Materiały źródłowe

• #1 Treatment of Allergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0615/p1440.html

  Allergic rhinitis is a common chronic respiratory illness that affects quality of life, productivity, and other comorbid conditions, including asthma. Treatment should be based on the patient’s age and severity of symptoms. Patients should be advised to avoid known allergens and be educated about their condition. Intranasal corticosteroids are the most effective treatment and should be first-line therapy for mild to moderate disease. Moderate to severe disease not responsive to intranasal corticosteroids should be treated with second-line therapies, including antihistamines, decongestants, cromolyn, leukotriene receptor antagonists, and nonpharmacologic therapies (e.g., nasal irrigation). […] Optimal treatment includes allergen avoidance, targeted symptom control, immunotherapy, and asthma evaluation, when appropriate.

• #2 Treatment of Allergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/1201/p985.html

  Allergic rhinitis is a common and chronic immunoglobulin Emediated respiratory illness that can affect quality of life and productivity, as well as exacerbate other conditions such as asthma. Treatment should be based on the patient’s age and severity of symptoms. Patients should be educated about their condition and advised to avoid known allergens. Intranasal corticosteroids are the most effective treatment and should be first-line therapy for persistent symptoms affecting quality of life. More severe disease that does not respond to intranasal corticosteroids should be treated with second-line therapies, including antihistamines, decongestants, cromolyn, leukotriene receptor antagonists, and nonpharmacologic therapies such as nasal irrigation. Subcutaneous or sublingual immunotherapy should be considered if usual treatments do not adequately control symptoms and in patients with allergic asthma.

• #2 Treatment of Allergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/1201/p985.html

  Optimal treatment includes allergen avoidance and pharmacotherapy. Targeted symptom control with immunotherapy and asthma evaluation should be considered when appropriate. […] Nasal saline irrigation is beneficial in treating the symptoms of allergic rhinitis and may be used alone or as adjuvant therapy. […] An intranasal corticosteroid alone should be the initial treatment for allergic rhinitis with symptoms affecting quality of life. […] Immunotherapy should be considered for patients with moderate or severe persistent allergic rhinitis that is not responsive to usual treatments, in patients who cannot tolerate standard therapies or want to avoid long-term medication use, and in patients with allergic asthma. […] Intranasal corticosteroids are the mainstay of treatment for allergic rhinitis. They act by decreasing the influx of inflammatory cells and inhibiting the release of cytokines, thereby reducing inflammation of the nasal mucosa.

• #3 Patient education: Allergic rhinitis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/allergic-rhinitis-beyond-the-basics/print

  Allergic rhinitis treatment includes reducing exposure to allergens and other triggers in combination with medication therapy. In most people, this combined approach can effectively control symptoms. […] Several different classes of drugs can treat the inflammation that causes symptoms of allergic rhinitis. […] Corticosteroid nasal sprays are the first-line treatment for the symptoms of allergic rhinitis. These drugs have few side effects and dramatically relieve symptoms in most people. […] Antihistamines relieve the itching, sneezing, and runny nose of allergic rhinitis, but they do not relieve nasal congestion. […] Nasal antihistamine sprays can be used daily or when needed to relieve symptoms of postnasal drip, congestion, and sneezing. […] Immunotherapy involves trying to alter the way a person’s immune system reacts to allergens.

• #3 Treatment of Allergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/1201/p985.html

  Many studies have demonstrated that intranasal corticosteroids are more effective than oral and intranasal antihistamines in the treatment of persistent or more severe allergic rhinitis. […] The most common adverse effects of intranasal corticosteroids are throat irritation, epistaxis, stinging, burning, and nasal dryness. […] The leukotriene D4 receptor antagonist montelukast (Singulair) is comparable to oral antihistamines but is less effective than intranasal corticosteroids. […] Immunotherapy should be considered for moderate or severe persistent allergic rhinitis that is not responsive to usual treatments, in patients who cannot tolerate standard therapies or who want to avoid long-term medication use, and in patients with allergic asthma.

