A novel and effective approach to treating rhinitis with nasal antihistamines.
OBJECTIVE
To review existing treatments for rhinitis and summarize data available on the use of a nasal antihistamine (azelastine) in treating allergic and nonallergic vasomotor rhinitis.


METHODS
Relevant articles and references published between 1995 and 2007 regarding the treatment of allergic and vasomotor rhinitis were identified from PubMed, review articles, meta-analyses, and practice guidelines.


METHODS
All key relevant articles were reviewed and the most relevant selected for inclusion in this review.


RESULTS
The efficacy and safety of azelastine nasal spray in treating allergic rhinitis and vasomotor rhinitis have been determined in a number of U.S. multicenter, randomized, double-blind, placebo-controlled trials. In all trials, azelastine was associated with a rapid onset of action and a sustained improvement over time in rhinitis, congestion, and other symptoms. In patients with allergic rhinitis, the combination of azelastine and nasal corticosteroids increased treatment efficacy by more than 40% compared with either product alone.


CONCLUSIONS
Intranasal antihistamine therapy represents an effective mode of drug delivery in patients with allergic and nonallergic vasomotor rhinitis and is an important option for rhinitis therapy, particularly if rapid symptom relief is required or if congestion is a major symptom. Use of azelastine plus nasal corticosteroids is effective in both allergic rhinitis and vasomotor rhinitis, suggesting that this combination represents an effective treatment strategy for all patients with either allergic or nonallergic vasomotor rhinitis.
Institute for Asthma and Allergy, Wheaton, Maryland 20902, USA. makaliner@aol.com
Michael A
MA
Kaliner
D000281:Administration, Intranasal; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D039563:Histamine H1 Antagonists, Non-Sedating / Q000008:administration & dosage*; D006801:Humans; D010793:Phthalazines / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D012220:Rhinitis / Q000188:drug therapy*
D000305:Adrenal Cortex Hormones; D039563:Histamine H1 Antagonists, Non-Sedating; D010793:Phthalazines; C020976:azelastine