Chair and Clinic of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland.
Otolaryngol Pol. 2022 Dec 15;76(6):45-59. doi: 10.5604/01.3001.0016.1488.
Allergic rhinitis (AR) is a common chronic respiratory disease, that affects millions of individuals, has significant impact on their quality of life, productivity, and other existing conditions, including asthma and conjunctivitis. Despite a substantial burden on individuals, society and health economies, AR remains under-diagnosed, under-estimated and under-treated. Main symptoms defining this IgE-dependent inflammation of nasal mucosa are: sneezing, itchy nose, rhinorrhoea and nasal congestion. Real-world data obtained by mobile technology offer new insights into AR phenotypes and therapy. Clinical management aims to relieve or control symptoms, resolve allergic inflammation, and potentially induce allergen tolerance, using allergen immunotherapy. Most cases of AR respond rather satisfied to pharmacotherapy. A very useful tool, especially recommended for everyday clinical practice, is VAS (visual analogue scale) which can help with: to assessing the intensity of AR symptoms as well as choosing the most optimal therapeutic option. Pharmacological treatment of the condition should be safe; effective and easy to administer as we treat patients with chronic condition, sometimes for a long time. Most frequently used treatment of AR include oral, intranasal or ocular antihistamines, intranasal corticosteroids or combined intranasal antihistamines and corticosteroids. Based on real-life clinical experience it can be concluded that a fixed combination of intranasal corticosteroid and intranasal antihistamines (mainly MP-AzeFlu) may be considered to be most beneficial, particularly in monotherapy and AR resistant to previous treatment. Some AR patients are not satisfied with provided treatment results when the disease becomes only partially controlled. We still have unmet patients needs and we are still looking for better therapeutic options in this area. New initiatives such as EUFOREA are developed in parallel with existing ones, such as ARIA to integrate patients and healthcare professionals in the therapeutic process and create new recommendations that are closest to the idea of precision medicine, delivering the right treatment to the right patient at the right time.
变应性鼻炎(AR)是一种常见的慢性呼吸道疾病,影响着数以百万计的个体,对他们的生活质量、生产力和其他现有疾病(包括哮喘和结膜炎)产生重大影响。尽管 AR 给个人、社会和卫生经济带来了巨大负担,但它仍然未得到充分诊断、估计和治疗。定义这种 IgE 依赖性鼻黏膜炎症的主要症状是:打喷嚏、鼻痒、流涕和鼻塞。移动技术获得的真实世界数据为 AR 表型和治疗提供了新的见解。临床管理旨在缓解或控制症状、缓解过敏炎症,并通过过敏原免疫治疗潜在地诱导过敏原耐受。大多数 AR 病例对药物治疗反应相当满意。VAS(视觉模拟量表)是一种非常有用的工具,特别是在日常临床实践中推荐使用,它可以帮助评估 AR 症状的强度以及选择最佳治疗方案。这种疾病的药物治疗应该是安全的;有效且易于管理,因为我们治疗的是慢性疾病患者,有时需要长期治疗。AR 最常用的治疗方法包括口服、鼻内或眼部抗组胺药、鼻内皮质类固醇或鼻内抗组胺药和皮质类固醇的联合治疗。根据实际临床经验,可以得出结论,鼻内皮质类固醇和鼻内抗组胺药的固定组合(主要是 MP-AzeFlu)可能被认为是最有益的,特别是在单药治疗和对先前治疗有抵抗的 AR 中。当疾病仅部分得到控制时,一些 AR 患者对提供的治疗结果不满意。我们仍然有未满足的患者需求,我们仍在该领域寻找更好的治疗选择。新的倡议,如 EUFOREA,与现有的倡议(如 ARIA)并行发展,将患者和医疗保健专业人员纳入治疗过程,并制定最接近精准医学理念的新建议,即在正确的时间为正确的患者提供正确的治疗。