Seasonal allergic rhinitis--a review of current therapy

Epidemiological studies in many countries strongly suggest an increase in the prevalence of seasonal allergic rhinitis, particularly in urban communities. The mechanisms of allergic rhinitis have been the subject of much research, elucidating symptomatology and improving the focus of therapeutic strategies. Ideally, avoidance of the offending allergen may be undertaken but is often incompatible with normal activity. Thus, active therapy is usually required, selected from a range of pharmacologic agents. Choice is determined by the severity of the symptoms, the age and individual circumstances of the patients, and may vary considerably from country to country. The menu will primarily include rapid onset, oral non-sedating H1 antihistamines, topical nasal steroids and topical sodium cromoglycate to the nose, eyes or both. These medications may be given alone or in combination, usually under the direction of the primary care physician, and should be commenced in advance of exposure to the seasonal allergen. If this proves ineffective, specialist referral should be made for further management.