Comparison of intranasal ciclesonide, oral levocetirizine, and combination treatment for allergic rhinitis

Chang Hoon Kim, Jin Kook Kim, Hyun Jun Kim, Jin Hee Cho, Jung Soo Kim, Yong Dae Kim, Heung Man Lee, Sung Wan Kim, Kyu Sup Cho, Sang Hag Lee, Chae Seo Rhee, Hun Jong Dhong, Ki Sang Rha, Joo Heon Yoon

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Purpose: To evaluate the efficacy and safety of once-daily ciclesonide in comparison to both levocetirizine alone, and a ciclesonide/levocetirizine combination in patients with seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR). Methods: Subjects exhibiting moderate to severe allergic rhinitis for longer than 1 year were randomized in an open-label, 3-arm, parallel group, multicenter study. Subjects received 200 μg ciclesonide, 5 mg levocetirizine, or a combination of both. Changes from baseline until the end-of-study visit (2 weeks following) were evaluated by reflective total nasal symptom scores (rTNSSs), reflective total ocular symptom scores (rTOSSs), physician-assessed overall nasal signs and symptoms severity (PANS), and rhinoconjunctivitis quality-of-life questionnaires (RQLQ). Results: Significant improvements in rTNSS, PANS, and RQLQ in the ciclesonide monotherapy group were observed in comparison to the levocetirizine alone group. Three individual symptoms of rTNSS, including runny nose, nasal itching, and congestion, were improved in the ciclesonide-treated group. rTOSS scores for ciclesonide monotherapy improved from baseline, but no superiority over levocetirizine was shown. The absolute score and changes in rTNSS and PANS were positively correlated. Ciclesonide spray was more effective than levocetirizine in reducing nasal symptoms in both SAR and PAR patients. Ciclesonide and levocetrizine were well tolerated alone and in combination. Conclusions: Our results provide support for an AR and its Impact on Asthma (ARIA) recommendation stipulating that ciclesonide is superior to levocetirizine for the treatment of AR, with tolerable safety. Addition of levocetirizine to ciclesonide did not give further clinical benefit over monotherapy.

Original languageEnglish
Pages (from-to)158-166
Number of pages9
JournalAllergy, Asthma and Immunology Research
Issue number2
Publication statusPublished - 2014

Bibliographical note

Publisher Copyright:
© The Korean Academy of Asthma, Allergy and Clinical Immunology.


  • Allergic rhinitis
  • Ciclesonide
  • Levocetirizine

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine


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