Overview of the Treatment of Allergic Rhinitis and Nonallergic Rhinopathy

Greiner, Alexander N.; Meltzer, Eli O.

doi:10.1513/pats.201004-033rn

Cited by 67 publications

(83 citation statements)

References 107 publications

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“…Current nasal sympathomimetic decongestants are associated with mechanism-based adverse effects (Corey et al, 2000;Nathan, 2008;Greiner and Meltzer, 2011;Kushnir, 2011). For oral decongestants, these side effects include insomnia nervousness, anxiety, and tremors, as well as tachycardia, palpitations, and hypertension.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Evaluation of Selectiveα2c-Adrenergic Agonists in Experimental Animal Models of Nasal Congestion

Jia

Mingo

Hunter

et al. 2014

J Pharmacol Exp Ther

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Nasal congestion is one of the most troublesome symptoms of many upper airways diseases. We characterized the effect of selective a2c-adrenergic agonists in animal models of nasal congestion. In porcine mucosa tissue, compound A and compound B contracted nasal veins with only modest effects on arteries. In in vivo experiments, we examined the nasal decongestant dose-response characteristics, pharmacokinetic/ pharmacodynamic relationship, duration of action, potential development of tolerance, and topical efficacy of a2c-adrenergic agonists. Acoustic rhinometry was used to determine nasal cavity dimensions following intranasal compound 48/80 (1%, 75 ml). In feline experiments, compound 48/80 decreased nasal cavity volume and minimum cross-sectional areas by 77% and 40%, respectively. Oral administration of compound A (0.1-3.0 mg/kg), compound B (0.3-5.0 mg/kg), and d-pseudoephedrine (0.3 and 1.0 mg/kg) produced dose-dependent decongestion. Unlike dpseudoephedrine, compounds A and B did not alter systolic blood pressure. The plasma exposure of compound A to produce a robust decongestion (EC 80 ) was 500 nM, which related well to the duration of action of approximately 4.0 hours. No tolerance to the decongestant effect of compound A (1.0 mg/kg p.o.) was observed. To study the topical efficacies of compounds A and B, the drugs were given topically 30 minutes after compound 48/80 (a therapeutic paradigm) where both agents reversed nasal congestion. Finally, nasal-decongestive activity was confirmed in the dog. We demonstrate that a2c-adrenergic agonists behave as nasal decongestants without cardiovascular actions in animal models of upper airway congestion.

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Section: Discussionmentioning

confidence: 99%

Pharmacological Evaluation of Selectiveα2c-Adrenergic Agonists in Experimental Animal Models of Nasal Congestion

Jia

Mingo

Hunter

et al. 2014

J Pharmacol Exp Ther

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“…It is historically classified in seasonal or perennial depending on whether an individual is sensitized to cyclic pollens or yearround allergens such as dust mites and animal dander [5,6]. A different classification has been proposed in the "Allergic Rhinitis and its Impact on Asthma (ARIA)" document [7] and distinguishes between intermittent allergic rhinitis (IAR) and persistent allergic rhinitis (PER) depending on the frequency of symptoms, and between mild or moderate/severe allergic rhinitis depending on symptoms' severity [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Its exact pathophysiology remains uncertain but, like AR, NAR is characterized by persistent or intermittent nasal symptoms. Nasal obstruction and rhinorrhea are its hallmark features and more commonly seen than sneezing, nasal and palatal itch, and concurrent ocular symptoms, which are more suggestive of allergic upper airway disease [6]. A variety of stimuli may trigger NAR, including irritants such as smoke from tobacco and strong odors, climate changes, humidity, and changing barometric pressure and/or temperature.…”

Section: Introductionmentioning

confidence: 99%

“…NAR may usually be differentiated from AR by characteristics including a relatively later age of onset, female sex, and a frequent lack of atopic comorbidities, such as atopic dermatitis, asthma, and food allergies. [6]. Rhinitis (in its multi-factorial etiology) is therefore a common rhinopathy and is characterized by the presence of at least one of the following nasal symptoms: anterior or posterior rhinorrhea, sneezing, nasal blockage and itching of the nose [12].…”

