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Intranasal antihistamines for allergic rhinitis: Examining the clinical impact

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Allergic rhinitis is likely the most common medical complaint to a clinical allergist and immunologist affecting between 10 and 30% of all adults. This disease causes significant impact on quality of life as well as creating a financial burden on society with decreased work productivity and medication costs. Often, many allergy sufferers do not adhere to the medication recommendations provided by their physician most often because these therapies have not provided relief. Although in the past, the mainstay of treatment for allergic rhinitis has been environmental avoidance, immunotherapy, nasal corticosteroids, and oral antihistamines, the most recent rhinitis diagnosis parameters published by the American Academy of Allergy, Asthma and Immunology have also discussed the importance of other often overlooked therapies. More specifically, the new guidelines discuss a place for the use of intranasal antihistamines as first-line therapy as well as potentially providing superior relief to second-generation oral antihistamines. The guidelines also identify the biphasic nature of the allergic response with both phases consisting of nasal pruritus, sneezing, rhinorrhea, and congestion with the late phase predominated by nasal congestion. It is important to understand how intranasal antihistamines fit into these latest guidelines as first-line therapy and to understand how they may be beneficial to the symptoms associated with allergic rhinitis. It is equally important to identify the individuals who have had less success with their current therapies to determine if intranasal antihistamines would be an important adjunct in therapy.

Keywords: Allergic rhinitis; azelastine; intranasal antihistamines; nasal congestion; nonallergic rhinitis; olopatadine; rhinitis therapies

Document Type: Research Article


Publication date: July 1, 2009

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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