• #4 Allergic Rhinitis: Assisting Patients in Achieving Optimal Outcomes

  https://www.uspharmacist.com/article/allergic-rhinitis-assisting-patients-in-achieving-optimal-outcomes

  The goals of therapy include symptom relief, minimizing sleep disturbances, improving work and school performances, and improving quality of life. One of the most important strategies is the prevention or avoidance of environmental triggers, although this is not always practical and is often difficult to achieve.5,15,17 A successful treatment plan will incorporate both nonpharmacologic strategies and pharmacologic therapy for the management and prevention of AR symptoms. There are many self-care options available to help with AR symptom relief. OTC medications include intranasal corticosteroids, antihistamines, decongestants, and mast-cell stabilizers. […] Intranasal corticosteroids are the most potent and effective medications for the treatment of AR. They are potent anti-inflammatory agents that are effective for relieving all symptoms of AR, including sneezing, rhinorrhea, nasal congestion, nasal itching, and ocular symptoms.5 This relief has been seen with both continuous and as-needed use; however, as-needed use may not be as effective as continuous use.5,15 It is important to educate patients about the onset of action of these agents; the onset of action after the first dose ranges anywhere from 3 to 36 hours, but it may take up to 1 week for patients to experience full relief.5 By improving symptoms, these agents significantly improve the quality of life of patients with AR.5

• #5 Patient education: Allergic rhinitis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/allergic-rhinitis-beyond-the-basics

  Antihistamines — Antihistamines relieve the itching, sneezing, and runny nose of allergic rhinitis, but they do not relieve nasal congestion. Using them along with nasal steroids or decongestants may provide greater symptom relief than using one of these medications alone. […] […] Combination corticosteroid/antihistamine spray — A prescription combination of the nasal steroid fluticasone and the nasal antihistamine azelastine appears to improve symptoms of allergic rhinitis better than either drug alone in three clinical trials. […] […] Decongestants — The decongestant pseudoephedrine is available in combination with antihistamines in some oral, over-the-counter allergy medications. […] […] Cromolyn — Cromolyn prevents the symptoms of allergic rhinitis by interfering with the ability of allergy cells to release natural chemicals that cause inflammation. […]

• #5 Patient education: Allergic rhinitis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/allergic-rhinitis-beyond-the-basics

  Nasal irrigation and saline sprays — Rinsing the nose with a saline (salt water) solution is called „nasal irrigation” or „nasal lavage.” […] […] Allergen immunotherapy — Immunotherapy involves trying to alter the way a person’s immune system reacts to allergens. […] […] Allergy shots — Allergy shots, also known as „allergen immunotherapy,” are only available for common allergens, including pollens, cat and dog dander, dust mites, and molds. […] […] Immunotherapy pills placed under the tongue — „Sublingual immunotherapy” is a form of immunotherapy given as a daily pill that dissolves under the tongue. […] […] Other treatments — Other drugs may be recommended for some people with allergic rhinitis. […] […] In children older than two years, treatment options for allergic rhinitis are generally the same as in adults.

• #6 Allergic rhinitis: impact, diagnosis, treatment and management – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/research/allergic-rhinitis-impact-diagnosis-treatment-and-management

  Intranasal corticosteroids are the primary treatment for nasal obstruction and act by reducing cytokine production thereby reducing eosinophil recruitment. They also reduce eosinophil activation and mediator release. […] The treatment of ocular symptoms of allergic rhinitis is summarised in Box 1. […] Oral antihistamines are the first-line treatment used by most patients, doctors and pharmacists for all allergic rhinitis. […] Therefore, the British and European Guidelines for both allergic rhinitis and urticaria specify that only second generation antihistamines should be used for symptom relief, because they penetrate less well into the brain than FGAHs and have negligible anticholinergic effects. […] Intranasal steroids are the most effective treatment for reducing nasal inflammation and improving conjunctival symptoms.

• #7 Allergic Rhinitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538186/

  Intranasal antihistamines, such as azelastine, have a rapid onset and are more efficacious than oral antihistamines in relieving nasal symptoms. […] For patients in whom avoidance measures and combination pharmacotherapy are not effective, allergen immunotherapy should be considered. […] Subcutaneous immunotherapy (SCIT) or sublingual immunotherapy (SLIT) are commonly used therapies. […] Budesonide is the only FDA-approved agent for pregnant patients experiencing symptoms of allergic rhinitis. […] Omalizumab, a monoclonal antibody, is beneficial in patients with AR, although the cost associated with therapy is a limiting factor in its use.

