title: Combination therapy in allergic rhinitis: What works and what does not work.
abstract: Allergic rhinitis and other rhinitis subtypes are increasingly becoming some of the most prevalent and expensive medical conditions that affect the U.S.
  
  
  METHODS
  Both direct health care costs and indirect costs significantly impact the health care system due to delays in diagnosis, lack of treatment, ineffective treatment, poor medication adherence, and associated comorbidities. Many patients who have AR turn to over-the-counter medications for relief but often find themselves dissatisfied with the results. Determining the correct diagnosis, followed by initiation of the most-effective treatment(s), is essential to provide patients with better symptomatic management and quality of life. Although there are many options, currently available combination therapies, e.g., azelastine with fluticasone and intranasal corticosteroids with nasal decongestants, offer distinct advantages for the management of complex rhinitis phenotypes. Further research is required to investigate the pathomechanisms and biomarkers for mixed rhinitis and nonallergic vasomotor rhinitis subtypes that will lead to novel targeted therapies for these conditions.
authors.affiliation: Bernstein Allergy Group, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA.
authors.forename: Justin C
authors.initials: JC
authors.lastname: Greiwe
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Bernstein
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D055118:Medication Adherence; D014663:Nasal Decongestants / Q000627:therapeutic use*; D065631:Rhinitis, Allergic / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome; D014481:United States
chemical_list: D000305:Adrenal Cortex Hormones; D006633:Histamine Antagonists; D014663:Nasal Decongestants