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Improvement and prevention of asthma with concomitant treatment of allergic rhinitis and allergen‐specific therapy
Author(s) -
Mener David J.,
Lin Sandra Y.
Publication year - 2015
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21569
Subject(s) - medicine , asthma , concomitant , allergen immunotherapy , pharmacotherapy , allergy , antihistamine , allergen , randomized controlled trial , nasal administration , immunology
Background Asthma and allergic rhinitis are 2 of the most prevalent chronic medical diseases. Asthma is estimated to affect 8% of adults and 9% of children, with nearly 300 million people affected worldwide. Poorly controlled allergic rhinitis may be associated with worsening asthma symptoms over time. Various treatments have been proposed in the improvement and prevention of asthma in children and adults with allergic symptoms, which have included pharmacotherapy with antihistamines and topical intranasal corticosteroids, as well as allergen‐specific immunotherapy. Methods Articles were selected through PubMed and personal knowledge of the authors based on a comprehensive literature review examining whether treatment of allergic rhinitis improves and/or prevents concomitant symptoms of asthma. The largest and highest‐quality studies were included in the literature review. The search selection was not standardized. Articles written in a language other than English were excluded. Results Clinical trials have showed improvement in asthma symptoms with concomitant treatment of allergic rhinitis with antihistamines and topical intranasal corticosteroids, though improvement in objective pulmonary function parameters has not been uniformly demonstrated with antihistamine use alone. There is very strong evidence to suggest that subcutaneous and sublingual immunotherapy may in addition prevent the progression of asthma in high‐risk atopic patients by inducing immunological tolerance. Conclusion Traditional pharmacotherapy with antihistamines and topical intranasal steroids has been shown to improve allergic rhinitis symptoms with concomitant allergic asthma; however, only allergen‐specific immunotherapy offers long‐term control in improving asthma symptoms, exacerbations, and likely ultimate prevention in developing asthma.