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      A polycentric, randomized, parallel-group, study on Lertal®, a multicomponent nutraceutical, as preventive treatment in children with allergic rhinoconjunctivitis: phase II

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          Abstract

          Background

          Lertal®, an oral nutraceutical, contains extract of Perilla, quercetin, and Vitamin D3. The current polycentric, randomized, parallel-group, controlled study aimed in the Phase II to evaluate the efficacy and safety of Lertal® in preventing allergic rhinitis (AR) exacerbations in children after the end of the pharmacological treatment phase.

          Materials and methods

          One hundred twenty-eight children completed Phase II. Sixty-four children continued Lertal® treatment (Lertal® Group: LG) and 64 ones did not assume any medication (Observation Group: OG) for 4–12 weeks.

          The study endpoints were the number, intensity, and duration of AR exacerbations, and the length of symptom-free time.

          Results

          Children of LG halved the risk (HR = 0.54) of having AR exacerbation. Children of LG had significantly ( p = 0.039) less AR exacerbations than OG children. In children with AR exacerbations, the total number of days in which each patient took at least one rescue medication was significantly ( p = 0.018) lesser in LG children than OG ones. In the global population, the cumulative days treated with rescue medication was significantly ( p < 0.0001) higher in OG than in LG. There was no clinically relevant adverse event.

          Conclusions

          The present study documented that prolonged Lertal® assumption was safe and able to significantly reduce, such as halving, the risk of AR exacerbation, their duration and the use of rescue medications, after the suspension of the one-month antihistamine treatment. Therefore, Lertal® could be envisaged as an effective preventive treatment in AR children able to guarantee long symptom-free time.

          Trial registration

          Clinical trial registration: ClinicalTrials gov ID NCT03365648.

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          Most cited references22

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          Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision.

          Allergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and school and work performance and is a frequent reason for office visits in general practice. Medical costs are large, but avoidable costs associated with lost work productivity are even larger than those incurred by asthma. New evidence has accumulated since the last revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in 2010, prompting its update.
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            Long-term inhaled corticosteroids in preschool children at high risk for asthma.

            It is unknown whether inhaled corticosteroids can modify the subsequent development of asthma in preschool children at high risk for asthma. We randomly assigned 285 participants two or three years of age with a positive asthma predictive index to treatment with fluticasone propionate (at a dose of 88 mug twice daily) or masked placebo for two years, followed by a one-year period without study medication. The primary outcome was the proportion of episode-free days during the observation year. During the observation year, no significant differences were seen between the two groups in the proportion of episode-free days, the number of exacerbations, or lung function. During the treatment period, as compared with placebo use, use of the inhaled corticosteroid was associated with a greater proportion of episode-free days (P=0.006) and a lower rate of exacerbations (P<0.001) and of supplementary use of controller medication (P<0.001). In the inhaled-corticosteroid group, as compared with the placebo group, the mean increase in height was 1.1 cm less at 24 months (P<0.001), but by the end of the trial, the height increase was 0.7 cm less (P=0.008). During treatment, the inhaled corticosteroid reduced symptoms and exacerbations but slowed growth, albeit temporarily and not progressively. In preschool children at high risk for asthma, two years of inhaled-corticosteroid therapy did not change the development of asthma symptoms or lung function during a third, treatment-free year. These findings do not provide support for a subsequent disease-modifying effect of inhaled corticosteroids after the treatment is discontinued. (ClinicalTrials.gov number, NCT00272441.). Copyright 2006 Massachusetts Medical Society.
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              • Article: not found

              International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis.

              Critical examination of the quality and validity of available allergic rhinitis (AR) literature is necessary to improve understanding and to appropriately translate this knowledge to clinical care of the AR patient. To evaluate the existing AR literature, international multidisciplinary experts with an interest in AR have produced the International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR).
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                Author and article information

                Contributors
                gl.marseglia@smatteo.pv.it
                amelialicari@gmail.com
                leonardi@unict.it
                maria.papale@unict.it
                annamaria.zicari@uniroma1.it
                laura.schiavi@unirm1.it
                gio.cip@libero.it
                Journal
                Ital J Pediatr
                Ital J Pediatr
                Italian Journal of Pediatrics
                BioMed Central (London )
                1824-7288
                18 July 2019
                18 July 2019
                2019
                : 45
                : 84
                Affiliations
                [1 ]ISNI 0000 0004 1762 5736, GRID grid.8982.b, Pediatrics Clinic, Pediatrics Department, Policlinico San Matteo, , University of Pavia, ; Pavia, Italy
                [2 ]ISNI 0000 0004 1757 1969, GRID grid.8158.4, Department of Clinical and Experimental Medicine, , University of Catania, ; Catania, Italy
                [3 ]GRID grid.7841.a, Pediatrics Department , Umberto I Hospital, Roma, , Sapienza University, ; Rome, Italy
                [4 ]Allergy Clinic, Casa di Cura Villa Montallegro, Via P. Boselli 5, 16146 Genoa, Italy
                Author information
                http://orcid.org/0000-0001-7016-8421
                Article
                678
                10.1186/s13052-019-0678-y
                6637471
                31319883
                bad563a3-0776-42e5-a58b-35e5b12f545c
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 7 February 2019
                : 12 July 2019
                Categories
                Research
                Custom metadata
                © The Author(s) 2019

                Pediatrics
                allergic rhinoconjunctivitis,nutraceutical,perilla frutescens,quercetin,vitamin d3,preventive treatment,exacerbation

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