An update regarding the treatment of nonallergic rhinitis

Curr Opin Otolaryngol Head Neck Surg. 2016 Feb;24(1):10-4. doi: 10.1097/MOO.0000000000000225.

Abstract

Purpose of review: The review presents some information on known options for treatment of nonallergic rhinitis (NAR) with introduction to new therapies. The merits and limitations of recent advancements in pharmacotherapy of this common problem are briefly discussed as well.

Recent findings: Intranasal corticosteroids are first-line therapy for NAR. Fluticasone propionate and beclomethasone remain the only topical corticosteroids approved for NAR. The use of azelastine - another first-line option - has also been found to be effective even though NAR is a nonallergic entity by definition. Combination of fluticasone propionate and azelastine is a promising option in achieving better symptom reduction. Coadministration of intranasal corticosteroid and topical decongestants is an attractive topic that requires additional safety studies before recommending treatment. Although promising, no scientifically valid recommendation can be made for treatment of NAR with capsaicin. Surgical options in patients with refractory NAR are limited. New studies demonstrate a lack of correlation between objective outcome of radiofrequency ablation of the inferior turbinate and subjective patient symptoms.

Summary: The heterogeneity in clinical presentation makes NAR treatment a daily challenge for otolaryngologists. The diversity of clinical studies with use of unique outcome measures limit systematic reviews which may be instrumental in providing strong recommendations.

Publication types

  • Review

MeSH terms

  • Administration, Intranasal
  • Adrenal Cortex Hormones / therapeutic use*
  • Beclomethasone / therapeutic use
  • Capsaicin / therapeutic use
  • Drug Therapy, Combination
  • Fluticasone / therapeutic use
  • Humans
  • Nasal Decongestants / therapeutic use*
  • Phthalazines / therapeutic use
  • Rhinitis / drug therapy*
  • Rhinitis / surgery
  • Sensory System Agents / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Nasal Decongestants
  • Phthalazines
  • Sensory System Agents
  • Fluticasone
  • Beclomethasone
  • Capsaicin
  • azelastine