JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2017, Vol. 31 ›› Issue (3): 4-8.doi: 10.6040/j.issn.1673-3770.0.2017.138

Previous Articles     Next Articles

Pharmacotherapeutic strategies for allergic rhinitis:Ithe importance of individualization and normalization.

XU Yu，  TAO Zezhang   

  1. Department of Otolaryngology Head and Neck Surgery, RenminHospital of Wuhan University, Wuhan 430060, Hubei, China
  • Received:2017-03-31 Online:2017-06-16 Published:2017-06-16

PDF (PC)

1328

Abstract: The prevalence of allergic rhinitis has increased in recently years. Pharmacotherapy is the main method to control the symptoms for the treatment of allergic rhinitis. A wide array of medical treatment options is available. Each drug has a different effect and speciality. Algorithms for management of allergic rhinitis AR and selection of drug should be based on each patients specific symptoms, and the presence of any comorbidities. Patient should be monitored to assess symptom control, therapy adjustment(step up/step down)is also needed.

Key words: Individualization, Allergic rhinitis, Pharmacotherapy

CLC Number: 

  • R765.21
[1] Wang XD, Zheng M, Lou HF, et al. An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011[J]. Allergy, 2016, 71(8):1170-1180.
[2] Juniper EF, Guyatt GH, O'Byrne PM, et al. Aqueous beclomethasonediproprionate nasal spray: regular versus “as required” use in the treatment of seasonal allergic rhinitis[J]. J Allergy Clin Immunol, 1990, 86(3):380-386.
[3] Juniper EF, Guyatt GH, Archer B, et al. Aqueous beclomethasonedipropionate in the treatment of ragweed pollen-induced rhinitis: further exploration of “as needed” use[J]. J Allergy Clin Immunol, 1993, 92(1 Pt 1):66-67.
[4] Dykewicz MS, Kaiser HB, Nathan RA, et al. Fluticasone propionate aqueous nasal spray improves nasal symptoms of seasonal allergic rhinitis when used as needed(prn)[J]. Ann Allergy Asthma Immunol, 2003, 91(1):44-48.
[5] Weiner JM, Abramson MJ, Puy RM. Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials[J]. BMJ, 1998, 317(7173):1624-1629.
[6] Yá(~overn)ez A, Rodrigo GJ. Intranasal corticosteroids versus topical H1 receptor antagonists for the treatment of allergic rhinitis: a systematic review with meta-analysis[J]. Ann Allergy Asthma Immunol, 2002, 89(5):479-484.
[7] Benninger M, Farrar JR, Blaiss M, et al. Evaluating approved medications to treat allergic rhinitis in the United States: an evidence-based review of efficacy for nasal symptoms by class[J]. Ann Allergy Asthma Immunol, 2010, 104(1):13-29.
[8] Wilson AM, O'Byrne PM, Parameswaran K. Leukotriene receptor antagonists for allergic rhinitis: a systematic review and meta-analysis[J]. Am J Med, 2004, 116(5):338-344.
[9] Bielory L, Chun Y, Bielory BP, et al. Impact of mometasonefuroate nasal spray on individual ocular symptoms of allergic rhinitis: a meta-analysis[J]. Allergy, 2011, 66(5):686-693.
[10] Lohia S, Schlosser RJ, Soler ZM. Impact of intranasal corticosteroids on asthmaoutcomes in allergic rhinitis: a meta-analysis[J]. Allergy, 2013, 68(5):569-579.
[11] Ratner PH, Meltzer EO, Teper A. Mometasonefuroate nasal spray is safe and effective for 1-year treatment of children with perennial allergic rhinitis[J]. Int J Pediatr Otorhinolaryngol, 2009, 73(5):651-657.
[12] Allen DB, Meltzer EO, Jr LR, et al. No growth suppression in children treated with the maximum recommended dose of fluticasone propionate aqueous nasal spray for one year[J]. Allergy Asthma Proc, 2002, 23(6):407-413.
