The Journal of Allergy and Clinical Immunology
Volume 118, Issue 5 , Pages 985-996 , November 2006

Pharmacologic rationale for treating allergic and nonallergic rhinitis

  • Alexander N. Greiner, MD

      Affiliations

    • Corresponding Author InformationReprint requests: Alexander N. Greiner, MD, Allergy and Asthma Medical Group and Research Center, 9610 Granite Ridge Dr, Suite B, San Diego, CA 92123.
    • ,
  • Eli O. Meltzer, MD

Received 22 May 2006 ,Revised 8 June 2006 ,Accepted 13 June 2006.

References 

  1. Hansen B, Mygind N. How often do normal persons sneeze and blow the nose?. Rhinology. 2002;40:10–12
  2. Nathan RA, Meltzer EO, Selner JC, Storms W. The prevalence of allergic rhinitis in the United States. J Allergy Clin Immunol. 1997;99(suppl):S808–S812
  3. Wright AL, Holberg CJ, Martinez FD, Halonen M, Morgan W, Taussig LM. Epidemiology of physician-diagnosed allergic rhinitis in childhood. Pediatrics. 1994;94:895–901
  4. Settipane RA, Lieberman P. Update on nonallergic rhinitis. Ann Allergy Asthma Immunol. 2001;86:494–507
  5. Bousquet J, van Cauwenberge PB, Khaltaev N, Aria Workshop Group , World Health Organization . Allergic rhinitis and its impact on asthma. ARIA workshop report. J Allergy Clin Immunol. 2001;108(suppl):S147–S334
  6. Scadding GK. Non-allergic rhinitis: diagnosis and management. Curr Opin Allergy Clin Immunol. 2001;1:15–20
  7. Ciprandi G. Treatment of nonallergic perennial rhinitis. Allergy. 2004;59(suppl 76):16–22
  8. Lindberg S, Malam L. Comparison of allergic rhinitis and vasomotor rhinitis patients on the basis of a computer questionnaire. Allergy. 1993;48:602–607
  9. Togias A. Age relationships and clinical features of nonallergic rhinitis. J Allergy Clin Immunol. 1990;85:182
  10. Powe DG, Huskisson RS, Carney AS, Jenkins D, McEuen AR, Walls AF, et al. Mucosal T-cell phenotypes in persistent atopic and nonatopic rhinitis show an association with mast cells. Allergy. 2004;59:204–212
  11. Powe DG, Huskisson RS, Carney AS, Jenkins D, Jones NS. Evidence for an inflammatory pathophysiology in idiopathic rhinitis. Clin Exp Allergy. 2001;31:864–872
  12. Carney AS, Powe DG, Huskisson RS, Jones NS. Atypical nasal challenges in patients with idiopathic rhinitis: more evidence for the existence of allergy in the absence of atopy?. Clin Exp Allergy. 2002;32:1436–1440
  13. Coker HA, Durham SR, Gould HJ. Local somatic hypermutation and class switch recombination in the nasal mucosa of allergic rhinitis patients. J Immunol. 2003;171:5602–5610
  14. Smurthwaite L, Durham SR. Local IgE synthesis in allergic rhinitis and asthma. Curr Allergy Asthma Rep. 2002;2:231–238
  15. Cameron L, Gounni AS, Frenkiel S, Lavigne F, Vercelli D, Hamid Q. S epsilon S mu and S epsilon S gamma switch circles in human nasal mucosa following ex vivo allergen challenge: evidence for direct as well as sequential class switch recombination. J Immunol. 2003;171:3816–3822
  16. van Rijswijk JB, Blom HM, KleinJan A, Mulder PG, Rijntjes E, Fokkens WJ. Inflammatory cells seem not to be involved in idiopathic rhinitis. Rhinology. 2003;41:25–30
  17. Numata T, Konno A, Hasegawa S, Hanazawa T, Nagata H, Motosugi H, et al. Pathophysiological features of the nasal mucosa in patients with idiopathic rhinitis compared to allergic rhinitis. Int Arch Allergy Immunol. 1999;119:304–313
  18. Ayars GH, Altman LC, McManus MM, Agosti JM, Baker C, Luchtel DL, et al. Injurious effect of the eosinophil peroxide-hydrogen peroxide-halide system and major basic protein on human nasal epithelium in vitro. Am Rev Respir Dis. 1989;140:125–131
