October 2021

Allergic rhinitis incidence has been growing in the past years, representing a medical and economic burden worldwide. This review describes the main findings with regards to allergic rhinitis for the past two years, including risk factors for the growing prevalence of allergic rhinitis, its strategy for the diagnosis, immunological mechanisms underlying the condition, and therapies used during the COVID-19 pandemic. It also aims at describing future perspectives.

Some of the most critical risk factors for allergic rhinitis are environmental exposures, climate changes, and lifestyle. There is an essential need to understand the connection between environmental exposures and health to design risk profiles instead of using single predictors and help eliminate adverse health outcomes in these conditions.

A newly defined allergic rhinitis phenotype, dual allergic rhinitis, includes perennial and seasonal related nasal symptoms but is more connected to seasonal allergic allergens. This indicates that it is crucial to assess inflammation at the local sites.

The authors suggest a combination of precise diagnosis in local sites and territories and traditional diagnostic methods to improve the precision medicine-based approach to managing allergic rhinitis.

In conclusion, further understanding of changes in cell profiles after treatment is needed. Apart from the usual treatments for allergic rhinitis during the current pandemic, social distancing, washing hands, and disinfection are also great aids in managing patients with allergic rhinitis.

Allergic rhinitis impacts the quality of life of people who suffer from it, such as sleep impairment and reduction in work and school productivity. Current treatment options for seasonal and perennial allergic rhinitis include pharmacotherapy and immunotherapy. These meta-analysis aimed to assess the efficacy of pharmacotherapies and sublingual immunotherapy tablets (SLIT) versus placebo on people with nasal symptoms associated with both types of allergic rhinitis.

A systematic search identified randomized, double-blind, placebo-controlled trials with these comparisons. The primary outcome was the mean numerical difference in total nasal symptom score (TNSS) between active treatment and placebo at the end of the assessment timeline. A meta-analysis estimated the mean difference for each group of medication weighted by the inverse of the trial variance.

Most pharmacotherapy trials did not allow rescue symptom-relieving medicines but were allowed in sublingual immunotherapy tablets. The following table includes total nasal symptom scores for children and adults with allergic rhinitis.

In conclusion, all treatments significantly improved nasal symptoms when compared with placebo. SLIT-tablets improved TNSS, even using rescue symptom-relieving pharmacotherapy. However, since trials have considerable heterogeneity, it is difficult to compare treatment effects among treatment classes.