[13] Schenkel EJ, Skoner DP, Bronsky EA, et al. Absence of growth retardation in children with perennial allergic rhinitis after one year of treatment with mometasonefuroate aqueous nasal spray[J]. Pediatrics, 2000, 105(2):E22.
[14] Karaki M, Akiyama K, Mori N. Efficacy of intranasal steroid spray(mometasonefuroate)on treatment of patients with seasonal allergic rhinitis: comparison with oral corticosteroids[J]. Auris Nasus Larynx, 2013, 40(3):277-281.
[15] Simons FE. Advances in H1-antihistamines[J]. New Eng J Med, 2004, 351(21):2203-2217.
[16] Dizdar EA, Sekerel BE, Keskin O, et al. The effect of regular versus on-demand desloratadine treatment in children with allergic rhinitis[J]. Int J Pediatr Otorhinolaryngol, 2007, 71(6):843-849.
[17] Laekeman G, Simoens S, Buffels J, et al. Continuous versus on-demand pharmacotherapy of allergic rhinitis: evidence and practice[J]. Respir Med, 2010, 4(5):615-625.
[18] Seidman MD, Gurgel RK, Lin SY, et al. Clinical practice guideline: allergic rhinitis[J]. Otolaryngol Head Neck Surg, 2015, 152(Suppl 1):S1-S43.
[19] Horak F, Zieglmayer UP, Zieglmayer R, et al. Azelastine nasal spray and desloratadine tablets in pollen-induced seasonal allergic rhinitis: a pharmacodynamic study of onset of action and efficacy[J]. Curr Med Res Opin, 2006, 22(1):151-157.
[20] Kaliner MA, Berger WE, Ratner PH, et al. The efficacy of intranasal antihistamines in the treatment of allergic rhinitis[J]. Allergy Asthma Immunol, 2011, 106(Suppl 2):S6-S11.
[21] Laforce CF, Corren J, Wheeler WJ, et al. Efficacy of azelastine nasal spray in seasonal allergic rhinitis patients who remain symptomatic after treatment with fexofenadine[J]. Ann Allergy Asthma Immunol, 2004, 93(2):154-159.
[22] Kaliner MA. Azelastine and olopatadine in the treatment of allergic rhinitis[J]. Ann Allergy Asthma Immunol, 2009, 103(5):373-380.
[23] Carr WW, Ratner P, Munzel U, et al. Comparison of intranasal azelastine to intranasal fluticasone propionate for symptom control in moderate-to-severe seasonal allergic rhinitis[J]. Allergy Asthma Proc, 2012, 33(6):450-458.
[24] Nayak A, Langdon RB. Montelukast in the treatment of allergic rhinitis: an evidence-based review[J]. Drugs, 2007, 67(6):887-901.
[25] Van AJ, Philip G, Pedinoff AJ, et al. Montelukast improves symptoms of seasonal allergic rhinitis over a 4-week treatment period[J]. Allergy, 2003, 58(58):1268-1276.
[26] Bisgaard H, Skoner D, Boza ML, et al. Safety and tolerability of montelukast in placebo-controlled pediatric studies and their open-label extensions[J]. Pediatr Pulmonol, 2009, 44(6):568-579.
[27] Mösges R, Klimek L. Todays allergic rhinitis patients are different: new factors that may play a role[J]. Allergy, 2007, 62(9):969-975.
[28] Anolik R. Clinical benefits of combination treatment with mometasonefuroate nasal spray and loratadinevsmonotherapy with mometasonefuroate in the treatment of seasonal allergic rhinitis[J]. Ann Allergy Asthma Immunol, 2008, 100(3):264-271.
[29] Can D, Tanaç R, Demir E, et al. Is the usage of intranasal glucocorticosteroids alone in allergic rhinitis sufficient?[J]. Allergy Asthma Proc, 2006, 27(3):248-253.
[30] Nasser M, Fedorowicz Z, Aljufairi H, et al. Antihistamines used in addition to topical nasal steroids for intermittent and persistent allergic rhinitis in children[J]. Cochrane Database Syst Rev, 2010, 7(7):CD006989.