Section: Introductionmentioning

confidence: 99%

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Economic Impact of Treatments for Controlling Symptoms Associated with Rhinitis: an Evaluation of Narivent® vs Standard Therapy

Damiani¹

2012

TOMDJ

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Rationale and aim: Upper airway disorders, like allergic and non-allergic rhinitis, are common nasal conditions affecting millions of individuals worldwide. The prevalence of allergic rhinitis (AR), in particular, has been increasing in the last decades. The pervasiveness of this disorder therefore imposes a large burden both on individual patients and the society. A wide range of drugs exists for symptomatic treatment of rhinitis, such as corticosteroids, decongestants, and antihistamines, but standard therapies are often associated with several side effects. A new class of medical devices, based on bio-mechanically innovative triggers, has been proven to have a good clinical effectiveness with lower adverse reactions, particularly over prolonged administration periods.The present study aims at evaluating the economic impact of rhinitis, with respect to direct and indirect costs, and analysing the use of the medical device Narivent ® compared to standard therapies to manage the symptoms of this illness.Methods: Via a Monte Carlo simulation study, data on disease prevalence, drug prescription and cost of both the specific therapeutic approach and the adverse events treatment will be combined to provide an estimate of the overall cost of the pharmacotherapy as compared with Narivent ® .Results: Lowering the impact of adverse reactions related to standard therapy through the use of novel therapeutic approaches like Narivent ® , might reduce the overall burden of rhinitis by about 5 billion per year. Conclusion:The use of the medical device Narivent ® , as an alternative approach to manage symptoms associated with rhinitis, may contribute to bring down its costs by about 3.5% yearly as compared to the standard therapy.

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“…8 Current available pharmacological agents for the treatment of allergic rhinitis include intranasal corticosteroids, H1 antihistamines, decongestants, cromolyn sodium, leukotriene antagonists and anticholinergics. 9 Medications to treat asthma can be classified as controllers or relievers.…”

Section: Introductionmentioning

confidence: 99%

Strategies of mucosal immunotherapy for allergic diseases

Chuang

Chiang

2011

Cell Mol Immunol

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Incidences of allergic disease have recently increased worldwide. Allergen-specific immunotherapy (SIT) has long been a controversial treatment for allergic diseases. Although beneficial effects on clinically relevant outcomes have been demonstrated in clinical trials by subcutaneous immunotherapy (SCIT), there remains a risk of severe and sometimes fatal anaphylaxis. Mucosal immunotherapy is one advantageous choice because of its non-injection routes of administration and lower side-effect profile. This study reviews recent progress in mucosal immunotherapy for allergic diseases. Administration routes, antigen quality and quantity, and adjuvants used are major considerations in this field. Also, direct uses of unique probiotics, or specific cytokines, have been discussed. Furthermore, some researchers have reported new therapeutic ideas that combine two or more strategies. The most important strategy for development of mucosal therapies for allergic diseases is the improvement of antigen formulation, which includes continuous searching for efficient adjuvants, collecting more information about dominant T-cell epitopes of allergens, and having the proper combination of each. In clinics, when compared to other mucosal routes, sublingual immunotherapy (SLIT) is a preferred choice for therapeutic administration, although local and systemic side effects have been reported. Additionally, not every allergen has the same beneficial effect. Further studies are needed to determine the benefits of mucosal immunotherapy for different allergic diseases after comparison of the different administration routes in children and adults. Data collected from large, well-designed, double-blind, placebo-controlled, and randomized trials, with post-treatment follow-up, can provide robust substantiation of current evidence.

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Overview of the Treatment of Allergic Rhinitis and Nonallergic Rhinopathy

Cited by 67 publications

References 107 publications

Pharmacological Evaluation of Selectiveα2c-Adrenergic Agonists in Experimental Animal Models of Nasal Congestion

Pharmacological Evaluation of Selectiveα2c-Adrenergic Agonists in Experimental Animal Models of Nasal Congestion

Economic Impact of Treatments for Controlling Symptoms Associated with Rhinitis: an Evaluation of Narivent® vs Standard Therapy

Strategies of mucosal immunotherapy for allergic diseases

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