title: Emerging drugs for the treatment of perennial allergic rhinitis.
abstract: BACKGROUND
  Allergic rhinitis is a worldwide health problem, currently affecting up to 40% of the general population, and characterized by the following symptoms in a variable degree of severity and duration: nasal congestion/obstruction, rhinorrhea, itchy nose and/or eyes, and/or sneezing. General symptoms like fatigue, reduced quality of sleep, impaired concentration and reduced productivity, if left untreated, may significantly affect quality of life. In addition, of being associated to various comorbidities, allergic rhinitis is also an independent risk factor for the development and worsening of asthma. Perennial allergic rhinitis is caused by allergens present around the year.
  
  
  METHODS
  Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines currently recommend a stepwise therapeutic approach that combines patient education with specific allergen avoidance, symptomatic pharmacotherapy and allergen immunotherapy. The available treatment strategies provide suboptimal symptom relief in patients with moderate-to-severe disease who continue to experience symptoms while treated, even on multiple therapies.
  
  
  CONCLUSIONS
  New insights into current therapy have been provided with the development of new symptomatic drugs with improved pharmacokinetics and safety. However, the ultimate research goal is beyond symptomatic treatment, and is mainly directed at modifying the immune response to allergens and prevent the progression of allergic rhinitis towards asthma. In this direction, promising advances are expected in the fields of allergen immunotherapy and biological drugs, such as omalizumab. Finally, significant research efforts are also focused on the growing number of new specific molecular targets involved in the Th2 pathway inflammation of allergic diseases.
authors.affiliation: a Department of Pediatrics, Foundation IRCCS Policlinico San Matteo , University of Pavia , Pavia , Italy.
authors.forename: Amelia
authors.initials: A
authors.lastname: Licari
authors.affiliation: a Department of Pediatrics, Foundation IRCCS Policlinico San Matteo , University of Pavia , Pavia , Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Castagnoli
authors.affiliation: a Department of Pediatrics, Foundation IRCCS Policlinico San Matteo , University of Pavia , Pavia , Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Bottino
authors.affiliation: a Department of Pediatrics, Foundation IRCCS Policlinico San Matteo , University of Pavia , Pavia , Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Marseglia
authors.affiliation: a Department of Pediatrics, Foundation IRCCS Policlinico San Matteo , University of Pavia , Pavia , Italy.
authors.forename: GianLuigi
authors.initials: G
authors.lastname: Marseglia
authors.affiliation: b Department of Medicine , IRCCS-A.O.U. San Martino di Genova , Genoa , Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
mesh_terms: D000485:Allergens / Q000276:immunology; D000818:Animals; D018926:Anti-Allergic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D003888:Desensitization, Immunologic / Q000379:methods; D015195:Drug Design; D006801:Humans; D058990:Molecular Targeted Therapy; D000069444:Omalizumab / Q000494:pharmacology / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000276:immunology
chemical_list: D000485:Allergens; D018926:Anti-Allergic Agents; D000069444:Omalizumab
keywords: H1-antihistamines; Th2 inflammation; allergen immunotherapy; intranasal steroids; omalizumab; perennial allergic rhinitis