  19. Garay R. Mechanisms of vasomotor rhinitis. Allergy. 2004;59(suppl 76):4–9
  20. Cervin A, Onnerfalt J, Edvinsson L, Grundemar L. Functional effects of neuropeptide Y receptors on blood flow and nitric oxide levels in the human nose. Am J Respir Crit Care Med. 1999;160:1724–1728
  21. Togias A, Proud D, Kagey-Sobotka A, Lichtenstein LM, Naclerio RM. Cold dry air (CDA) and histamine (Hist) induce more potent responses in perennial rhinitis compared to normal individuals. J Allergy Clin Immunol. 1991;87:148
  22. Borum P. Nasal methacholine challenge. J Allergy Clin Immunol. 1979;63:253–257
  23. Luisi BF, Xu WX, Otwinoeski Z, Freedman LP, Yamamoto KR, Sigler PB. Crystallographic analysis of the interaction of the glucocorticoid receptor with DNA. Nature. 1991;352:497–505
  24. Diamond MI, Miner JN, Yoshinaga SK, Yamamoto KR. Transcription factors interactions: selectors of positive or negative regulation form a single DNA element. Science. 1990;249:1266–1272
  25. Meltzer EO. The pharmacological basis for the treatment of perennial allergic rhinitis and non-allergic rhinitis with topical corticosteroids. Allergy. 1997;52(suppl):33–40
  26. Corren J. Intranasal corticosteroids for allergic rhinitis: how do different agents compare?. J Allergy Clin Immunol. 1999;104(suppl):S144–S149
  27. Welsh PW, Stricker WE, Chu CP, Naessens JM, Reese ME, Reed CE, et al. Efficacy of beclomethasone nasal solution, flunisolide, and cromolyn in relieving symptoms of ragweed allergy. Mayo Clin Proc. 1987;62:125–134
  28. Holm AF, Fokkens WJ, Godthelp T, Mulder PG, Vroom TM, Rijntjes E. A 1-yr placebo-controlled study of intranasal fluticasone propionate aqueous nasal spray in patients with perennial allergic rhinitis: a safety and biopsy study. Clin Otolaryngol. 1998;23:69–73
  29. Minshall E, Ghaffar O, Cameron L, O'Brien F, Quinn H, Rowe-Jones J, et al. Assessment by nasal biopsy of long-term use of monetasone furoate nasal spray (Nasonex) in the treatment of perennial rhinitis. Otolaryngol Head Neck Surg. 1998;118:648–654
  30. Wilson AM, McFarlane LC, Lipworth BJ. Effect of repeated once daily dosing of three intranasal corticosteroids on basal and dynamic measurements of hypothalamic-pituitary-adrenal axis activity. J Allergy Clin Immunol. 1998;101:470–474
  31. Wilson AM, Sims EJ, McFarlane LC, Lipworth BJ. Effects of intranasal corticosteroids on adrenal, bone, and blood markers of systemic activity in allergic rhinitis. J Allergy Clin Immunol. 1998;102:598–604
  32. Suissa S, Baltzan M, Kremer R, Ernst P. Inhaled and nasal corticosteroid use and the risk of fracture. Am J Respir Crit Care Med. 2004;169:83–88
  33. Skoner DP, Rachelefsky GS, Meltzer EO, Chervinsky P, Morris RM, Seltzer JM, et al. Detection of growth suppression in children during treatment with intranasal beclomethasone dipropionate. Pediatrics. 2000;105:E23
  34. Schenkel EJ, Skoner DP, Bronsky EA, Miller SD, Pearlman DS, Rooklin A, et al. Absence of growth retardation in children with perennial allergic rhinitis after one year of treatment with mometasone furoate aqueous nasal spray. Pediatrics. 2000;105:E22
  35. Allen DB, Meltzer EO, Lemanske RF, Philpot EE, Faris MA, Kral KM, et al. No growth suppression in children treated with the maximum recommended dose of fluticasone propionate aqueous nasal spray for one year. Allergy Asthma Proc. 2002;23:407–413