• #8 Allergic rhinitis | Allergy, Asthma & Clinical Immunology | Full Text

  https://aacijournal.biomedcentral.com/articles/10.1186/s13223-024-00923-6

  If intranasal corticosteroids are not effective, a combination intranasal corticosteroid/antihistamine spray can be tried, such as combination fluticasone propionate/azelastine hydrochloride (Dymista) or olopatadine hydrochloride/mometasone furoate monohydrate (Ryaltris). […] Allergen immunotherapy, which involves the subcutaneous or sublingual administration of the patients relevant allergens, is an option for patients who do not achieve symptom control with pharmacotherapy or who prefer this form of therapy.

• #8 Allergic rhinitis | Allergy, Asthma & Clinical Immunology | Full Text

  https://aacijournal.biomedcentral.com/articles/10.1186/s13223-024-00923-6

  Allergen immunotherapy is an effective immune-modulating treatment in conjunction with or as an alternative to pharmacologic therapy. […] The treatment goal for AR is relief of symptoms. Therapeutic options available to achieve this goal include avoidance measures, nasal saline irrigation, oral antihistamines, intranasal corticosteroids, combination intranasal corticosteroid/antihistamine sprays, leukotriene receptor antagonists (LTRAs), and allergen immunotherapy. […] Second-generation oral antihistamines, such as desloratadine (Aerius), fexofenadine (Allegra), loratadine (Claritin), cetirizine (Reactine), bilastine (Blexten) and rupatadine (Rupall), can be used as first-line therapies for patients with AR. […] Intranasal corticosteroids are a first-line therapy for patients with AR and they can be used alone or in combination with oral antihistamines.

• #9 Treatments for Seasonal Allergic Rhinitis | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/allergy-seasonal/research-protocol

  Treatments for allergic rhinitis comprise allergen avoidance, pharmacotherapy, and immunotherapy. For SAR, total allergen avoidance may be undesirable, as it may require limiting time spent outdoors. Thus, pharmacotherapy is preferable to allergen avoidance for symptom relief of SAR. […] Six classes of drugs and nasal saline are used to treat SAR. Several drugs have more than one route of administration (e.g., intranasal and oral), as described below. […] Antihistamines used to treat allergic rhinitis target the H1 receptor. Oral antihistamines are classified as selective and nonselective for H1 receptors. […] Corticosteroids are potent anti-inflammatory molecules. Intranasal corticosteroids are recommended as first-line treatment for moderate/severe or persistent allergic rhinitis. […] Decongestants are -adrenergic agonists that produce vasoconstriction.

• #10 Allergic Rhinitis: Assisting Patients in Achieving Optimal Outcomes

  https://www.uspharmacist.com/article/allergic-rhinitis-assisting-patients-in-achieving-optimal-outcomes

  Antihistamines are recommended for patients with AR who have primary complaints of sneezing and itching, but they have little effect on congestion.5 They are categorized as first- and second-generation agents. […] Systemic and topical decongestants are effective in AR patients who experience nasal congestion. They work by stimulating the alpha-adrenergic receptors to constrict dilated arteries within the nasal mucosa.21 […] The use of intranasal cromolyn sodium is considered a second-line agent in the management of allergic rhinitis; it is less effective than antihistamines and intranasal corticosteroids.21 Mast-cell stabilizers inhibit the influx of calcium into the mast cell, preventing mediator release of the allergic response and inflammation.26 If degranulation has already occurred, cromolyn will have no effect; it is more useful as a preventive agent rather than as treatment.26

• #11 Managing Nasal Allergies: Tips for Year-Round Coping

  https://www.webmd.com/allergies/rhinitis

  Decongestants. As their name says, these medications help with congestion. They reduce swelling in the nasal passages, opening them up. The most common decongestant is pseudoephedrine. It’s sold on its own as Sudafed, and it’s also combined with antihistamines such as Zyrtec, Allegra, and Claritin. When these medications have pseudoephedrine, the name will be followed by -D — Zyrtec-D, Allegra-D, Claritin-D. […] Steroid nasal sprays. These drugs work by reducing the swelling in the nasal passages. Although some of these are only available by prescription, many are OTC, such as budesonide (Rhinocort), fluticasone propionate (Flonase), and triamcinolone acetonide (Nasacort). Nasal steroids have benefits as well as risks. They are generally safe and effective, and they focus the medication on the affected area — in your nose — instead of circulating it throughout your body. They have some side effects, too, such as nosebleeds and eye problems if you use them the wrong way. Only use these medicines if your doctor tells you that it’s OK.

• #11 Managing Nasal Allergies: Tips for Year-Round Coping

  https://www.webmd.com/allergies/rhinitis

  Prescription treatments for allergic rhinitis include: […] Prescription antihistamines and decongestants. Your doctor may also recommend a prescription antihistamine pill such as desloratadine (Clarinex) or levocetirizine (Xyzal). Some prescription antihistamines also contain a decongestant. Azelastine (Astelin) is a nasal spray antihistamine, which is often used alongside steroid sprays. Antihistamines also come as prescription eye drops. […] Immunotherapy. If youre wary of long-term drug use, allergy shots might be an option. Your doctor puts a little bit of the allergy trigger into your body. The goal is that over time you get used to the substance and dont react to it anymore. This doesn’t work for everyone. If it does work for you, youll need to get the shots for at least 3-5 years to make the benefits last. […] Also, the FDA has approved some tablets that you can take at home by dissolving them under your tongue. The prescription tablets treat hay fever and work the same way as shots — the goal is to boost your tolerance of allergy triggers.

• #12 Treatments for Seasonal Allergic Rhinitis | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/allergy-seasonal/research-protocol

  Ipratropium is an anticholinergic agent that blocks parasympathetic nerve conduction and the production of glandular secretions within the nasal mucosa. […] Intranasal mast cell stabilizers, including cromolyn, inhibit the antigen-induced release of inflammatory mediators from mast cells. […] Cysteinyl leukotrienes are biological inflammatory mediators. Leukotriene receptor antagonists are oral medications that reduce allergy symptoms by inhibiting inflammation. Montelukast is the only leukotriene receptor antagonist approved by the FDA for the treatment of SAR. […] A 2007 Cochrane review provides evidence that nasal saline is beneficial in treating nasal SAR symptoms. […] The optimal treatment of SAR during pregnancy is unknown. […] Most pharmacologic treatments for SAR are approved for use in adults and adolescents older than 12 years of age.

• #13 Treatment of Allergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0615/p1440.html

  The initial treatment of mild to moderate allergic rhinitis should be an intranasal corticosteroid alone, with the use of second-line therapies for moderate to severe disease. […] Although safe for general use, intranasal cromolyn (Nasalcrom) is not considered first-line therapy for allergic rhinitis because of its decreased effectiveness at relieving the symptoms of allergic rhinitis and its inconvenient dosing schedule. […] Immunotherapy should be considered for patients with moderate or severe persistent allergic rhinitis that is not responsive to usual treatments. […] Omalizumab (Xolair), an anti-immunoglobulin E antibody, has been shown to be effective in reducing nasal symptoms and improving quality-of-life scores in patients with allergic rhinitis. […] Nasal irrigation is beneficial in the treatment of chronic rhinorrhea and may be used alone or as adjuvant therapy.

• #14 Allergic Rhinitis – Immunology; Allergic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/immunology-allergic-disorders/allergic-autoimmune-and-other-hypersensitivity-disorders/allergic-rhinitis

  Montelukast, a leukotriene inhibitor, relieves allergic rhinitis symptoms but, due to a risk of psychiatric adverse effects (eg, hallucination, obsessive-compulsive disorder, suicidal thoughts and behavior), montelukast should be used only when other treatments are not effective or not tolerated. […] Desensitization immunotherapy may be more effective for seasonal than for perennial allergic rhinitis; it is indicated when symptoms are severe, the allergen cannot be avoided, or medication treatment is inadequate. […] Try intranasal corticosteroids first because they are the most effective treatment and have few systemic effects. Other treatments include oral and intranasal antihistamines and decongestants; intranasal mast cell stabilizers are less effective. […] Desensitization sublingual immunotherapy is indicated when symptoms are severe, allergens cannot be avoided, or medication treatment is inadequate.

• #15

  https://www2.hse.ie/conditions/allergic-rhinitis/allergic-rhinitis-treatment/

  Treatment for allergic rhinitis depends on your symptoms and how they affect your life. […] In most cases treatment aims to relieve symptoms, such as sneezing and a blocked or runny nose. […] If you have mild allergic rhinitis, you can often treat the symptoms yourself. […] You can treat the symptoms of mild allergic rhinitis with over-the-counter medicines. These include long-acting non-sedating antihistamines. […] Medication will not cure your allergy, but it can treat the common symptoms. […] Antihistamines relieve symptoms of allergic rhinitis. They block the action of a chemical called histamine. […] For more serious cases, your GP may prescribe a corticosteroid nasal spray or drops. […] Corticosteroids help reduce inflammation and swelling. […] If allergic rhinitis does not improve with treatment, your GP may add to your treatment. […] Immunotherapy is another type of treatment used for some allergies. It’s also known as hyposensitisation or desensitisation. […] Immunotherapy involves introducing more and more of the allergen into your body over time. This makes your immune system less sensitive to it.

• #16 Allergic rhinitis – Wikipedia

  https://en.wikipedia.org/wiki/Allergic_rhinitis

  Allergen immunotherapy, also called desensitization, treatment involves administering doses of allergens to accustom the body to substances that are generally harmless (pollen, house dust mites), thereby inducing specific long-term tolerance. […] Allergen immunotherapy is the only treatment that alters the disease mechanism.

• #16 Allergic rhinitis – Wikipedia

  https://en.wikipedia.org/wiki/Allergic_rhinitis

  Allergic rhinitis is typically triggered by environmental allergens such as pollen, pet hair, dust, or mold. […] Several different types of medications reduce allergic symptoms, including nasal steroids, intranasal antihistamines such as olopatadine or azelastine, 2nd generation oral antihistamines such as loratadine, desloratadine, cetirizine, or fexofenadine; the mast cell stabilizer cromolyn sodium, and leukotriene receptor antagonists such as montelukast. […] Oftentimes, medications do not completely control symptoms, and they may also have side effects. […] Exposing people to larger and larger amounts of allergen, known as allergen immunotherapy, is often effective and is used when first line treatments fail to control symptoms. […] Treatment typically lasts three to five years, after which benefits may be prolonged.

• #17

• #18 Allergic rhinitis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000813.htm

  LIFESTYLE AND AVOIDING ALLERGENS […] The best treatment is to avoid the pollens that cause your symptoms. It may be impossible to avoid all pollen. But you can often take steps to reduce your exposure. […] You may be prescribed medicine to treat allergic rhinitis. The medicine your provider prescribes depends on your symptoms and how severe they are. Your age and whether you have other medical conditions, such as asthma, will also be considered. […] For mild allergic rhinitis, a nasal wash can help remove mucus from the nose. You can buy a saline solution at a drug store or make one at home using 1 cup (240 milliliters) of distilled or boiled then cooled water, half a teaspoon (3 grams) of salt, and pinch of baking soda. […] Treatments for allergic rhinitis include: […] ANTIHISTAMINES […] Medicines called antihistamines work well for treating allergy symptoms. They may be used when symptoms do not happen often or do not last long. Be aware of the following: […] Many antihistamines taken by mouth

• #19 Try These 15 Natural Home Remedies for Allergy Relief

  https://www.healthline.com/health/home-remedies-for-allergies

  Home remedies, like nasal irrigation or certain essential oils, may help relieve some symptoms of allergies. But its best to identify the source of your allergy and follow your doctors advice. […] Doctors typically treat allergies with various approaches, including medications and allergy shots. Natural and home remedies might also help when used with your doctors recommendations. […] The best natural remedy for allergies is, when possible, avoidance. […] In this case, after discussing your symptoms with your doctor, you might consider a home remedy to help manage the symptoms. […] Saline nasal irrigation involves using a saline solution to clear mucus, allergens, bacteria, and other irritants from your sinus and nasal cavities. Its main function is to reduce allergy-related inflammation and nasal symptoms, such as a runny or stuffy nose and sneezing.

• #20 Allergic Rhinitis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/allergic-rhinitis-pro

  For those with pollen allergies, advise avoidance of exposure to open grassy spaces, keeping windows shut in cars and buildings and regular servicing of car pollen filters where these are present. […] Topical nasal antihistamines are first-line for 'as-required’ treatment, other than for children aged 2-5 or for those who prefer oral treatment. […] Oral antihistamines are used where sneezing or nasal discharge is a predominant symptom and regular preventative therapy is required. […] Topical intranasal steroids are more effective than antihistamines for nasal obstruction. […] When drugs fail and a structural abnormality exists, surgery may be indicated. […] Where pharmacotherapy fails, allergen-specific immunotherapy should be considered. […] Biologic therapies (monclonal antibody therapy such as omalizumab, and dupilumab) may be useful in cases refractory to standard treatments.

• #21 Allergic rhinitis – effective treatment according to t…

  https://otolaryngologypl.com/seo/article/161488/en

  The role of MP-AzeFlu is not only due to its high efficacy in controlling AR symptoms, which was confirmed by numerous studies, but also meeting the patient’s expectations of an optimal medication, which should quickly and effectively relieve symptoms, be easy to use and have a good safety profile. […] Monitoring of the effectiveness of treatment using the VAS scale as well as endoscopy was described by Kaulsay et al. […] The results of the multicenter European study published in Autumn 2022, in which the data collected from 10.860–13.122 AR patients were analyzed, indicate that by one third of days with AR symptoms, the patients were treated with 2 or more drugs. […] The conclusions from current guidelines and recent studies on AR treatment are as follows: oral AH therapy is less effective than inGCS; inAH therapy is less effective than inGCS, but inAH start to work within a few minutes, while inGCS start to work after a few hours or days; the addition of oral AH to inGCS does not bring additional benefits, compared to monotherapy with inGCS; inGCS and fixed combination containing inAH and inGCS (recommended based on the analysis of efficacy MP-AzeFlu) show greater efficacy than oral AH (more symptom-free days); fixed combination of inAH and inGCS has a stronger effect/ is more effective than inGCS alone; fixed combination of inAH and inGCS (based on the analysis of the speed of action of MP-AzeFlu) shows effects in a few minutes; fixed combination of inAH and inGCS (recommended based on the analysis of the effectiveness of MP-AzeFlu) can be applied to every stage of treatment, especially for moderate and severe AR; if AR monotherapy is ineffective, the patient should receive a fixed combination containing inGCS and azelastine (recommendation based on the analysis of the effectiveness of MP-AzeFlu); if there is pronounced nasal obstruction, initial treatment can be complemented by nasal or oral decongestants (for no longer than 5 to 7 days).

• #21 Allergic rhinitis – effective treatment according to t…

  https://otolaryngologypl.com/seo/article/161488/en

  The newest ARIA guidelines are based on the GRADE (the Grading of Recommendations Assessment, Development and Evaluation) method, as well as EUFOREA guidelines, considering the real-life research, i.e. in the conditions of daily clinical practice (real-world evidence; RWE), also using mobile devices. […] The summary of EUFOREA guidelines for adults is shown in Fig. 2. […] In children with AR, the recommendations are similar; step-up approach is strongly recommended, considering the child’s age and the age of registration for each product. […] The pediatric guidelines of EUFOREA recommend the use of fixed combination containing inAH and inGCS as early as after the age of 6, although in Poland those products are registered for patients aged over 12. […] If there is a significant nasal obstruction, nasal (topical) decongestants may be used for short-term treatment (in children, preferably for no more than 5 days).

• #21 Allergic rhinitis – effective treatment according to t…

  https://otolaryngologypl.com/seo/article/161488/en

  A modern scheme based mainly on ARIA-GRADE / MASK, EUFOREA and ICAR:AR guidelines (International consensus Statement on Allergy and Rhinology: Allergic Rhinitis), should include the following elements: 1. diagnosis based on history, physical examination, and laboratory tests; determination of the cause, type, and severity of symptoms (VAS scale), classification of the AR phenotype, 2. identification and reduction/elimination of exacerbating factors (both allergens and non-specific factors), 3. AR treatment based on the ICP (integrated care pathways) – i.e. an integrated patient care system. […] The evolution of the recommendations in the treatment of allergic rhinitis strongly gravitates towards precision medicine, in order to improve and optimize AR patient care, which translates to better disease control, considering the patient’s personalized needs.

• #22

  https://link.springer.com/article/10.1007/s40629-020-00133-7

  AHs and nasal GCs represent the therapeutic standard in AR. Their efficacy is well documented for several preparations. The evidence for combination therapies is documented very well for a fixed combination of azelastine and fluticasone (MP29-02). For the simultaneous use of non-fixed combined monopreparations, only a few efficacy and safety studies based on modern evidence criteria exist. […] The free combination therapies of mast cell stabilizers, decongestants, AHs and nasal GCs, frequently used in the routine care of patients with AR, cannot be recommended because they are not evidence-based. […] In summary, intranasal GKs are most effective in the treatment of AR. […] Overall, studies show that about 40% of patients use a combination therapy with different preparations, although the additional benefit of a second preparation could not be proven in many studies.

• #23 Hay fever allergic rhinitis and your asthma – National Asthma Council Australia

  https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/brochures/hay-fever-allergic-rhinitis-and-your-asthma

  For best results, these medications should be taken regularly and long term, just like preventers for asthma. […] People who experience allergic rhinitis symptoms throughout the year may need to continue treatment indefinitely. […] Antihistamine nasal sprays (available over the counter) can provide quick relief of itching and sneezing, and may help with blocked nose. […] Your doctor may recommend that you use a salt water (saline) solution daily to help clear your nose and soothe the lining of the nose. […] If medication does not clear a badly blocked nose, doctors may occasionally recommend a surgical operation called turbinate reduction. […] If your allergic rhinitis is troublesome, or if effective treatment for your allergic rhinitis helps control your asthma symptoms, your doctor might recommend that you take medicine while you are pregnant.

• #23 Hay fever allergic rhinitis and your asthma – National Asthma Council Australia

  https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/brochures/hay-fever-allergic-rhinitis-and-your-asthma

  Some corticosteroid nasal sprays can be used in children as young as 2 years. […] Your doctor may recommend other medicines. […] Specific allergen immunotherapy (desensitisation) is an effective treatment for allergic rhinitis in some people and can achieve lasting relief from symptoms. […] Treatment must be continued for 3-5 years. […] Injectable immunotherapy involves weekly to monthly injections.

• #24 Allergic Rhinitis Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/allergic-rhinitis

  Treating Allergic Rhinitis […] Nationwide Children’s Hospital offers a team of experts focused on the treatment of children with allergic rhinitis […] […] What Treatment Options Are Available for Allergic Rhinitis? […] Treatment of allergic rhinitis primarily involves avoiding exposure to the things that cause symptoms. Allergy testing can help to determine which allergens cause the most problems. Your doctor can discuss avoidance measures with you depending on the things your child is allergic to. […] Medical treatments for allergic rhinitis include a trial of a medicated nasal spray. Examples of this include Flonase, Rhinocort, Nasonex, Nasocor. These sprays help to decrease the inflammation of the nasal lining by acting locally in the nose. This means that almost all of the steroid spray works only in the nose and little gets into the body. This type of medication needs to be used every day and can take up to 1 month of chronic daily usage to notice a difference in nasal breathing, nasal congestion, or obstruction. Allergies may also be treated with oral anti-histamine medications. Examples of these medications include Zyrtec, Allegra, or Claritin. Antihistamines usually work very quickly compared to nasal steroid sprays. Most children notice an improvement in runny nose and nasal congestion within 30-60 minutes of taking these medications. Your doctor may recommend other types of medications for treatment as well.

• #25 Mechanisms and Comparative Treatments of Allergic Rhinitis including Phototherapy

  https://www.mdpi.com/2313-5786/4/1/2

  Limitations in the conventional therapies mean that alternative treatments for AR are required. Intranasal phototherapy has received growing interest as an alternative treatment to relieve the symptoms of AR patients. AR is often treated using pharmacological products alone or in combination, depending on the symptoms suffered. Many affected by AR would like to reduce the requirement for medicines or may have other conditions where there are other side effects of the medicines. Many allergic rhinitis sufferers wish to reduce the amount of medication that they take. Many find that medication does not control their symptoms adequately. […] Considerable evidence exists which shows that phototherapy is an effective treatment for allergic rhinitis. Phototherapy can be used on all AR sufferers as a replacement therapy or concurrent with traditional medication. It can be an effective treatment for inflammatory and immune-mediated diseases. Phototherapy has an immunosuppressive effect, and ultraviolet (UV) and visible light treatment are used as a therapy for inflammatory skin diseases.

• #25 Mechanisms and Comparative Treatments of Allergic Rhinitis including Phototherapy

  https://www.mdpi.com/2313-5786/4/1/2

  Phototherapy has therefore a role to play in the effective treatment of AR as it has effects on different inflammatory and immune-mediated mucosal symptoms. It is also shown to be effective where AR symptoms persist. […] The effectiveness of phototherapy on allergic symptoms has been documented previously. The main trials where effects are reported are listed in Table 1. It is not possible to list all trials in summary as over 2000 trials/reports have been published on the beneficial effects of phototherapy. Many wavelengths of light used in phototherapy studies have been shown to be effective. These studies showed that phototherapy (UV-A, UV-B, visible light wavelengths and near-red and infra-red wavelengths) suppresses the clinical symptoms of allergic rhinitis. Most trials combined different wavelengths in treatments and this was shown to have a synergistic effect on the suppression of allergic rhinitis.

