Rethinking our approach to allergic rhinitis management.
OBJECTIVE
This article reviews the recommendations by the World Health Organization's new guidelines, "Allergic Rhinitis and Its Impact on Asthma" (ARIA), and the paradigm for treating allergic rhinitis based on disease classification. After reading this article, readers should understand the ARIA guidelines and the salient issues involving the challenges inherent in the management of allergic rhinitis.


METHODS
Relevant and appropriately controlled clinical studies and results of patient surveys were used. Only literature in the English language was reviewed.


METHODS
Material was taken from academic/scholarly journals, published abstracts, and presentations at a major congress.


RESULTS
The ARIA guidelines' new classification categorizes patients' allergic rhinitis as either intermittent or persistent with gradations from mild to moderate-severe. These guidelines propose a stepwise approach to management guided by symptom severity and evaluation of treatment response, with the underlying concept for treatment being to select therapies that address individual patients' symptoms. Although few data were available at the time of their inception, the guidelines recognize that antileukotriene medications may play an important role in the treatment of allergic rhinitis. Results of recent clinical trials support the use of antileukotriene medications in allergic rhinitis, alone or concomitantly with an antihistamine.


CONCLUSIONS
Targeting specific and multiple mechanisms of allergic rhinitis and individualizing all available and effective treatments to each patient, with specific medications for specific symptoms, will be of particular benefit to patients with allergic rhinitis.
Storms
William W
WW
University of Colorado Health Sciences Center, Colorado Springs, USA. sneezedoc@aol.com
D000328:Adult; D002648:Child; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D012221:Rhinitis, Allergic, Perennial / Q000145:classification / Q000188:drug therapy / Q000628:therapy*; D014944:World Health Organization
D006634:Histamine H1 Antagonists; D020024:Leukotriene Antagonists