Allergic rhinitis - effective treatment according to the latest recommendations

Otolaryngol Pol. 2022 Dec 15;76(6):45-59. doi: 10.5604/01.3001.0016.1488.

Abstract

Allergic rhinitis (AR) is a common chronic respiratory disease, that affects millions of individuals, has significant impact on their quality of life, productivity, and other existing conditions, including asthma and conjunctivitis. Despite a substantial burden on individuals, society and health economies, AR remains under-diagnosed, under-estimated and under-treated. Main symptoms defining this IgE-dependent inflammation of nasal mucosa are: sneezing, itchy nose, rhinorrhoea and nasal congestion. Real-world data obtained by mobile technology offer new insights into AR phenotypes and therapy. Clinical management aims to relieve or control symptoms, resolve allergic inflammation, and potentially induce allergen tolerance, using allergen immunotherapy. Most cases of AR respond rather satisfied to pharmacotherapy. A very useful tool, especially recommended for everyday clinical practice, is VAS (visual analogue scale) which can help with: to assessing the intensity of AR symptoms as well as choosing the most optimal therapeutic option. Pharmacological treatment of the condition should be safe; effective and easy to administer as we treat patients with chronic condition, sometimes for a long time. Most frequently used treatment of AR include oral, intranasal or ocular antihistamines, intranasal corticosteroids or combined intranasal antihistamines and corticosteroids. Based on real-life clinical experience it can be concluded that a fixed combination of intranasal corticosteroid and intranasal antihistamines (mainly MP-AzeFlu) may be considered to be most beneficial, particularly in monotherapy and AR resistant to previous treatment. Some AR patients are not satisfied with provided treatment results when the disease becomes only partially controlled. We still have unmet patients needs and we are still looking for better therapeutic options in this area. New initiatives such as EUFOREA are developed in parallel with existing ones, such as ARIA to integrate patients and healthcare professionals in the therapeutic process and create new recommendations that are closest to the idea of precision medicine, delivering the right treatment to the right patient at the right time.

Keywords: ARIA; EUFOREA; MP-AzeFlu; allergic rhinitis; azelastine; intranasal corticosteroids; precision medicine; treatment.

MeSH terms

  • Humans
  • Inflammation
  • Nasal Mucosa
  • Quality of Life*
  • Rhinitis, Allergic* / drug therapy
  • Treatment Outcome