[31] Hilberg O. Effect of terfenadine and budesonide on nasal symptoms, olfaction, and nasal airway patency following allergen challenge[J]. Allergy, 1995, 50(8):683-688.
[32] Ratner PH, Hampel F, Bavel JV, et al. Combination therapy with azelastine hydrochloride nasal spray and fluticasone propionate nasal spray in the treatment of patients with seasonal allergic rhinitis[J]. Ann Allergy Asthma Immunol, 2008, 100(1):74-81.
[33] Hampel FC, Ratner PH, Van BJ, et al. Double-blind, placebo-controlled study of azelastine and fluticasone in a single nasal spray delivery device[J]. Ann Allergy Asthma Immunol, 2010, 105(2):168-173.
[34] Laforce CF, Carr W, Tilles SA, et al. Evaluation of olopatadine hydrochloride nasal spray, 0.6%, used in combination with an intranasal corticosteroid in seasonal allergic rhinitis[J]. Allergy Asthma Proc, 2010, 31(2):132-140.
[35] Carr W, Bernstein J, Lieberman P, et al. A novel intranasal therapy of azelastine with fluticasone for the treatment of allergic rhinitis[J]. J Allergy Clin Immunol, 2012, 129(129):1282-1289.e10.
[36] Rael EL, Ramey J, Lockey RF. Oxymetazoline hydrochloride combined with mometasone nasal spray for persistent nasal congestion(pilot study)[J]. World Allergy Organ J, 2011, 4(3):65-67.
[37] Meltzer EO, Bernstein DI, Prenner BM, et al. Mometasonefuroate nasal spray plus oxymetazoline nasal spray: short-term efficacy and safety in seasonal allergic rhinitis[J]. Am J Rhinol Allergy, 2013, 27(2):102-108.
[38] Cingi C, Gunhan K, Gage-White L, et al. Efficacy of leukotriene antagonists as concomitant therapy in allergic rhinitis[J]. Laryngoscope, 2010, 120(9):1718-1723.
[39] Rodrigo GJ, Ya(~overn)ez A. The role of antileukotriene therapy in seasonal allergic rhinitis: a systematic review of randomized trials[J]. Ann Allergy Asthma Immunol, 2006, 96(6):779-786.
[40] Lu S, Malice MP, Dass SB, et al. Clinical studies of combination montelukast and loratadine in patients with seasonal allergic rhinitis.[J]. J Asthma, 2009, 46(9):878-883.
[41] Nayak AS, Philip G, Lu S, et al. Efficacy and tolerability of montelukast alone or in combination with loratadine in seasonal allergic rhinitis: a multicenter, randomized, double-blind, placebo-controlled trial performed in the fall[J]. Ann Allergy Asthma Immunol, 2002, 88(6):592-600.
[42] Esteitie R, Detineo M, Naclerio RM, et al. Effect of the addition of montelukast to fluticasone propionate for the treatment of perennial allergic rhinitis[J]. Ann Allergy Asthma Immunol, 2010, 105(2):155-161.
[43] Goh BS, Ismail MI, Husain S. Quality of life assessment in patients with moderate to severe allergic rhinitis treated with montelukast and/or intranasal steroids: a randomised, double-blind, placebo-controlled study[J]. J Laryngol Otol, 2014, 128(3):242-248.
[44] 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 变应性鼻炎诊断和治疗指南(2015年,天津)[J]. 中华耳鼻咽喉头颈外科杂志, 2016, 51(1):6-24. Subspecialty Group of Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery; Subspecialty Group of Rhinology, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association. Chinese guidelines for diagnosis and treatment of allergic rhinitis[J]. Chin J Otorhinolaryngol Head Neck Surg, 2016, 51(1):6-24.
[45] Meltzer EO. Pharmacotherapeutic strategies for allergic rhinitis: matching treatment to symptoms, disease progression, and associated conditions.[J]. Allergy Asthma Proceed, 2013, 34(4):301-311.
[46] Bousquet J, Khaltaev N, Cruz AA, et al. Allergic rhinitis and its impact on asthma(ARIA)2008 update(in collaboration with the World Health Organization, GA(2)LEN and AllerGen)[J]. Allergy, 2008, 63(Suppl 86):8-160.
