Bozek Andrzej
Clinical Department of Internal Disease, Dermatology and Allergology, Medical University of Silesia in Katowice, MC Sklodowskiej 10, 41-800, Zabrze, Poland.
Drugs Aging. 2017 Jan;34(1):21-28. doi: 10.1007/s40266-016-0425-7.
Recent studies suggest that allergic rhinitis is highly prevalent in the elderly population, but is underdiagnosed and undertreated. This review article briefly introduces allergic rhinitis in the elderly (epidemiology and pathophysiology) and identifies the main goals of treatment in these patients with respect to age-related physiological factors, comorbid conditions and polypharmacy. The primary focus of the article is a narrative review of the literature concerning the different types of treatment options in elderly patients aged 60+ years (pharmacological therapy and allergen-specific immunotherapy). The main management trend for allergic rhinitis in elderly patients is the same as the trend in young patients. Second-generation antihistamines and nasal glucocorticosteroids are also the first-line therapies in seniors. In a few trials, allergen-specific immunotherapy for grass pollen or house dust mites has been shown to be effective and safe in patients aged 60 years or older with allergic rhinitis. In conclusion, undertreatment of allergic rhinitis in the elderly is a reality. Pharmacological treatment is quite similar in both older and younger patients with allergic rhinitis.
近期研究表明，变应性鼻炎在老年人群中极为普遍，但存在诊断不足和治疗不足的情况。这篇综述文章简要介绍了老年人变应性鼻炎（流行病学和病理生理学），并根据与年龄相关的生理因素、合并症和多重用药情况，确定了这些患者的主要治疗目标。文章的主要重点是对60岁及以上老年患者不同类型治疗选择（药物治疗和变应原特异性免疫治疗）的文献进行叙述性综述。老年患者变应性鼻炎的主要管理趋势与年轻患者相同。第二代抗组胺药和鼻用糖皮质激素也是老年人的一线治疗方法。在一些试验中，已证明针对草花粉或屋尘螨的变应原特异性免疫治疗对60岁及以上变应性鼻炎患者有效且安全。总之，老年人变应性鼻炎治疗不足是事实。老年和年轻变应性鼻炎患者的药物治疗颇为相似。
