39 Studies with ebastine 10 mg and 20 mg in seasonal and perennial allergic rhinitis 40 , 41 have also demonstrated some congestion relief versus placebo, but the improvement in congestion in patients with perennial allergic rhinitis failed to reach statistical significance with either dose. 40 Mizolastine therapy in patients with perennial allergic rhinitis also reduced congestion score after 4 weeks of treatment, but the improvement over placebo was not statistically significant. 42 Some of the most extensively evaluated second-generation oral H 1 -antihistamines in allergic rhinitis include loratadine, fexofenadine, cetirizine, desloratadine, and levocetirizine.
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51 In adults with persistent allergic rhinitis, therapy with levocetirizine 5 mg once daily was associated with a nonsignificant trend toward greater reduction in nasal congestion versus placebo at weeks 1 or 4, and the reduction achieved statistical significance after 6 months of treatment. 52 Intranasal antihistamines In general, clinical trials with intranasal antihistamines have demonstrated some efficacy against nasal congestion in allergic rhinitis compared with placebo, although no meta-analyses of studies with different agents have been published to date.