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过敏性鼻炎的联合治疗:哪些有效,哪些无效。

Combination therapy in allergic rhinitis: What works and what does not work.

作者信息

Greiwe Justin C, Bernstein Jonathan A

机构信息

Bernstein Allergy Group, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA.

出版信息

Am J Rhinol Allergy. 2016 Nov 1;30(6):391-396. doi: 10.2500/ajra.2016.30.4391.

Abstract

UNLABELLED

Allergic rhinitis and other rhinitis subtypes are increasingly becoming some of the most prevalent and expensive medical conditions that affect the U.S.

POPULATION

Both direct health care costs and indirect costs significantly impact the health care system due to delays in diagnosis, lack of treatment, ineffective treatment, poor medication adherence, and associated comorbidities. Many patients who have AR turn to over-the-counter medications for relief but often find themselves dissatisfied with the results. Determining the correct diagnosis, followed by initiation of the most-effective treatment(s), is essential to provide patients with better symptomatic management and quality of life. Although there are many options, currently available combination therapies, e.g., azelastine with fluticasone and intranasal corticosteroids with nasal decongestants, offer distinct advantages for the management of complex rhinitis phenotypes. Further research is required to investigate the pathomechanisms and biomarkers for mixed rhinitis and nonallergic vasomotor rhinitis subtypes that will lead to novel targeted therapies for these conditions.

摘要

未标注

变应性鼻炎和其他鼻炎亚型正日益成为影响美国人群的一些最常见且费用高昂的医疗状况。

人群

由于诊断延迟、缺乏治疗、治疗无效、药物依从性差以及相关合并症,直接医疗费用和间接费用均对医疗保健系统产生重大影响。许多患有变应性鼻炎的患者转向非处方药物寻求缓解,但往往对结果不满意。确定正确的诊断,随后开始最有效的治疗,对于为患者提供更好的症状管理和生活质量至关重要。尽管有很多选择,但目前可用的联合疗法,例如氮卓斯汀与氟替卡松以及鼻内皮质类固醇与鼻减充血剂,在复杂鼻炎表型的管理方面具有明显优势。需要进一步研究以调查混合性鼻炎和非变应性血管运动性鼻炎亚型的发病机制和生物标志物,这将为这些疾病带来新的靶向治疗方法。

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