. SETTING A tertiary care center. PATIENTS Following inclusion and exclusion criteria, 60 patients were assigned to either the rupatadine or levocetirizine group. INTERVENTIONS Two-week treatment with rupatadine or levocetirizine. MAIN OUTCOME MEASURES After 2 weeks, all postdrug symptoms were listed, baseline laboratory investigations (total and differential leukocyte count and IgE level) were repeated, and clinical improvement was assessed in terms of change in Total Nasal Symptom Score, Rhinoconjunctivitis Quality of Life Questionnaire score, and laboratory parameters. RESULTS Differential count (P = .01) and absolute eosinophil count (P = .009) was significantly lowered by both drugs, but rupatadine was found to be superior. In the rupatadine group there was a significantly higher reduction (P = .004) in IgE level and Total Nasal Symptom Score (P < .001) compared with the levocetirizine group. There was a decrease of 18.08% (P = .02) in Rhinoconjunctivitis Quality of Life Questionnaire score in the rupatadine group, which was significantly greater compared with the levocetirizine group. Incidence of adverse effects was less in the rupatadine group compared with the levocetirizine group. CONCLUSION Rupatadine is a better choice for seasonal allergic rhinitis compared with levocetirizine because of its better efficacy and safety profile.