  36. Murphy KR, Uryniak T, Simpson B, O'Dowd L. Recommended once-daily dose of budesonide aqueous nasal spray does not suppress growth velocity in pediatric patients with perennial allergic rhinitis. J Allergy Clin Immunol. 2004;113(suppl):S175
  37. American Academy of Allergy, Asthma and Immunology . The allergy report. Milwaukee (WI): American Academy of Allergy, Asthma and Immunology; 2000;
  38. Weiner JM, Abramson MJ, Puy RM. Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: sytematicreview of randomized controlled trials. BMJ. 1998;317:1624–1629
  39. Rinne J, Simola M, Malmberg H, Haahtela T. Early treatment of perennial rhinitis with budesonide or cetirizine and it effects on long-term outcome. J Allergy Clin Immunol. 2002;109:426–432
  40. Nathan RA, Yancey SW, Waitkus-Edwards K, Prillaman BA, Stauffer JL, Philpot E, et al. Fluticasone propionate nasal spray is superior to montelukast for allergic rhinitis while neither affects overall asthma control. Chest. 2005;128:1910–1920
  41. Ratner PH, Howland WC, Arastu R, Philpot EE, Klein KC, Baidoo CA, et al. Fluticasone propionate aqueous nasal spray provided significantly greater improvement in daytime and nighttime nasal symptoms of seasonal allergic rhinitis compared with montelukast. Ann Allergy Asthma Immunol. 2003;90:536–542
  42. Wilson AM, Orr LC, Sims EJ, Lipworth BJ. Effects of monotherapy with intra-nasal corticosteroids or combined oral histamine and leukotriene receptor antagonists in seasonal allergic rhinitis. Clin Exp Allergy. 2001;31:61–68
  43. Di Lorenzo G, Pacor ML, Pellitteri ME, Morici G, Di Gregoli A, Lo Bianco C, et al. Randomized placebo-controlled trial comparing fluticasone aqueous nasal spray in mono-therapy, fluticasone plus cetirizine, fluticasone plus montelukast and cetirizine plus montelukast for seasonal allergic rhinitis. Clin Exp Allergy. 2004;34:259–267
  44. Pullerits T, Praks L, Ristioja V, Lötvall J. Comparison of a nasal glucocorticoid, antileukotriene, and a combination of antileukotriene and antihistamine in the treatment of seasonal allergic rhinitis. J Allergy Clin Immunol. 2002;109:949–955
  45. Barnes ML, Ward JH, Fardon TC, Lipworth BJ. Effects of levocetirizine as add-on therapy to fluticasone in seasonal allergic rhinitis. Clin Exp Allergy. 2006;36:676–684
  46. Ratner PH, van Bavel JH, Martin BG, Hampel FC, Howland WC, Rogenes PR, et al. A comparison of the efficacy of fluticasone propionate aqueous nasal spray and loratadine, alone and in combination, for the treatment of seasonal allergic rhinitis. J Fam Pract. 1998;47:118–125
  47. Flonase [prescribing information]. Available at: http://www.flonase.com. Accessed May 17, 2006.
  48. Webb DR, Meltzer EO, Finn AF, Rickard KA, Pepsin PJ, Westlund R, et al. Intranasal fluticasone propionate is effective for perennial nonallergic rhinitis with or without eosinophilia. Ann Allergy Asthma Immunol. 2002;88:385–390
  49. Arikan OK, Koc C, Kendi T, Muluk NB, Ekici A. CT assessment of the effect of fluticasone propionate aqueous nasal spray treatment on lower turbinate hypertrophy due to vasomotor rhinitis. Acta Otolaryngol. 2006;126:37–42
  50. Lundblad L, Sipila P, Farstad T, Drozdziewicz D. Mometasone furoate nasal spray in the treatment of perennial non-allergic rhinitis: a nordic, multicenter, randomized, double-blind, placebo-controlled study. Acta Otolaryngol. 2001;121:505–509
  51. Van Cauwenberge P, Juniper EF. Comparison of the efficacy, safety and quality of life provided by fexofenadine hydrochloride 120 mg, loratadine 10 mg and placebo administered once daily for the treatment of seasonal allergic rhinitis. Clin Exp Allergy. 2000;30:891–899
