Evidence-based strategies for treatment of allergic rhinitis.
In this review, an evidence-based medicine approach to diagnosis and treatment for allergic rhinitis is reviewed. We performed a search of the medical literature for randomized, placebo-controlled trials of nonsedating antihistamines, intranasal corticosteroids, montelukast, azelastine, allergen immunotherapy, and anti-IgE. The mean numbers needed to treat were: nonsedating antihistamines--15.2; nasal corticosteroids--4.4; montelukast--14.3; azelastine--5.0; allergen immunotherapy--4.6; and anti-IgE--12.4. Treatment thresholds for use were: antihistamines--23%; nasal corticosteroids--8%; azelastine--16%; montelukast--8%; anti-IgE--50%; and immunotherapy--25%. When used appropriately, this information could become very useful for clinicians, particularly if cost, convenience, and other indirect factors can be included.
Section of Allergy, Asthma, and Immunology, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA. jportnoy@cmh.edu
Jay M
JM
Portnoy
Tom
T
Van Osdol
P Brock
PB
Williams
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control
D000305:Adrenal Cortex Hormones; D006634:Histamine H1 Antagonists