Background: Allergic diseases are on the rise in many parts of the world, including the Asia–Pacifc (APAC) region.
Second-generation antihistamines are the frst-line treatment option in the management of allergic rhinitis and urticaria. International guidelines describe the management of these conditions; however, clinicians perceive the additional need to tailor treatment according to patient profles. This study serves as a consensus of experts from several countries in APAC (Hong Kong, Malaysia, the Philippines, Singapore, Thailand, Vietnam), which aims to describe the unmet needs, practical considerations, challenges, and key decision factors when determining optimal secondgeneration antihistamines for patients with allergic rhinitis and/or urticaria.
Methods: Specialists from allergology, dermatology, and otorhinolaryngology were surveyed on practical considerations and key decision points when treating patients with allergic rhinitis and/or urticaria.
Results: Clinicians felt the need for additional tools for diagnosis of these diseases and a single drug with all preferred features of an antihistamine. Challenges in treatment include lack of clinician and patient awareness and compliance, fnancial constraints, and treatment for special patient populations such as those with concomitant disease. Selection of optimal second-generation antihistamines depends on many factors, particularly drug safety and efcacy, impact on psychomotor abilities, and sedation. Country-specifc considerations include drug availability and cost-efectiveness. Survey results reveal bilastine as a preferred choice due to its high efcacy and safety, suitability for special patient populations, and the lack of sedative efects.
Conclusions: Compliance to the international guidelines is present among allergists, dermatologists and otorhinolaryngologists; however, this is lower amongst general practitioners (GPs). To increase awareness, allergy education programs targeted at GPs and patients may be benefcial. Updates to the existing international guidelines are suggested in APAC to refect appropriate management for diferent patient profles and varying symptoms of allergic rhinitis and urticaria.
Keywords: Allergic rhinitis, Antihistamines, Bilastine, Treatment algorithm, Urticaria.
Marysia Tiongco Recto, Ma. Teresita Gabriel, Kanokvalai Kulthanan, Pongsakorn Tantilipikorn, Derrick Chen‑Wee Aw, Tak Hong Lee, Ch’ng Chin Chwen, Somasundran Mutusamy, Nguyen Trong Hao, Vo Thanh Quang and Giorgio Walter Canonica