  52. Simons FER, Simons KJ. Clinical pharmacology of H1-antihistamines. In:  Simons FER editors. Histamine and H1-anti histamines in allergic disease. 2nd ed.. New York: Marcel Dekker; 2002;p. 141–178
  53. Simons FER. Advances in H1-antihistamines. N Engl J Med. 2004;351:2203–2217
  54. Abdelaziz MM, Devalia JL, Khair OA, Bayram H, Prior AJ, Davies RJ. Effect of fexofenadine on eosinophil-induced changes in epithelial permeability and cytokine release from nasal epithelial cells of patients with seasonal allergic rhinitis. J Allergy Clin Immunol. 1998;101:410–420
  55. Geha RS, Meltzer EO. Desloratadine: a new, nonsedating, oral antihistamine. J Allergy Clin Immunol. 2001;107:751–762
  56. Albanesi C, Pastore S, Fanales-Belasio E, Girolomoni G. Cetirizine and hydrocortisone differentially regulate ICAM-1 expression and chemokine release in cultured human keratinocytes. Clin Exp Allergy. 1998;28:101–109
  57. Passalacqua G, Scordamaglia A, Ruffoni S, Parodi MN, Canonica GW. Sedation from H1 antagonists: evaluation methods and experimental results. Allergol Immunopathol. 1993;21:79–83
  58. Soper JW, Chaturvedi AK, Canfield DV. Prevalence of chlorpheniramine in aviation accident pilot fatalities, 1991-1996. Aviat Space Environ Med. 2000;71:1206–1209
  59. Gilmore TM, Alexander BH, Mueller BA, Rivara FP. Occupational injuries and medication use. Am J Ind Med. 1996;30:234–239
  60. Cockburn IM, Bailit HL, Berndt ER, Finkelstein SN. Loss of work productivity due to illness and medical treatment. J Occup Environ Med. 1999;41:948–953
  61. Weiler JM, Bloomfield JR, Woodworth GG, Grant AR, Layton TA, Brown TL, et al. Effects of fexofenadine, diphenhydramine, and alcohol on driving performance: a randomized, placebo-controlled trial in the Iowa Driving Simulator. Ann Intern Med. 2000;132:354–363
  62. Goetz DW, Jacobson JM, Murnane JE, Reid MJ, Repperger DW, Goodyear C, et al. Prolongation of simple and choice reaction times in a double–blinded comparison of twice-daily hydroxyzine versus terfenadine. J Allergy Clin Immunol. 1989;84:316–322
  63. Simons FER. H1-Antihistamines. In:  Adkinson NF,  Yunginger JW,  Busse WW,  Bochner BS,  Holgate ST,  Simons FER editor. Middleton allergy principles and practice. 6th ed.. Philadelphia: Mosby; 2003;p. 834–869
  64. Richardson GS, Roehrs TA, Rosenthal L, Koshorek G, Roth T. Tolerance to daytime sedative effects of H1 antihistamines. J Clin Psychopharmacol. 2002;22:511–515
  65. Druce HM, Thoden WR, Mure P, Furey SA, Lockhart EA, Xie T, et al. Brompheniramine, Loratadine and placebo in allergic rhinitis: a placebo-controlled comparative clinical trial. J Clin Pharmacol. 1998;38:382–389
  66. Shamsi Z, Hindmarch I. Sedation and antihistamines: a review of inter-drug differences using proportional impairment ratios. Hum Psychopharmacol. 2000;15(suppl):S3–S30
  67. Hindmarch I, Shamsi Z. Antihistamines: models to assess sedative properties, assessment of sedation, safety and other side-effects. Clin Exp Allergy. 1999;29(suppl 3):133–142
  68. Zyrtec [prescribing information]. Available at: http://www.zyrtec.com. Accessed February 23, 2005.
  69. Allegra. Fexofenadine HCl [prescribing information]. Available at: http://www.allegra.com. Accessed March 19, 2006.
  70. Hwang K, Correll M, Offord SJ. Evaluation of desloratadine for absorption drug-drug interactions with ketoconazole. J Allergy Clin Immunol. 2001;107(suppl):S153
