Overview of the treatment of allergic rhinitis and nonallergic rhinopathy

Proc Am Thorac Soc. 2011 Mar;8(1):121-31. doi: 10.1513/pats.201004-033RN.

Abstract

Allergic rhinitis (AR) and nonallergic rhinopathy (NAR) represent common nasal conditions affecting millions of individuals across the world. Although patients present with similar symptomatology, those with NAR are frequently affected only after childhood and present with a lack of other comorbid atopic disorders such as asthma, atopic dermatitis, and food allergies. Patients with pure NAR usually have no identifiable specific allergen sensitivity, whereas those with mixed (allergic and nonallergic) rhinitis are sensitized to aeroallergens in a manner that does not fully explain the duration or extent of their symptoms. This review presents the diverse options of currently available pharmacologic agents for the treatment of AR and NAR, including intranasal corticosteroids, H(1)-antihistamines, decongestants, cromolyn sodium, antileukotrienes, anticholinergics, capsaicin, anti-IgE, and intranasal saline, in addition to subcutaneous immunotherapy. Furthermore, treatment algorithms for AR and NAR are presented with a stepped-up, stepped-down scheme to aid the clinician in choosing appropriate therapy.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Allergens / adverse effects
  • Allergens / immunology
  • Anti-Allergic Agents / therapeutic use*
  • Anti-Inflammatory Agents / therapeutic use
  • Chronic Disease
  • Drug Therapy, Combination
  • Environmental Monitoring
  • Epidemiological Monitoring
  • Female
  • Follow-Up Studies
  • Humans
  • Immunization / methods
  • Male
  • Nasal Decongestants / therapeutic use
  • Rhinitis, Allergic, Perennial / drug therapy*
  • Rhinitis, Allergic, Perennial / immunology
  • Rhinitis, Allergic, Perennial / physiopathology
  • Rhinitis, Allergic, Seasonal / drug therapy*
  • Rhinitis, Allergic, Seasonal / epidemiology
  • Rhinitis, Allergic, Seasonal / immunology
  • Rhinitis, Allergic, Seasonal / physiopathology
  • Rhinitis, Atrophic / diagnosis
  • Rhinitis, Atrophic / drug therapy*
  • Rhinitis, Atrophic / physiopathology
  • Rhinitis, Vasomotor / diagnosis
  • Rhinitis, Vasomotor / drug therapy*
  • Rhinitis, Vasomotor / physiopathology
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Allergens
  • Anti-Allergic Agents
  • Anti-Inflammatory Agents
  • Nasal Decongestants