Zhang Min, Ao Tian, Cheng Lei
Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated Hospital.
International Centre for Allergy Research, Nanjing Medical University, Nanjing, China.
Curr Opin Allergy Clin Immunol. 2023 Aug 1;23(4):334-340. doi: 10.1097/ACI.0000000000000921. Epub 2023 Jun 20.
This review aimed to introduce the pharmacotherapy of allergic rhinitis according to the 2022 updated Chinese guidelines.
Despite recent advances in basic and clinical research worldwide, pharmacotherapy remains a mainstream in allergic rhinitis treatment. Usually, the first-line drugs, involving intranasal corticosteroids, second-generation oral and intranasal H1-antihistamines, or leukotriene receptor antagonists, can achieve acceptable outcomes in the treatment of allergic rhinitis. The second-line drugs, such as oral corticosteroids, intranasal decongestants and intranasal anticholinergics, can assist in controlling severe symptoms, like nasal congestion/blockage and watery rhinorrhea. For those with moderate-to-severe allergic rhinitis, evidence-based stepwise strategies are suitable, in which the types and dosages of drugs are de-escalated or upgraded according to their therapeutic efficacy. Meanwhile, omalizumab, a novel biological agent, has burgeoned to satisfy the need of patients.
This review highlights the staples in Chinese guidelines about the pharmacotherapy for allergic rhinitis to better understand the guidelines and promote the clinical practice.
本综述旨在根据2022年更新的中国指南介绍变应性鼻炎的药物治疗。
尽管全球基础和临床研究取得了最新进展,但药物治疗仍然是变应性鼻炎治疗的主流。通常,一线药物,包括鼻用糖皮质激素、第二代口服和鼻用H1抗组胺药或白三烯受体拮抗剂,在变应性鼻炎治疗中可取得可接受的效果。二线药物,如口服糖皮质激素、鼻用减充血剂和鼻用抗胆碱能药物,可辅助控制严重症状,如鼻充血/鼻塞和水样鼻漏。对于中重度变应性鼻炎患者,基于证据的逐步治疗策略是合适的,其中药物的类型和剂量根据治疗效果进行递减或递增。同时,新型生物制剂奥马珠单抗迅速发展以满足患者需求。
本综述强调了中国变应性鼻炎药物治疗指南中的要点,以更好地理解指南并促进临床实践。