REVIEW PAPER
ALLERGIC RHINITIS TREATMENT: OVERVIEW OF THE LATEST GUIDELINES
 
More details
Hide details
1
Military Medical Academy Memorial Teaching Hospital of the Medical University of Lodz, Central Veteran Hospital, Lodz, Poland
 
2
Karol Jonscher Municipal Medical Center, Lodz, Poland
 
3
Mikolaj Pirogow Provincial Specialist Hospital, Lodz, Poland
 
4
S. Zeromski Specialist Hospital in Cracow, Poland
 
5
Faculty of Medicine, Medical College, Jagiellonian University, Cracow, Poland
 
6
Maria Skłodowska-Curie Specialist Hospital in Brzeziny, Poland
 
7
Nicolaus Copernicus Specialist Hospital, Lodz, Poland
 
 
Submission date: 2024-06-19
 
 
Final revision date: 2024-08-11
 
 
Acceptance date: 2024-08-21
 
 
Publication date: 2024-09-05
 
 
 
KEYWORDS
TOPICS
ABSTRACT
Allergic rhinitis (AR) is a prevalent atopic disease in Poland, affecting approximately 25% of the adult population. It is characterized by chronic inflammation induced by IgE-dependent reactions to environmental allergens, leading to symptoms such as nasal congestion, sneezing, itching, and ocular manifestations. AR can be categorized as intermittent or persistent based on symptom duration and frequency. Common allergens include dust mites, pollen, animal secretions, and occupational agents. AR often coexists with asthma, necessitating accurate diagnosis and treatment to prevent bronchial complications. Diagnosis of AR relies on clinical symptoms and diagnostic tests such as skin prick testing and immunological assays. Skin prick testing is particularly useful in identifying IgE-mediated processes and guiding allergen avoidance and treatment decisions. Pharmacotherapy options include oral antihistamines and intranasal corticosteroids, with combination therapies showing promising results. Immunotherapy, in the form of subcutaneous or sublingual administration, aims to induce immunological tolerance and alleviate symptoms. In conclusion, effective management of AR involves a multifaceted approach, including allergen avoidance, pharmacotherapy, and immunotherapy. Early intervention and personalized treatment strategies are crucial for improving patient outcomes and quality of life.
REFERENCES (35)
1.
Samoliński B, Raciborski F, Lipiec A, Tomaszewska A, Krzych-Fałta E, Samel-Kowalik P, et al. [Epidemiology of allergic diseases in Poland]. Alergol Pol. 2014; 1: 10-8 (in Polish). https://doi.org/10.1016/j.aler....
 
2.
Akhouri S, House SA, Doerr C. Allergic rhinitis (nursing). Treasure Island (FL): StatPearls Publishing; 2023 Jan.
 
3.
Bousquet J, Schünemann HJ, Togias A, Bachert C, Erhola M, Hellings PW, et al. Allergic rhinitis and its impact on Asthma Working Group. Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2022; 149(6): 2180. https://doi.org/10.1016/j.jaci....
 
4.
Bousquet J, Annesi-Maesano I, Carat F, Léger D, Rugina M, Pribil C, et al. Characteristics of intermittent and persistent allergic rhinitis: DREAMS study group. Clin Exp Allergy. 2005; 35: 728-32. https://doi.org/10.1111/j.1365....
 
5.
Scadding GK, Durham SR, Mirakian R, Mirakian R, Buckley RJ, Dixon T, et al. BSACI guidelines for the management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2008; 38(1): 19-42. https://doi.org/10.1111/j.1365....
 
6.
Linneberg A, Dam Petersen K, Hahn-Pedersen J, Hammerby E, Serup-Hansen N, Boxall N. Burden of allergic respiratory disease: a systematic review. Clin Mol Allergy. 2016; 14: 12. https://doi.org/10.1186/s12948....
 
7.
Yum HY, Ha EK, Shin YH, Han MY. Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis. Clin Exp Pediatr. 2021; 64(8): 373-83. https://doi.org/10.3345/cep.20....
 
8.
Seidman MD, Gurgel RK, Lin SY, Schwartz SR , Baroody FM, Bonner JR, et al. AAO- Clinical practice guideline: allergic rhinitis. Otolaryngol Head Neck Surg. 2015; 152(S1): S1-S43. https://doi.org/10.1177/019459....
 
9.
Antunes J, Borrego L, Romeira A, Pinto P. Skin prick tests and allergy diagnosis. Allergol Immunopathol (Madr). 2009; 37(3): 155-64. https://doi.org/10.1016/S0301-....
 
10.
Wise SK, Damask C, Roland LT, Ebert C, Levy JM, Lin S, et al. International consensus statement on allergy and rhinology: allergic rhinitis – 2023. Int Forum Allergy Rhinol. 2023; 13: 293-859. https://doi.org/10.1002/alr.23....
 
11.
Cho SH, Nanda A, Keswani A, Adinoff A, Baroody FM, Bernstein JA, et al. Nasal allergen challenge (NAC): Practical aspects and applications from an EU/US perspective—a Work Group Report of the AAAAI Rhinitis, Rhinosinusitis and Ocular Allergy Committee. J Allergy Clin Immunol. 2023; 151(5): 1215-1222.e4. https://doi.org/10.1016/j.jaci....
 
12.
Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008; 122(2 Suppl): S1-S84. https://doi.org/10.1016/j.jaci....
 
13.
www.dlapacjentow.pta.med.pl [Internet]. Łódź: Polskie Towarzystwo Alergologiczne; 2023. [Pollen calendar]. [access 2024 Feb]. Available from: https://dlapacjentow.pta.med.p... (in Polish).
 
14.
Ferguson BJ. Environmental controls of allergies. Otolaryngol Clin North Am. 2008; 41(2): 411-7. https://doi.org/10.1016/j.otc.....
 
