Allergic rhinitis: Difference between revisions
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Among [[alpha adrenergic receptor agonist]]s, [[pseudoephedrine]] may be better than [[phenylephrine]] in the improvement of nasal congestion.<ref name="pmid19230461">{{cite journal |author=Horak F, Zieglmayer P, Zieglmayer R, ''et al'' |title=A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber |journal=Ann. Allergy Asthma Immunol. |volume=102 |issue=2 |pages=116–20 |year=2009 |month=February |pmid=19230461 |doi= |url= |issn=}}</ref> | Among [[alpha adrenergic receptor agonist]]s, [[pseudoephedrine]] may be better than [[phenylephrine]] in the improvement of nasal congestion.<ref name="pmid19230461">{{cite journal |author=Horak F, Zieglmayer P, Zieglmayer R, ''et al'' |title=A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber |journal=Ann. Allergy Asthma Immunol. |volume=102 |issue=2 |pages=116–20 |year=2009 |month=February |pmid=19230461 |doi= |url= |issn=}}</ref> | ||
The most effective treatment is intranasal [[corticosteroid]]s according to | The most effective treatment is intranasal [[corticosteroid]]s according to [[systematic review]]s of [[randomized controlled trial]]s.<ref name="pmid20143641">{{cite journal| author=Benninger M, Farrar JR, Blaiss M, Chipps B, Ferguson B, Krouse J et al.| title=Evaluating approved medications to treat allergic rhinitis in the United States: an evidence-based review of efficacy for nasal symptoms by class. | journal=Ann Allergy Asthma Immunol | year= 2010 | volume= 104 | issue= 1 | pages= 13-29 | pmid=20143641 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=20143641 }} </ref><ref name="pmid9848901">{{cite journal| author=Weiner JM, Abramson MJ, Puy RM| title=Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials. | journal=BMJ | year= 1998 | volume= 317 | issue= 7173 | pages= 1624-9 | pmid=9848901 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=9848901 | pmc=PMC28740 }} </ref> | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=9848901 | pmc=PMC28740 }} </ref> | ||
===Combination treatment=== | ===Combination treatment=== | ||
Regarding adding [[histamine H1 antagonist]]s to intranasal [[corticosteroid]]s: | |||
* [[Azelastine]] nasal spray and [[fluticasone]] nasal spray in combination may be more effective than either used alone according to a [[randomized controlled trial]].<ref name="pmid18254486">{{cite journal |author=Ratner PH, Hampel F, Van Bavel J, ''et al'' |title=Combination therapy with azelastine hydrochloride nasal spray and fluticasone propionate nasal spray in the treatment of patients with seasonal allergic rhinitis |journal=Ann. Allergy Asthma Immunol. |volume=100 |issue=1 |pages=74–81 |year=2008 |pmid=18254486 |doi=10.1016/S1081-1206(10)60408-5 |issn=}}</ref> | * Intranasal [[histamine H1 antagonist]]s may help. [[Azelastine]] nasal spray and [[fluticasone]] nasal spray in combination may be more effective than either used alone according to a [[randomized controlled trial]].<ref name="pmid18254486">{{cite journal |author=Ratner PH, Hampel F, Van Bavel J, ''et al'' |title=Combination therapy with azelastine hydrochloride nasal spray and fluticasone propionate nasal spray in the treatment of patients with seasonal allergic rhinitis |journal=Ann. Allergy Asthma Immunol. |volume=100 |issue=1 |pages=74–81 |year=2008 |pmid=18254486 |doi=10.1016/S1081-1206(10)60408-5 |issn=}}</ref> | ||
