Allergic Rhinitis Mechanisms and Treatment (2025)

Treatment strategy of allergic rhinitis in the face of modern world threats

Allergic rhinitis (AR) is the most common form of allergy, which -as epidemiological research has shown -applies to nearly 25% of the population. AR significantly affects the quality of life of the patient, and the more severe the disease, the greater the risk of developing bronchial asthma. One of the factors affecting the severity of symptoms and the degree of their control is air pollution. In some patients, despite proper treatment, persistence or only partial remission of symptoms (uncontrolled allergic rhinitis) is observed. This can lead to an increase in comorbidities -inflammation of the paranasal sinuses, otitis media and asthma -both in children and in adults. The treatment of allergic rhinitis, in accordance with the standards, consists in: education of the patient, elimination of the allergen from the environment and factors intensifying the course of the disease, selection of proper pharmacotherapy and specific allergen immunotherapy. Many factors influence the selection of the antihistamine used, e.g., the opportunity of safe increase of the dosage. Treatment strategy of allergic rhinitis in the face of modern world threats; Otolaryngol Pol 2018; 72 (2): 1-12

Pharmacotherapy of allergic rhinitis: a pharmaco-economic approach

Allergy, 2009

Control of environmental allergens as a therapeutic approach

Immunology and Allergy Clinics of North America, 2003

Guidelines from the National Asthma Education and Prevention Program include avoidance of environmental triggers among the other principles of good asthma treatment [1,2]: use of objective outcome measures of lung function, comprehensive pharmacologic therapy, and patient education. The evidence on which these recommendations are based has been summarized in several reviews [3-6]. The most comprehensive assessment of evidence can be found in an Institute of Medicine report entitled ''Clearing the Air'' that critically assessed experimental evidence supporting the role of environmental control in asthma. The report concluded that the evidence of the effectiveness of avoidance measures of house dust mites in the management of asthma was sufficiently strong and that these measures ''should be part of normal management of asthma in mite-allergic individuals'' [6]. This article summarizes the generally accepted recommendations [3] and the data supporting them. The first rule of environmental allergen control is that avoidance is appropriate for allergic patients with asthma. Although this rule is obvious to allergists, it frequently is not considered by families and physicians who are not trained in allergy. For allergists who present suggestions to such individuals, it should be noted that these measures will not benefit the 10% to 30% of children and 50% of adults with asthma who have no evidence of allergy. The next step in environmental avoidance is to determine the specific sensitivity of a patient-removing a cat does not help a person who is allergic to house dust mite. Most of the methods that are discussed in this article are targeted to a single allergen. Because more than half of allergic asthmatics have multiple sensitivities, it is remarkable that clinical trials have shown that treatment of a single allergen improves symptoms, despite exposure to other allergens. Clinically, practitioners have to address reduction of

Escaping the trap of allergic rhinitis

Clinical and Molecular Allergy, 2015

Rhinitis is often the first symptom of allergy but is frequently ignored and classified as a nuisance condition. Ironically it has the greatest socioeconomic burden worldwide caused by its impact on work and on daily life. However, patients appear reticent to seek professional advice, visiting their doctor only when symptoms become 'intolerable' and often when their usual therapy proves ineffective. Clearly, it's time for new and more effective allergic rhinitis treatments. MP29-02 (Dymista®; Meda, Solna, Sweden) is a new class of medication for moderate to severe seasonal and perennial allergic rhinitis if monotherapy with either intranasal antihistamine or intranasal corticosteroids is not considered sufficient. MP29-02 is a novel formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP). It benefits not only from the incorporation of two active agents, but also from a novel formulation; its lower viscosity, smaller droplet size, larger volume (137 μl) and wider spray angle ensure optimal coverage of, and retention on the nasal mucosa and contribute to its clinical efficacy. In clinical trials, patients treated with MP29-02 experienced twice the symptom relief as those treated with FP and AZE, who in turn exhibited significantly greater symptom relief than placebo-patients. Indeed, the advantage of MP29-02 over FP was approximately the same as that shown for FP over placebo. The advantage of MP29-02 was particularly evident in those patients for whom nasal congestion is predominant, with MP29-02 providing three times the nasal congestion relief of FP (p = 0.0018) and five times the relief of AZE (p = 0.0001). Moreover, patients treated with MP29-02 achieved each and every response up to a week faster than those treated with FP or AZE alone and in real life 1 in 2 patients reported the perception of well-controlled disease after only 3 days. MP29-02's superiority over FP was also apparent long-term in patients with perennial allergic rhinitis or non-allergic rhinitis, with statistical significance noted from the first day of treatment, with treatment difference maintained for a full year. Taken together, these data suggest that MP29-02 may improve the lives of many of our patients, enabling them to finally escape the allergic rhinitis trap.

Allergic Rhinitis and its Impact on Asthma (ARIA): Achievements in 10 years and future needs

Allergic rhinitis management pocket reference 2008

Allergy, 2008

Current controversies and challenges in allergic rhinitis management

Expert review of clinical immunology, 2015

There are many obstacles in the path of effective allergy management, in general, and allergic rhinitis (AR) control, in particular. Chief among them are: insufficient symptom relief in some patients provided by some currently considered first-line AR treatments in real life; an over-reliance on randomized controlled trials to direct AR guideline recommendations; the need for a broader interpretation of the AR evidence base (to include randomized controlled trials and real-life studies); poorly designed and interpreted studies; and lack of an AR control concept and common language of control. These controversies are fully reviewed here and challenging solutions have been presented.

Environmental allergen avoidance: An overview

Journal of Allergy and Clinical Immunology, 2001

Allergic Rhinitis and its Impact on Asthma (ARIA) Guidelines – 2016 Revision

Advances in allergy management

Allergy, 2002

Since the early 1990s, several advances have been made in the biomedical research and medical treatment of allergy. Understanding of the pathophysiology of allergy has moved to the molecular level, enabling the discovery of new treatment targets and new tools to assess drug ef®cacy and safety. The ®elds of epidemiology and genetics have converged to reveal risks of developing disease, based on environmental and genetic pro®les. This may allow the identi®cation of those at risk before the disease is clinically apparent. Pharmacoeconomic studies allow both the costs of illness and the bene®ts of wellness to be measured, thus enabling accurate measurement of the burden of allergic disease.