15.
Nurmatov U, van Schayck CP, Hurwitz B, Sheikh A. House dust mite avoidance measures for perennial allergic rhinitis: an updated Cochrane systematic review. Allergy. 2012; 67(2): 158-65. https://doi.org/10.1111/j.1398....
 
16.
Gøtzsche PC, Johansen HK. House dust mite control measures for asthma: systematic review. Allergy. 2008; 63(6): 646-59. https://doi.org/10.1111/j.1398....
 
17.
Lieberman P. The basics of histamine biology. Ann Allergy Asthma Immunol. 2011; 106(2 Suppl). https://doi.org/10.1016/j.anai....
 
18.
Golightly LK, Greos LS. Second-generation antihistamines: actions and efficacy in the management of allergic disorders. Drugs. 2005; 65(3): 341-84. https://doi.org/10.2165/000034....
 
19.
Fein MN, Fischer DA, O'Keefe AW, Sussman GL. CSACI position statement: newer generation H1-antihistamines are safer than first-generation H1-antihistamines and should be the first-line antihistamines for the treatment of allergic rhinitis and urticaria. Allergy Asthma Clin Immunol. 2019; 15: 61. https://doi.org/10.1186/s13223....
 
20.
Rachelefsky G, Farrar JR. A control model to evaluate pharmacotherapy for allergic rhinitis in children. JAMA Pediatr. 2013; 167(4): 380-6. https://doi.org/10.1001/jamape....
 
21.
Meltzer EO, Munafo DA, Chung W, Gopalan G, Varghese ST. Intranasal mometasone furoate therapy for allergic rhinitis symptoms and rhinitis-disturbed sleep. Ann Allergy Asthma Immunol. 2010; 105(1): 65-74. https://doi.org/10.1016/j.anai....
 
22.
Wise SK, Lin SY, Toskala E. International consensus statement on allergy and rhinology: allergic rhinitis. Int Forum Allergy Rhinol. 2018; 8(2): 108-52. https://doi.org/10.1002/alr.22....
 
23.
Kaliner MA, Storms W, Tilles S, Spector S, Tan R, LaForce C, et al. Comparison of olopatadine 0.6% nasal spray versus fluticasone propionate 50 microg in the treatment of seasonal allergic rhinitis. Allergy Asthma Proc. 2009; 30(3): 255-62. https://doi.org/10.2500/aap.20....
 
24.
Berger W, Hampel Jr F, Bernstein J, Shah S, Sacks H, Meltzer EO. Impact of azelastine nasal spray on symptoms and quality of life compared with cetirizine oral tablets in patients with seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2006; 97(3): 375-81. https://doi.org/10.1016/S1081-....
 
25.
Bousquet J, Arnavielhe S, Bedbrook A, Bewick M, Laune D, Mathieu-Dupas E, et al. MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidence. Clin Transl Allergy. 2018; 8: 45. https://doi.org/10.1186/s13601....
 
26.
Price D, Shah S, Bhatia S, Bachert C, Berger W, Bousquet J, et al. A new therapy (MP29-02) is effective for the long-term treatment of chronic rhinitis. J Investig Allergol Clin Immunol. 2013; 23(7): 495-503.
 
27.
van Weissenbruch R, Klimek L, Gálffy G, Emmeluth M, Koltun A, Kopietz F, et al. MP-AzeFlu improves the quality-of-life of patients with allergic rhinitis. J Asthma Allergy. 2020; 13: 633-45. https://doi.org/10.2147/JAA.S2....
 
28.
Patel P, Salapatek AM, Tantry SK. Effect of olopatadine-mometasone combination nasal spray on seasonal allergic rhinitis symptoms in an environmental exposure chamber study. Ann Allergy Asthma Immunol. 2019; 122(2): 160-6.e1. https://doi.org/10.1016/j.anai....
 
29.
Altounyan RE. Review of clinical activity and mode of action of sodium cromoglycate. Clin Allergy. 1980; 10(S1): 481-489. https://doi.org/10.1111/j.1365....
 
30.
Tandon MK, Strahan EG. Double-blind crossover trial comparing beclomethasone dipropionate and sodium cromoglycate in perennial allergic rhinitis. Clin Allergy. 1980; 10(4): 459-62. https://doi.org/10.1111/j.1365....
 
31.
Mazzotta P, Loebstein R, Koren G. Treating allergic rhinitis in pregnancy. Safety considerations. Drug Saf. 1999; 20(4): 361-75. https://doi.org/10.2165/000020....
 
32.
Garavello W, Somigliana E, Acaia B, Gaini L, Pignataro L, Gaini RM. Nasal lavage in pregnant women with seasonal allergic rhinitis: a randomized study. Int Arch Allergy Immunol. 2010; 151(2): 137-41. https://doi.org/10.1159/000236....
 
33.
Roberts G, Pfaar O, Akdis CA, Ansotegui IJ, Durham SR, Gerth van Wijk R, et al. EAACI Guidelines on allergen immunotherapy: allergic rhinoconjunctivitis. Allergy. 2018; 73(4): 765-98. https://doi.org/10.1111/all.13....
 
34.
Cox L, Nelson H, Lockey R, Calabria C, Chacko T, Finegold I, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol. 2011; 127(1 Suppl): S1-S55. https://doi.org/10.1016/j.jaci....
 
35.
Akdis M, Akdis CA. Mechanisms of allergen-specific immunotherapy: multiple suppressor factors at work in immune tolerance to allergens. J Allergy Clin Immunol. 2014; 133(3): 621-31. https://doi.org/10.1016/j.jaci....
 
eISSN:2354-0265
ISSN:2353-6942
Journals System - logo
Scroll to top