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Treatment update: allergic rhinitis.

W E Berger1

  • 1Mission Viejo Medical Center, 27800 Medical Center Drive, 244, Mission Viejo, CA 92691, USA.

Allergy and Asthma Proceedings
|September 13, 2001
PubMed
Summary
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Accurate diagnosis and a multi-faceted approach are key for managing allergic rhinitis. Treatment emphasizes allergen avoidance, immunotherapy, and broad-based pharmacologic therapies for optimal symptom relief.

Area of Science:

  • Allergy and Immunology
  • Otolaryngology

Background:

  • Allergic rhinitis management has evolved with new pharmacologic agents and a focus on prevention.
  • Accurate differential diagnosis is crucial for effective allergic rhinitis treatment.

Purpose of the Study:

  • To outline current trends and an evidence-based algorithm for allergic rhinitis management.
  • To emphasize the role of allergists in diagnosing and treating complex rhinitis cases.

Main Methods:

  • Review of evolving management trends and a proposed algorithm by the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology.
  • Differential diagnosis incorporating medical history, physical examination, and ancillary tests like skin tests.
  • Allergist-led management utilizing a three-pronged approach: avoidance, immunotherapy, and pharmacologic therapy.

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Main Results:

  • Primary care physicians initiate evaluation, referring to allergists as needed.
  • Allergists employ evidence-based strategies for differential diagnosis and treatment.
  • Pharmacologic therapy, particularly broad-based options, remains central due to limitations of avoidance and immunotherapy.

Conclusions:

  • Optimal allergic rhinitis management requires accurate diagnosis and a comprehensive strategy.
  • Broad-based pharmacologic therapies, including first-generation antihistamines, topical corticosteroids, and azelastine, are recommended first-line treatments.
  • Second-generation antihistamines and leukotriene antagonists are also valuable for allergic rhinitis.