Clinical use of oral antihistamines and intranasal corticosteroids in patients with allergic rhinitis

J Investig Allergol Clin Immunol. 2011;21(5):363-9.

Abstract

Background: Second-generation oral antihistamines (AH) and intranasal corticosteroids (ICS) are the most widely used drugs for allergic rhinitis (AR).

Objective: To obtain information on the preferences for and applications of these drugs under conditions of routine clinical practice.

Methods: We performed a multicenter multidisciplinary observational study. Participating physicians completed a questionnaire with information on preferences for and application of drugs for AR, patient characteristics, and physician/patient satisfaction with the treatment provided (visual analog scale).

Results: A total of 1008 physicians participated in the study (primary care physicians, 53%; ear, nose, and throat specialists, 28%; allergologists, 19%). Treatment preferences in AR were AH combined with ICS (7.68), AH (7.25), and ICS (6.94). AH and ICS were used continuously by 58% and 71% of patients, respectively. Physicians reported having a good knowledge of the Allergic Rhinitis and its Impact on Asthma guidelines (93%), and 90% claimed to follow the guidelines. A total of 4040 patients were recruited (52% females, mean [SD] age 34 [14] years). The findings for AR were as follows: mean (SD) duration, 9 (8) years; persistent AR, 52%; mild AR, 72%; moderate AR, 7%; and severe AR, 1%. Patients considered the disorder to be well controlled/almost controlled (79%). As for treatment, 77% followed the regimen recommended by the physician. Oral treatment (41%) and intranasal treatment (22%) were preferred, while 35% showed no preference for any given administration route. The treatments prescribed were AH combined with ICS (66%), AH (20%), ICS (11%), other antihistamines (4%), and other drugs (6%). Combination treatment was the preferred therapy, regardless of the type of rhinitis.

Conclusions: Physicians prefer and more often use combination treatment with oral AH and ICS, regardless of the frequency and intensity of AR.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Allergens / immunology*
  • Histamine Antagonists / therapeutic use
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Patient Preference
  • Patient Satisfaction
  • Poaceae
  • Pollen / immunology*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prescriptions / statistics & numerical data*
  • Rhinitis, Allergic, Seasonal / drug therapy
  • Rhinitis, Allergic, Seasonal / epidemiology*
  • Spain
  • Surveys and Questionnaires

Substances

  • Adrenal Cortex Hormones
  • Allergens
  • Histamine Antagonists