[1] LYU Qian, TANG Yuan, GU Zijun, SHI Sailei, LIU Ping, WAN Wenjin. Current status of benefit finding among patients with allergic rhinitis and its influence factors [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 21-28.
[2] GU Min, LU Meiping. Advances in the application of nanomedicine delivery systems in allergen immunotherapy for allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 106-111.
[3] QIN Nana, LI Yufen, SUN Yuhao, WEI Jian, LI Qin. Effect of interleukin-13 receptor-α2 on nasal mucosal remodeling in rats with allergic rhinitis by TGF-β1/Smad signaling pathway [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 71-77.
[4] DU Kangli, ZHENG Zhenyu, XU Zhanjiang, ZHANG Yu, CHEN Lu, LU Mengyao. Construction and validation of risk prediction model for nasal septal deviation complicated with chronic sinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 78-86.
[5] XIONG Qin, ZHANG Yan, WU Rina, LI Feng, TANG Lixing. Application of intranasal corticosteroids in pediatrics [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 160-167.
[6] XU Xuemeng, FAN Lei, YU Wangbo, JIANG Zhiyue, PAN Chen, HUANG Yongqin. Meta-analysis of the efficacy of omalizumab in combination with specific immunotherapy for allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 26-33.
[7] HUANG Huan, HUA Hongli, DENG Yuqin, JIANG Chengyang, WANG Yuwei, YANG Xinghai. Correlation of allergic rhinitis, tonsil adenoid hypertrophy, and sinusitis in children and analysis of its clinical guiding value [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 34-41.
[8] LIU Yijun, GU Yue, GUAN Dayu, YANG Yucheng, SHEN Yang. The long-term clinical efficacy and safety of vidian neurectomy in refractory allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 42-48.
[9] ZHANG Ting, WANG Meilan, GAO Yingqin. Research progress of IL-35 in allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 139-147.
[10] ZHANG Zhuping, PENG Zican, XIAO Zhenlong, LI Cheng, YU Di, WANG Xinglong, CHEN Wei, Guo Bei. The value of a novel nasal secretion eosinophil cationic protein-myeloperoxidase test paper assay in allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 129-134.
[11] LIU Chang, YANG Jingpu, GAO Yu, WANG Wenjia. Analysis of allergen detection results in children with allergic rhinitis in the Changchun area [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 51-58.
[12] ZHOU Heqing, SHEN Qi. Research progress on biomarkers of traditional Chinese medicine in the treatment of allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 168-176.
[13] WANG Manxian, ZHENG Quan, YANG Liang. Research progress in the treatment of allergic rhinitis with bacterial lysates [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 141-145.
[14] LIU Chang, FANG Hongyan, LIU Xiao, FU Dongna, WANG He, WANG Jing, YANG Jingpu. Analysis of sensitization characteristics of Artemisia pollen in autumn allergic rhinitis in the Changchun area of China [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(5): 13-19.
[15] ZHANG Jie, CHEN Min, SHEN Zhengzheng, WU Yuhua, LIU Yuanhu, SUN Hao, TAN Xinhua, NI Shuren, YANG Shuxun, SHI Xuezheng, NI Xin. Study on the correlation between allergic rhinitis and coronavirus disease-2019 infection and symptoms in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(4): 36-42.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd