New Therapies for Allergic Rhinitis

Abstract

Because of its burden on patient's lives and its impact on asthma, allergic rhinitis must be treated properly with more effective and safer treatments. According to guidelines by Allergic Rhinitis and Its Impact on Asthma (ARIA), the classification, pathogenesis, and treatment of allergic rhinitis are well defined. Currently, second-generation antihistamines and inhaled steroids are considered the cornerstone of first-line therapy. However, new formulations of available drugs (e.g., loratadine and rupatadine oral solution, ebastine fast-dissolving tablets, and the combination of intranasal fluticasone propionate and azelastine hydrochloride), recently discovered molecules (e.g., ciclesonide, bilastine, and phosphodiesterase-4 inhibitors), immunologic targets (e.g., omalizumab), and unconventional treatments (e.g., homeopathic treatments) are currently under investigation and represent a new frontier in modern medicine and in allergic rhinitis management. The aim of this review is to provide an update on allergic rhinitis treatment, paying particular attention to clinical trials published within the past 20 months that assessed the efficacy and safety of new formulations of available drugs or new molecules.

Associations Between Topical Ophthalmic Corticosteroids and Central Serous Chorioretinopathy: A Taiwanese Population-Based Study

“…22,24 Intranasal steroids and second-generation antihistamines are recommended as first-line allergic rhinitis therapy drugs, which are aimed at reducing allergy-related inflammation. 42 Notably, only four cases of CSCR specifically linked to intranasal corticosteroids were detected in a search of the English literature. Our report is the largest population-based case-controlled study to investigate the association between intranasally administered corticosteroids and CSCR development.…”

Contemporary Pharmacotherapy for Allergic Rhinitis and Chronic Rhinosinusitis

“…33 In the late phase following allergen exposure, recruitment of other effector cells including eosinophils and Th2 cells can be found. 13,34 However, atopy does not significantly influence symptom severity, extent of sinus disease on CT scans and likelihood of undergoing revision surgery among CRS patients. 35 …”

“…Typical allergens include dust mites, grass, tree, or weed pollens, cats, dogs and molds 12,13 and hypersensitivity is detected by skin or serum testing. AR has a significant effect on patient QoL additionally it is often comorbid to and contributes to the development and progression of asthma.…”

Reviewing the Safety of Loratadine for Elderly Adults: A Potential Shortcoming of the 2012 Beers Criteria

“…Moreover, first-generation H1 antihistamines are associated with undesirable sedation and anticholinergic side effects. [4][5][6] Under the umbrella term "sedation" is a range of conditions including somnolence, impaired concentration, and poor learning ability. 5 Central nervous system (CNS) and cardiac toxicity have been the most serious adverse effects associated with H1 antihistamines.…”