Updates in the diagnosis and practical management of allergic rhinitis

Expert Rev Clin Pharmacol. 2023 Jul-Dec;16(7):669-676. doi: 10.1080/17512433.2023.2225770. Epub 2023 Jun 16.

Abstract

Introduction: Allergic rhinitis (AR) is a widespread disease that can be associated with other conditions, including conjunctivitis, rhinosinusitis, asthma, food allergy, and atopic dermatitis. Diagnosis is based on the history and documentation of sensitization, such as the production of allergen-specific IgE, preferably using molecular diagnostics. Treatments are based on patient education, non-pharmacological and pharmacological remedies, allergen-specific immunotherapy (AIT), and surgery. Symptomatic treatments mainly concern intranasal/oral antihistamines and/or nasal corticosteroids.

Areas covered: This review discusses current and emerging management strategies for AR, covering pharmacological and non-pharmacological remedies, AIT, and biologics in selected cases with associated severe asthma. However, AIT presently remains the unique causal treatment for AR.

Expert opinion: The management of allergic rhinitis could include new strategies. In this regard, particular interest should be considered in the fixed association between intranasal antihistamines and corticosteroids, probiotics and other natural substances, and new formulations (tablets) of AIT.

Keywords: allergen-specific immunotherapy; allergic rhinitis; biologics; medications; molecular diagnostics; nutraceuticals; patient education; surgery; type 2 inflammation.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Allergens / therapeutic use
  • Asthma* / drug therapy
  • Desensitization, Immunologic
  • Histamine Antagonists / therapeutic use
  • Humans
  • Rhinitis, Allergic* / drug therapy
  • Rhinitis, Allergic* / therapy

Substances

  • Histamine Antagonists
  • Adrenal Cortex Hormones
  • Allergens