  71. Clarinex [prescribing information]. Available at: http://www.clarinex.com. Accessed March 19, 2006.
  72. Hampel F, Ratner P, Mansfield L, Meeves S, Liao Y, Georges G. Fexofenadine hydrochloride, 180 mg, exhibits equivalent efficacy to cetirizine, 10 mg, with less drowsiness in patients with moderate-to-severe seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2003;91:354–361
  73. Howarth PH, Stern MA, Roi L, Reynolds R, Bousquet J. Double-blind, placebo-controlled study comparing the efficacy and safety of fexofenadine hydrochloride (120 and 180 mg once daily) and cetirizine in seasonal allergic rhinitis. J Allergy Clin Immunol. 1999;104:927–933
  74. Day JH, Briscoe MP, Rafeiro E, Ratz JD, Ellis AK, Frankish CW, et al. Comparative efficacy of cetirizine and fexofenadine for seasonal allergic rhinitis, 5-12 hours postdose, in the environmental exposure unit. Allergy Asthma Proc. 2005;26:275–278
  75. Day JH, Briscoe MP, Rafeiro E, Hewlett D, Chapman D, Kramer B. Randomized double-blind comparison of cetirizine and fexofenadine after pollen challenge in the Environmental Exposure Unit: duration of effect in subjects with seasonal allergic rhinitis. Allergy Asthma Proc. 2004;25:59–68
  76. Wilson AM, Haggart K, Sims EJ, Lipworth BJ. Effects of fexofenadine and desloratadine on subjective and objective measures of nasal congestion in seasonal allergic rhinitis. Clin Exp Allergy. 2002;32:1504–1509
  77. Day JH, Briscoe M, Widlitz MD. Cetirizine, loratadine, or placebo in subjects with seasonal allergic rhinitis: effects after controlled ragweed pollen challenge in an environmental exposure unit. J Allergy Clin Immunol. 1998;101:638–645
  78. Nunes C, Ladeira S. Double-blind study of cetirizine and loratadine versus placebo in patients with allergic rhinitis. J Investig Allergol Clin Immunol. 2000;10:20–23
  79. Purello-D'Ambrosio F, Isola S, Ricciardi L, Gangemi S, Barresi L, Bagnato GF. A controlled study on the effectiveness of loratadine in combination with flunisolide in the treatment of nonallergic rhinitis with eosinophilia (NARES). Clin Exp Allergy. 1999;29:1143–1147
  80. Shinoda M, Watanabe N, Suko T, Mogi G, Takeyama M. Effects of anti-allergic drugs on substance P (SP) and vasoactive intestinal peptide (VIP) in nasal secretions. Am J Rhinol. 1997;11:237–241
  81. Hamasaki Y, Shafigeh M, Yamamoto S, Sato R, Zaitu M, Muro E, et al. Inhibition of leukotriene synthesis by azelastine. Ann Allergy Asthma Immunol. 1996;76:469–475
  82. Yoneda K, Yamamoto T, Ueta E, Osaki T. Suppression by azelastine hydrochloride of NF-kappa B activation involved in generation of cytokines and nitric oxide. Jpn J Pharmacol. 1997;73:145–153
  83. Storms WW, Pearlman DS, Chervinsky P, Grossman J, Halverson PC, Freitag JJ, et al. Effectiveness of azelastine nasal solution in seasonal allergic rhinitis. Ear Nose Throat J. 1994;73:382–386390-4
  84. Ratner PH, Findlay SR, Hampel F, van Bavel J, Widlitz MD, Freitag JJ. A double-blind, controlled trial to assess the safety and efficacy of azelastine nasal spray in seasonal allergic rhinitis. J Allergy Clin Immunol. 1994;94:818–825
  85. Meltzer EO, Weiler JM, Dockhorn RJ, Widlitz MD, Freitag JJ. Azelastine nasal spray in the management of seasonal allergic rhinitis. Ann Allergy Asthma Innumol. 1994;72:354–359
  86. Meltzer EO, Hampel FC, Ratner PH, Bernstein DI, Larsen LV, Berger WE, et al. Safety and efficacy of olopatadine hydrochloride nasal spray for the treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2005;95:600–606
  87. Corren J, Storms W, Bernstein J, Berger W, Nayak A, Sacks H, et al. Effectiveness of azelastine nasal spray compared with oral cetirizine in patients with seasonal allergic rhinitis. Clin Ther. 2005;27:543–553