* However | * However oral [[histamine H1 antagonist]]s may not help. [[Mometasone]] monotherapy may be as effective as mometasone combined with oral [[loratadine]].<ref name="pmid18426147">{{cite journal| author=Anolik R, Mometasone Furoate Nasal Spray With Loratadine Study Group| title=Clinical benefits of combination treatment with mometasone furoate nasal spray and loratadine vs monotherapy with mometasone furoate in the treatment of seasonal allergic rhinitis. | journal=Ann Allergy Asthma Immunol | year= 2008 | volume= 100 | issue= 3 | pages= 264-71 | pmid=18426147 |doi=10.1016/S1081-1206(10)60452-8 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=18426147 }} </ref> | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=18426147 }} </ref> | ||
Revision as of 12:48, 29 April 2010
Allergic rhinitis, also called seasonal allergic rhinitis is defined as "rhinitis that occurs at the same time every year. It is characterized by acute conjunctivitis with lacrimation and itching, and regarded as an allergic condition triggered by specific allergens."[1]
Cause / etiology
Allergic rhinitis may be associated with bronchial hyperreactivity.[2]
Diagnosis
Treatment
Clinical practice guidelines by written by authors with conflict of interests address the treatment.[3]
Among alpha adrenergic receptor agonists, pseudoephedrine may be better than phenylephrine in the improvement of nasal congestion.[4]
The most effective treatment is intranasal corticosteroids according to systematic reviews of randomized controlled trials.[5][6]
Combination treatment
Regarding adding histamine H1 antagonists to intranasal corticosteroids:
- Intranasal histamine H1 antagonists may help. Azelastine nasal spray and fluticasone nasal spray in combination may be more effective than either used alone according to a randomized controlled trial.[7]
- However oral histamine H1 antagonists may not help. Mometasone monotherapy may be as effective as mometasone combined with oral loratadine.[8]
References
- ↑ National Library of Medicine. Allergic rhinitis. Retrieved on 2007-11-08.
- ↑ Shaaban R, Zureik M, Soussan D, et al (2007). "Allergic rhinitis and onset of bronchial hyperresponsiveness: a population-based study". Am. J. Respir. Crit. Care Med. 176 (7): 659–66. DOI:10.1164/rccm.200703-427OC. PMID 17615387. Research Blogging.
- ↑ Wallace DV, Dykewicz MS, Bernstein DI, et al (August 2008). "The diagnosis and management of rhinitis: an updated practice parameter". J. Allergy Clin. Immunol. 122 (2 Suppl): S1–84. DOI:10.1016/j.jaci.2008.06.003. PMID 18662584. Research Blogging.
- ↑ Horak F, Zieglmayer P, Zieglmayer R, et al (February 2009). "A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber". Ann. Allergy Asthma Immunol. 102 (2): 116–20. PMID 19230461. [e]
- ↑ Benninger M, Farrar JR, Blaiss M, Chipps B, Ferguson B, Krouse J et al. (2010). "Evaluating approved medications to treat allergic rhinitis in the United States: an evidence-based review of efficacy for nasal symptoms by class.". Ann Allergy Asthma Immunol 104 (1): 13-29. PMID 20143641.
- ↑ Weiner JM, Abramson MJ, Puy RM (1998). "Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials.". BMJ 317 (7173): 1624-9. PMID 9848901. PMC PMC28740.
- ↑ Ratner PH, Hampel F, Van Bavel J, et al (2008). "Combination therapy with azelastine hydrochloride nasal spray and fluticasone propionate nasal spray in the treatment of patients with seasonal allergic rhinitis". Ann. Allergy Asthma Immunol. 100 (1): 74–81. DOI:10.1016/S1081-1206(10)60408-5. PMID 18254486. Research Blogging.
- ↑ Anolik R, Mometasone Furoate Nasal Spray With Loratadine Study Group (2008). "Clinical benefits of combination treatment with mometasone furoate nasal spray and loratadine vs monotherapy with mometasone furoate in the treatment of seasonal allergic rhinitis.". Ann Allergy Asthma Immunol 100 (3): 264-71. DOI:10.1016/S1081-1206(10)60452-8. PMID 18426147. Research Blogging.
External links
- Allergic rhinitis - Information for patients from MedlinePlus (United States National Library of Medicine).