Bilastina

Allergic rhinitis is a very common condition, affecting approximately 113 million in Europe and 30 to 60 million in the United States. Allergic rhinitis treatment is usually symptomatic, nevertheless it has both high economic burden and impact in the quality of life of patients.

Allergen immunotherapy (AIT) is a well-established and proven effective treatment of allergic rhinitis because it treats its symptoms but also the underlying cause of allergic rhinitis by stimulating immunologic changes that produce long-term allergen-specific tolerance.

The investigator produced a literature review on AIT and concluded that besides reducing symptoms, it improves overall quality of life of patients with allergic rhinitis. The 2 most commonly prescribed AIT routes are SCIT (subcutaneous immunotherapy) and SLIT (sublingual immunotherapy), which have comparable efficacy. The safety profile of SLIT is superior to SCIT, but both have been shown to have poor adherence in real-life studies. AIT has shown to prevent the progression of allergic rhinitis to asthma and may provide long-term clinical benefits after discontinuation of medications, which can translate into cost savings, when compared to standard treatment. However, more research is needed.

Allergic rhinitis is characterized by symptoms of sneezing, rhinorrhea, nasal obstruction, and pruritus caused by inhaled allergens and involving mucosal inflammation. Allergic rhinitis is a disease with high prevalence all over the world.

This review aimed at highlighting recent developments in the etiology and management of allergic rhinitis.

Exposure of atopic individuals to external environmental factors such as ambient air pollutants, aeroallergens and climate play a crucial role in the pathogenesis of allergic rhinitis. When the nasal mucosa is exposed to inciting allergens such as pollen and dust mites, innate and adaptive immune cells are involved in the pathophysiologic mechanism of allergic rhinitis, which induce specific immunoglobulin E (IgE) production, activation of eosinophils, and degranulation of mast cells and basophils, with the consequent clinical symptoms.

At a cellular and molecular mechanism, several studies reported the role of IL-17 in allergic rhinitis. Serum IL-17 levels are significantly associated with allergy severity during the pollen season and are considered a marker of allergy severity in allergic rhinitis patients.

Current treatment options include patient education, irritant and allergen avoidance measures, pharmacotherapy, allergen immunotherapy, nasal irrigation and other less common measures such as acupuncture and surgery. Recent studies have strengthened the evidence base for the treatment of all aspect of allergic rhinitis.

Allergic rhinitis impacts negatively the quality of life and occupational activities of patients.

A 10-year duration cross-sectional study evaluated the quality of life and work productivity of patients diagnosed with allergic occupational rhinitis. Quality of Life was assessed by the Mini-RQLQ (rhinitis quality of life questionnaire) and work impairment was assessed by the Work Productivity and Activity Impairment questionnaire.

This study included 414 participants from both genders and with a mean age of 38 years old. Most of them were workers from the textile and clothing industry. Absenteeism was not relevant, however participants experienced activity limitations and practical problems, reducing productivity and quality of life.