  88. Horak F, Zieglmayer UP, Zieglmayer R, Kavina A, Marschall K, Munzel U, et al. Azelastine nasal spray and desloratadine tablets in pollen-induced seasonal allergic rhinitis: a pharmacodynamic study of onset of action and efficacy. Curr Med Res Opin. 2006;22:151–157
  89. Laforce CF, Corren J, Wheeler WJ, Berger WE Rhinitis Study Group. Efficacy of azelastine nasal spray in seasonal allergic rhinitis patients who remain symptomatic after treatment with fexofenadine. Ann Allergy Asthma Immunol. 2004;93:154–159
  90. Charpin D, Godard P, Garay RP, Baehre M, Herman D, Michel FB. A multicenter clinical study of the efficacy and tolerability of azelastine nasal spray in the treatment of seasonal allergic rhinitis: a comparison with oral cetirizine. Eur Arch Otorhinolaryngol. 1995;252:455–458
  91. Banov CH, Lieberman P. Vasomotor Rhinitis Study Groups. Efficacy of azelastine nasal spray in the treatment of vasomotor (perennial nonallergic) rhinitis. Ann Allergy Asthma Immunol. 2001;86:28–35
  92. Malm L, McCaffrey TV, Kern EB. Alpha-adrenoceptor-mediated secretion from the anterior nasal glands of the dog. Acta Otolaryngol. 1983;96:149–155
  93. Mucha SM, deTineo M, Naclerio RM, Baroody FM. Comparison of montelukast and pseudoephedrine in the treatment of allergic rhinitis. Arch Otolaryngol Head Neck Surg. 2006;132:164–172
  94. Malm L, Anggard A. Vasoconstrictors. In:  Mygind N,  Naclerio RM editor. Allergic and non-allergic rhinitis: clinical aspects. Copenhagen: Munsgaard; 1993;p. 95–100
  95. Cos JSG. Disodium cromoglycate (FPL 670 “Intal”): a specific inhibitor of reaginic antigen-antibody mechanisms. Nature. 1967;216:1328–1329
  96. Orie NGM, Booij-Nord H, Pelikan Z. Protective effect of disodium cromoglycate on nasal and bronchial reactions after allergen challenge. In:  Pepys J,  Frankland AW editor. Disodium cromoglycate in allergic airway disease. London: Butterworth; 1970;p. 33–41
  97. Meltzer EO NasalCrom Study Group. Efficacy and patient satisfaction with cromolyn sodium nasal solution in the treatment of seasonal allergic rhinitis: a placebo-controlled study. Clin Ther. 2002;24:942–952
  98. Cohan RH, Bloom FL, Rhoades RB, Wittig HJ, Haugh LD. Treatment of perennial allergic rhinitis with cromolyn sodium. Double-blind study on 34 adult patients. J Allergy Clin Immunol. 1976;58:121–128
  99. Nelson BL, Jacobs RL. Response of nonallergic rhinitis with eosinophilia (NARES) syndrome to 4% cromoly sodium nasal solution. J Allergy Clin Immunol. 1982;70:125–128
  100. Lofkvist T, Rundcrantz H, Svensson G. Treatment of vasomotor rhinitis with intranasal disodium cromoglycate (SCG). Results from a double-blind cross-over study. Acta Allergol. 1977;32:35–43
  101. Wang D, Clement P, Smitz J, Derde M-P. Concentrations of chemical mediators in nasal secretions after nasal allergen challenges in atopic patients. Eur Arch Otorhinolaryngol. 1995;252(suppl):S40–S43
  102. Bisgaard H, Olsson P, Bende M. Effect of leukotriene D4 on nasal mucosal blood flow, nasal airway resistance and nasal secretions in humans. Clin Allergy. 1986;16:289–297
  103. Fujita M, Yonetomi Y, Shimouchi K, Takeda H, Aze Y, Kawabata K, et al. Involvement of cysteinyl leukotrienes in biphasic increase of nasal airway resistance of antigen-induced rhinitis in guinea pigs. Eur J Pharmacol. 1999;369:349–356
  104. Philip G, Malmstrom K, Hampel FC, Weinstein SF, LaForce CF, Ratner PH, et al. Montelukast for treating seasonal allergic rhinitis: a randomized, double-blind, placebo-controlled trial performed in the spring. Clin Exp Allergy. 2002;32:1020–1028
  105. van Adelsberg J, Philip G, Pedinoff AJ, Meltzer EO, Ratner PH, Menten J, et al. Montelukast improves symptoms of seasonal allergic rhinitis over a 4-week treatment period. Allergy. 2003;58:1268–1276
  106. Chervinsky P, Philip G, Malice MP, Bardelas J, Nayak A, Marchal JL, et al. Montelukast for treating fall allergic rhinitis: effect of pollen exposure in 3 studies. Ann Allergy Asthma Immunol. 2004;92:367–373
