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Monthly Archives

October 2021

Allergic rhinitis and COVID-19: friends or foes?

By Artículos seleccionados, Selected articles

F Gani

Eur Ann Allergy Clin Immunol . 2021 Sep 10. doi: 10.23822/EurAnnACI.1764-1489.234. Online ahead of print.

Allergic rhinitis is a usual condition that affects around 40% of the world population. During the COVID-19 pandemic, there was an increase in observational studies on the effect of asthma and chronic obstructive pulmonary disease and the risk of developing COVID-19. Still, there were no studies on allergic rhinitis and COVID-19.

This review aimed at assessing the risk of patients with allergic rhinitis developing worse COVID-19 outcomes. It also evaluated if COVID-19 can influence allergic rhinitis symptoms and influence the psychological conditions of pediatric and adult patients with allergic rhinitis.

The authors performed a comprehensive review of the literature. It included a set of different keywords, such as allergic rhinitis, rhinitis, allergy, atopy, COVID-19, and SARS-CoV-2.

From the articles selected, allergic rhinitis patients, appear to be protected from COVID-19 infection. However, there is not enough data on the influence of allergic rhinitis and the severity of COVID-19 disease; there is some information that being an allergic rhinitis patient does not increase the risk of a poor prognosis SARS-CoV-2 infection. The authors suggest that patients with allergic rhinitis follow their treatment accordingly, especially while the COVID-19 pandemic persists.

This document is only available for registered healthcare professionals


Advances and highlights in allergic rhinitis

By Artículos seleccionados, Selected articles

Yuan Zhang, Feng Lan, Luo Zhang

Allergy . 2021 Aug 11. doi: 10.1111/all.15044. Online ahead of print.

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.

This document is only available for registered healthcare professionals


Association of severity of allergic rhinitis with neutrophil-to-lymphocyte, eosinophil-to-neutrophil, and eosinophil-to-lymphocyte ratios in adults

By Artículos seleccionados, Selected articles

Aydin Kant, Kadriye Terzioğlu

Allergol Immunopathol (Madr). 2021 Sep 1;49(5):94-99. doi: 10.15586/aei.v49i5.204. eCollection 2021.

Allergic rhinitis is an immunoglobulin E-mediated disorder of the nasal mucosa, with symptoms such as recurrent sneezing, rhinorrhea, and nasal congestion. People with allergic rhinitis suffer from sleep disturbances, emotional distress, and impaired social activity, which results in a reduced quality of life. This study aimed to assess the practicality of inflammatory parameters of neutrophil-to-lymphocyte ratio (NLR), eosinophil-to-neutrophil ratio (ENR), and eosinophil-to-lymphocyte ratio (ELR) as markers used to distinguish between intermittent and persistent allergic rhinitis.

This double-center, retrospective study included 205 patients with allergic rhinitis and 49 healthy individuals who acted as a control group. Patients with active infection were excluded. NLR, ENR, and ELR were calculated using the results from the participants’ complete blood count. A statistical analysis was also performed.

The participants with allergic rhinitis had significantly higher levels of absolute eosinophils, ENR, and ELR, and also lower levels of NLR when compared to healthy controls. A total of 80% of participants with persistent allergic rhinitis had significantly higher levels of absolute eosinophils, ENR, and ELR and significantly lower levels of NLR than patients with intermittent allergic rhinitis.

In conclusion, allergic rhinitis severity is classified according to the patient’s anamnesis, with serum eosinophil levels and the proportions of ENR and ELR in patients with persistent allergic rhinitis, highlighting the severity of the disease.

This document is only available for registered healthcare professionals


Meta-analyses of the efficacy of pharmacotherapies and sublingual allergy immunotherapy tablets for allergic rhinitis in adults and children

By Artículos seleccionados, Selected articles

Eli O. Meltzer, Dana Wallace, Howard S. Friedman, Prakash Navaratnam, Erin P. Scott, Hendrik Nolte

Rhinology . 2021 Aug 31. doi: 10.4193/Rhin21.054. Online ahead of print.

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.


Seasonal allergic rhinitis TNSS mean numerical difference (95%CI) vs. placebo

Perennial allergic rhinitis TNSS mean numerical difference (95%CI) vs. placebo

Intranasal corticosteroids 1.38 (1.18-1.58) 0.82 (0.66-0.97)
Combination intranasal antihistamines+corticosteroids 1.34 (1.15-1.54)
Intranasal antihistamines 0.72 (0.56-0.89)
Oral antihistamine 0.62 (0.35-0.90) 0.27 (0.11-0.42)
SLIT tablets 0.57 (0.41-0.73) 0.65 (0.42-0.88)
Montelukast 0.48 (0,36-0,60)


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.

This document is only available for registered healthcare professionals


Bilastine 10 and 20 mg in paediatric and adult patients: an updated practical approach to treatment decisions

By Articles about Bilastine, Publicaciones sobre Bilastina

Amalia Leceta, Aintzane García, Ander Sologuren, Cristina Campo

Drugs Context . 2021 Aug 10;10:2021-5-1. doi: 10.7573/dic.2021-5-1. eCollection 2021

Bilastine is a non-drowsy H1-antihistamine for treating allergic conditions such as rhinoconjunctivitis and urticaria in people of all ages. This review aims to update a former article, focusing on recent clinical data on the use of bilastine in children and adults.

Data was collected from recent clinical studies in children and adults from Faes Farma. Most of the new information was updated on paediatric and elderly use. The European Medicines Agency approval took place in 2017 following a Paediatric Investigation Plan from 2009. Faes Farma received questions related to drug interactions involving bilastine and other concomitant medicines and the use of bilastine in special populations or for the treatment of specific conditions. The summarized advice from specialists consisted of interactions involving the cytochrome P450 isozyme system, leading to changes in drug exposure and, therefore, clinical efficacy and safety. Elderly patients are at particular risk of drug-drug interactions due to the number of concurrent medicines and comorbidities. Of importance are also potential drug-drug interactions between bilastine and drugs with a narrow therapeutic index.

In conclusion, although bilastine has a favorable pharmacokinetic profile, decisions on its use should rely on evidence, expert opinions, and the SmPC of bilastine. Nevertheless, further studies are needed to answer specific questions regarding its use.

This document is only available for registered healthcare professionals

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