The Obama dilemma: allergic rhinitis (animal dander allergy)-the great burden of illness.

Allergic rhinitis is one of the most common chronic diseases with over 600 million people affected worldwide. More than 200 million of them also suffer from concomitant asthma. Allergic rhinitis is generally under-diagnosed and under-treated. A significant burden of allergic rhinitis is due to pet allergies. In 2008 two major evidence-based documents on the management of allergic rhinitis were published, namely the US Rhinitis Practice Parameters and the ARIA/WHO Guidelines that stress the burden of allergic rhinitis due to animal allergens and the comorbidities of allergic rhinitis. We need a new approach targeting individual disease control in rhinitis due to animal allergens emphasizing avoidance and active treatment. The goals of the avoidance-treatment are to first improve patient care by recognizing each individual patient's burden of disease and expectations of therapy, and then to target and adjust the appropriate therapies to meet these expectations. Achieving these goals will, ultimately, help the patient to better self-manage his or her disease, thereby improving overall quality of life.