Sophia Linton, Alyssa G. Burrows, Lubnaa Hossenbaccus, Anne K. Ellis

Ann Allergy Asthma Immunol . 2021 May 7;S1081-1206(21)00337-9. doi: 10.1016/j.anai.2021.04.029. Online ahead of print.

Allergic rhinitis is a chronic inflammatory condition that affects up to 30% of people in America. Immunoglobulin E-mediated hypersensitivity responses to allergens cause it. This review aimed to provide a complete, clinical assessment of therapeutic agents and practices to manage allergic rhinitis.

A systematic review of the literature was completed using PubMed, published abstracts and virtual presentations, and results published on clinicaltrials.gov. Manuscripts with trial results, case reports, case series, and clinical trial data were selected.

Social media, telemedicine, and mHealth demonstrated useful tools for integrated care for allergic rhinitis management, as they can connect allergologists and their patients. A multidisciplinary approach is positive for optimal control of allergic rhinitis. Pharmacotherapy is the standard of care for the management of allergic rhinitis (azelastine hydrochloride and fluticasone propionate, or a combination of both) and represents the future of allergic rhinitis care. Intralymphatic immunotherapy (ILIT) and peptide immunotherapy (PIT) are the most promising new allergen immunotherapy options, with better time and cost-effectiveness than subcutaneous immunotherapy and sublingual immunotherapy, with studies demonstrating positive results. Studies of targeted biologics for allergic rhinitis are ongoing.

Probiotics, in particular, Bifidobacterium spp may be beneficial for allergic rhinitis management and as an add-on to allergen immunotherapy (AIT).

In conclusion, being a chronic and often comorbid condition, allergic rhinitis requires integrated care for optimal management. New formulations and combinations of existing treatments are the most promising and deserve future research.

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