title: Escaping the trap of allergic rhinitis.
abstract: Rhinitis is often the first symptom of allergy but is frequently ignored and classified as a nuisance condition. Ironically it has the greatest socioeconomic burden worldwide caused by its impact on work and on daily life. However, patients appear reticent to seek professional advice, visiting their doctor only when symptoms become 'intolerable' and often when their usual therapy proves ineffective. Clearly, it's time for new and more effective allergic rhinitis treatments. MP29-02 (Dymista®; Meda, Solna, Sweden) is a new class of medication for moderate to severe seasonal and perennial allergic rhinitis if monotherapy with either intranasal antihistamine or intranasal corticosteroids is not considered sufficient. MP29-02 is a novel formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP). It benefits not only from the incorporation of two active agents, but also from a novel formulation; its lower viscosity, smaller droplet size, larger volume (137 μl) and wider spray angle ensure optimal coverage of, and retention on the nasal mucosa and contribute to its clinical efficacy. In clinical trials, patients treated with MP29-02 experienced twice the symptom relief as those treated with FP and AZE, who in turn exhibited significantly greater symptom relief than placebo-patients. Indeed, the advantage of MP29-02 over FP was approximately the same as that shown for FP over placebo. The advantage of MP29-02 was particularly evident in those patients for whom nasal congestion is predominant, with MP29-02 providing three times the nasal congestion relief of FP (p = 0.0018) and five times the relief of AZE (p = 0.0001). Moreover, patients treated with MP29-02 achieved each and every response up to a week faster than those treated with FP or AZE alone and in real life 1 in 2 patients reported the perception of well-controlled disease after only 3 days. MP29-02's superiority over FP was also apparent long-term in patients with perennial allergic rhinitis or non-allergic rhinitis, with statistical significance noted from the first day of treatment, with treatment difference maintained for a full year. Taken together, these data suggest that MP29-02 may improve the lives of many of our patients, enabling them to finally escape the allergic rhinitis trap.
authors.affiliation: Allergy Unit, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 1, 50129 Firenze, Italy.
authors.forename: Oliviero
authors.initials: O
authors.lastname: Rossi
authors.affiliation: Denothe Center, University of Florence, Firenze, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Massaro
authors.affiliation: Allergy Unit, Verona University and General Hospital, Verona, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Caminati
authors.affiliation: Allergy Unit, Melegnano Hospital, Melegnano (Milano), Italy and Clinical Pedagogical Laboratory and Biomedical Research, Pediatric Hospital, Brescia, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Quecchia
authors.affiliation: Medicine Unit, ASL 3 Pistoia, Pistoia, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Fassio
authors.affiliation: Respiratory Medicine and Allergy - Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Heffler
authors.affiliation: Respiratory Diseases & Allergy Clinic, DIMI-Department Internal Medicine, Respiratory Diseases and Allergy Clinic, University of Genoa, IRCCS AOU S. Martino Genoa, Genoa, Italy.
authors.forename: Giorgio Walter
authors.initials: GW
authors.lastname: Canonica
keywords: Allergic rhinitis; Intranasal antihistamines; Intranasal corticosteroids; Therapy