• #25 Mechanisms and Comparative Treatments of Allergic Rhinitis including Phototherapy

  https://www.mdpi.com/2313-5786/4/1/2

  The evidence shows that nostril-based application of phototherapy improves blood rheology and cerebral blood flow without needing to puncture blood vessels, indicating that this treatment may have equivalent results to peripheral intravenous laser irradiation. […] The use of phototherapy as a therapeutic treatment for AR is a safe and promising treatment which could be useful. The evidence suggests that phototherapy suppresses the effector phase of AR, which produces a significant suppression of clinical symptoms. Phototherapy has been used as a treatment for inflammatory skin diseases and is considered a new and alternative treatment in allergic rhinitis. Phototherapy is attributed to a local immunosuppressive and immunomodulant action. Therefore, phototherapy could inhibit other aspects of effector phases of allergic reactions. This includes the inhibition of antigen presentation by dendritic cells, which induces apoptosis of immune cells. Other types of inhibition resulting from phototherapy include the synthesis and release of pro-inflammatory mediators from eosinophils, mast cells, basophils and T cells. Phototherapy could therefore become another key treatment for use by allergic rhinitis sufferers.

• #26 Rhinitis – La Crosse, Wisconsin – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/locations/la-crosse/services-and-treatments/otorhinolaryngology/nose-conditions-and-treatment/rhinitis

  Allergic rhinitis, also known as hay fever, occurs due to an allergic response to outdoor or indoor allergens such as pollen, dust mites, or pet dander. Unlike nonallergic rhinitis, allergic rhinitis can also cause itchy nose, roof of mouth, or throat. Your allergic rhinitis signs and symptoms may start or worsen at a particular time of year. Triggers include: […] For treatment of allergic rhinitis, over-the-counter oral antihistamines may help to alleviate your symptoms. […] In some cases, surgical procedures may be an option to treat complicating problems. […] Cryotherapy, or cold therapy, is an innovative, minimally invasive treatment for rhinitis. Cryotherapy uses an endoscope and cryotherapy device to freeze nerves in your nasal passages. When the cold temperature hits the nerves, the nerve signals are interrupted and no longer tell the nose to swell, drip and run. The interruption of the nerve signals provides long-lasting relief from runny or stuffy nasal symptoms. Cryotherapy can provide patients with symptom relief for up to a year or longer.

• #27 How to Cure Allergic Rhinitis Permanently | Kaplan Sinus ReliefExitFacebookTwitterLinkedinMailYoutubeFacebook

  https://www.kaplansinusrelief.com/blog/how-to-cure-allergic-rhinitis-permanently/

  If you’re searching for tips on how to cure allergic rhinitis permanently, we must inform you that conditions involving allergens are unfortunately difficult to permanently get rid of. The good news is that there are many treatment options for those who suffer from allergic rhinitis that will help to control and manage the symptoms. […] As we have mentioned above, there is truly no concrete answer to how to cure allergic rhinitis permanently, but there are ways to keep the symptoms at bay. Here are a few methods that you can utilize to temporarily fix your symptoms, as well as a long-term solution. […] If natural remedies for allergic rhinitis are just not cutting it, ClariFix for rhinitis relief is a great option for those who just can’t seem to find allergy relief through common methods. ClariFix cryotherapy is a device that targets the posterior nasal nerve, which signals the nose whether it should start secreting mucus or become congested. During this very quick procedure, the device is gently inserted into the nose and releases cooling nitrogen gas to reduce the nasal nerve’s activity. This will not only keep allergy symptoms away, but the results are long-lasting!

• #28 Treatments for Seasonal Allergic Rhinitis | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/allergy-seasonal/research-protocol

  Multiple guidelines for the treatment of allergic rhinitis exist. […] Although these guidelines generally support the use of intranasal corticosteroids as first-line treatment of moderate/severe SAR, the guidelines are not consistently based on systematic reviews of the literature and often do not address the treatment of SAR in children and pregnant women. […] Our review aims to address these aspects of treatments for SAR.

• #29 Allergic Rhinitis: Assisting Patients in Achieving Optimal Outcomes

  https://www.uspharmacist.com/article/allergic-rhinitis-assisting-patients-in-achieving-optimal-outcomes

  Management strategies should include the combination of allergen avoidance and pharmacotherapy. Treatment should be individualized based on the frequency and severity of bothersome symptoms. With appropriate questioning and education, pharmacists can aid the patient in achieving optimum symptom control.

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