November 30, 2017:
New Clinical Guidelines from the US on allergic rhinitis (hay fever) treatment were published this week (28 November 2017) in the Annals of Internal Medicine http://annals.org/aim
The Guidelines were developed by representatives of the American Academy of Allergy, Asthma and Immunology (AAAAI) and the American College of Allergy, Asthma and Immunology (ACAAI). Their recommendations for initial treatment of seasonal allergic rhinitis emphasise the use of an intranasal corticosteroid rather than an intranasal corticosteroid in combination with an oral antihistamine.
The Australasian Society of Clinical Immunology and Allergy (ASCIA) website includes the following information for patients, consumers and carers about allergic rhinitis medication options:
- Intranasal corticosteroid nasal sprays (INCS) have a potent action on inflammation when used regularly (like asthma preventer medications). These need to be used regularly and with careful attention to the way in which they are used. Different brands of INCS vary in strength and effectiveness, so it is important to read the labels and check details with your doctor or pharmacist.
- Combination medications containing an antihistamine and intranasal corticosteroid nasal spray are available and offer the combined advantages of both medications.
- Antihistamine tablets, syrups, intranasal sprays and eye drops (non-sedating) help to reduce symptoms (sneezing, itchy and irritating eyes), but they are not as effective in controlling severe nasal blockage and dribble. The advantage of antihistamines is their flexibility; you can take them when you have problems, and avoid them when you are well. Antihistamine eye drops can be helpful in controlling watery eyes due to allergies.
In addition, the ASCIA allergic rhinitis clinical update for health professionals includes the following key points:
- Intranasal corticosteroids sprays or combined intranasal/antihistamine sprays are recommended preventer treatments.
- Patients should be instructed on the correct and consistent use of intranasal sprays - see ASCIA Treatment Plan for Allergic Rhinitis:
- Effective treatment of allergic rhinitis is important in management of asthma.
- If patients are allergic to pollen, recommend staying indoors during thunderstorms in pollen seasons and use preventer treatments.
- Referral to a specialist should be considered when severe or inadequately controlled allergic rhinitis persists and consideration is being made for allergen immunotherapy.
- Allergen immunotherapy is effective in reducing the frequency and severity of symptoms of allergic rhinitis.
For further information from the ASCIA website go to:
https://etrainingpharm.ascia.org.au/ - e-training for pharmacists accredited by the APC
https://allergicrhinitis.ascia.org.au/ - e-training for other health professionals
For recent media reports on this topic go to:
www.abc.net.au/radio/adelaide/programs/afternoons/afternoons/9178180 the radio interview with the ASCIA President Dr William Smith starts at 1:42:50 and ends at 1:54:30