The complex pathophysiology of allergic rhinitis: scientific rationale for the development of an alternative treatment option

被引:58
作者
Bjermer, Leif [1 ]
Westman, Marit [2 ,3 ]
Holmstrom, Mats [4 ]
Wickman, Magnus C. [5 ,6 ]
机构
[1] Skane Univ Hosp, Dept Resp Med & Allergol, S-22185 Lund, Sweden
[2] Karolinska Univ Hosp, Dept ENT Dis, S-17176 Stockholm, Sweden
[3] Karolinska Inst, Dept Med Solna, Immunol & Allergy Unit, S-17177 Stockholm, Sweden
[4] Karolinska Inst, Div Ear Nose & Throat Dis, Dept Clin Sci Intervent & Technol, S-17177 Stockholm, Sweden
[5] Karolinska Inst, Dept Environm Med, S-17177 Stockholm, Sweden
[6] Sachs Childrens Hosp, S-11883 Stockholm, Sweden
关键词
Allergic rhinitis; Azelastine; Fluticasone; MP-AzeFlu; AQUEOUS NASAL SPRAY; INTRANASAL FLUTICASONE PROPIONATE; QUALITY-OF-LIFE; PLACEBO-CONTROLLED TRIAL; KAPPA-B ACTIVATION; ADVANCED DELIVERY-SYSTEM; VISUAL ANALOG SCALE; CULTURED MAST-CELLS; AZELASTINE HYDROCHLORIDE; OCULAR SYMPTOMS;
D O I
10.1186/s13223-018-0314-1
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Allergic rhinitis (AR) poses a global health problem and can be challenging to treat. Many of the current symptomatic treatments for AR have been available for decades, yet there has been little improvement in patient quality of life or symptom burden over the years. In this review, we ask why this might be and explore the pathophysiological gaps that exist within the various AR treatment classes. We focus on the benefits and drawbacks of different treatment options and delivery routes for AR treatments and consider how, given what is known about AR pathophysiology and symptomatology, patients may be offered more effective treatment options for rapid, effective, and sustained AR control. In particular, we consider how a new AR preparation, MP-AzeFlu (Dymista (R), Meda, Sweden), comprising a formulation of an intranasal antihistamine (azelastine hydrochloride), an intranasal corticosteroid (fluticasone propionate), and excipients delivered in a single spray, may offer benefits over and above single and multiple AR therapy options. We review the evidence in support of this treatment across the spectrum of AR disease. The concept of AR control is also reviewed within the context of new European Union and Contre les Maladies Chroniques pour un VIeillissement Actif-Allergic Rhinitis and its Impact on Asthma initiatives.
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页数:15
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