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.
Portnoy
Jay M
JM
Section of Allergy, Asthma, and Immunology, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA. jportnoy@cmh.edu
Van Osdol
Tom
T
Williams
P Brock
PB
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