title: Recommendations for the pharmacologic management of allergic rhinitis.
abstract: Allergic rhinitis (AR) affects at least 60 million people in the United States each year, resulting in a major impact on patient quality of life, productivity, and direct and indirect costs. As new therapies, data, and literature emerge in the management of AR, there is a need to communicate and disseminate important information to health care professionals to advance the practice of medicine and lessen the disease burden from AR. Treatment recommendations for AR have not been updated since the 2012 Food and Drug Administration approval of nonaqueous intranasal aerosol agents using hydrofluoroalkane propellants and the first aqueous intranasal combination product. Here, we present an updated algorithm for the pharmacologic treatment of AR that includes these new treatment options. Treatment recommendations are categorized by disease severity (mild versus moderate/severe) and duration of symptoms (episodic versus nonepisodic, with episodic defined as <3 days/wk or for <3 weeks). Preferred treatments are suggested, as well as alternative options for consideration by clinicians in the context of individual patient needs. This recommendation article also outlines the importance of treatment monitoring, which can be conducted using the recently developed Rhinitis Control Assessment Test. Successful therapeutic outcomes depend on multiple factors, including use of the most effective pharmacologic agents as well as patient adherence to therapy. Therefore, it is imperative that rhinitis patients not only receive the most effective therapeutic options, but that they also understand and are able to adhere to the comprehensive treatment regimen. Successful treatment, with all of these considerations in mind, results in better disease outcomes, improved quality of life for patients, and greater economic productivity in the home and workplace.
authors.forename: Flavia C L
authors.initials: FC
authors.lastname: Hoyte
authors.forename: Eli O
authors.initials: EO
authors.lastname: Meltzer
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Ostrom
authors.forename: Harold S
authors.initials: HS
authors.lastname: Nelson
authors.forename: Greg W
authors.initials: GW
authors.lastname: Bensch
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Spangler
authors.forename: William W
authors.initials: WW
authors.lastname: Storms
authors.forename: Steven F
authors.initials: SF
authors.lastname: Weinstein
authors.forename: Rohit K
authors.initials: RK
authors.lastname: Katial
mesh_terms: D000465:Algorithms; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017281:Cost of Illness; D006801:Humans; D055118:Medication Adherence; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D065631:Rhinitis, Allergic / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics
chemical_list: D018926:Anti-Allergic Agents