  107. Chen ST, Lu KH, Sun HL, Chang WT, Lue KH, Chou MC. Randomized placebo-controlled trial comparing montelukast and cetirizine for treating perennial allergic rhinitis in children aged 2-6 yr. Pediatr Allergy Immunol. 2006;17:49–54
  108. Patel P, Philip G, Yang W, Call R, Horak F, LaForce C, et al. Randomized, double-blind, placebo-controlled study of montelukast for treating perennial allergic rhinitis. Ann Allergy Asthma Immunol. 2005;95:551–557
  109. Wilson AM, O'Byrne PM, Parameswaran K. Leukotriene receptor antagonists for allergic rhinitis: a systematic review and meta-analysis. Am J Med. 2004;116:338–344
  110. Wood CC, Fireman P, Grossman J, Wecker M, MacGregor T. Product characteristics and pharmacokinetics of intranasal ipratropium bromide. J Allergy Clin Immunol. 1995;95:1111–1116
  111. Kirkegaard J, Mygind N, Molgaard F, Grahne B, Holopainen E, Malmberg H, et al. Ordinary and high-dose ipratropium in perennial nonallergic rhinitis. J Allergy Clin Immunol. 1987;79:585–590
  112. Kim KT, Kerwin E, Landwehr L, Bernstein JA, Bruner D, Harris D, et al. Use of 0.06% ipratropium bromide nasal spray in children aged 2 to 5 years with rhinorrhea due to a common cold or allergies. Ann Allergy Asthma Immunol. 2005;94:73–79
  113. Milgrom H, Biondi R, Georgitis JW, Meltzer EO, Munk ZM, Drda K, et al. Comparison of ipratropium bromide 0.03% with beclomethasone dipropionate in the treatment of perennial rhinitis in children. Ann Allergy Asthma Immunol. 1999;83:105–111
  114. Meltzer EO, Orgel HA, Biondi R, Georgitis J, Milgrom H, Munk Z, et al. Ipratropium nasal spray in children with perennial rhinitis. Ann Allergy Asthma Immunol. 1997;78:485–491
  115. Bronsky EA, Druce H, Findlay SR, Hampel FC, Kaiser H, Ratner P, et al. A clinical trial of ipratropium bromide nasal spray in patients with perennial nonallergic rhinitis. J Allergy Clin Immunol. 1995;95:1117–1122
  116. Kaiser HB, Findlay SR, Georgitis JW, Grossman J, Ratner PH, Tinkelman DG, et al. Long-term treatment of perennial allergic rhinitis with ipratropium bromide nasal spray 0.06%. J Allergy Clin Immunol. 1995;95:1128–1132
  117. Grossman J, Banov C, Boggs P, Bronsky EA, Dockhorn RJ, Druce H, et al. Use of ipratropium bromide nasal spray in chronic treatment of nonallergic perennial rhinitis, alone and in combination with other perennial rhinitis medications. J Allergy Clin Immunol. 1995;95:1123–1127
  118. Blom HM, Van Rijswijk JB, Garrelds IM, Mulder PG, Timmermans T, Gerth van Wijk R. Intranasal capsaicin is efficacious in non-allergic, non-infectious perennial rhinitis. A placebo-controlled study. Clin Exp Allergy. 1997;27:796–801
  119. Wolf G, Anderhuber W, Hauser-Kronberger C, Saria A. Treatment of nonspecific hyper-reflectory rhinopathy (vasomotor rhinitis) with capsaicin. Laryngorhinootologie. 1995;74:289–293
  120. Van Rijswijk JB, Boeke EL, Keizer JM, Mulder PG, Blom HM, Fokkens WJ. Intranasal capsaicin reduces nasal hyperreactivity in idiopathic rhinitis: a double-blind randomized application regimen study. Allergy. 2003;58:754–761
  121. van Rijswijk JB, Blom HM, Fokkens WJ. Idiopathic rhinitis, the ongoing quest. Allergy. 2005;60:1471–1481
  122. Casale TB. Anti-IgE (Omalizumab) therapy in seasonal allergic rhinitis. Am J Respir Crit Care Med. 2001;164(suppl):S18–S21
  123. Adelroth E, Rak S, Huahtela T, Aasand G, Rosenhall L, Zetterstrom L, et al. Recombinant humanized mAb-E25, an anti IgE mAb, in birch pollen-induced seasonal allergic rhinitis. J Allergy Clin Immunol. 2000;106:253–259
  124. Chervinsky P, Casale T, Townley R, Tripathy I, Hedgecock S, Fowler-Taylor A, et al. Omalizumab, an anti-IgE antibody, in the treatment of adults and adolescents with perennial allergic rhinitis. Ann Allergy Asthma Immunol. 2003;91:160–167
  125. Vignola AM, Humbert M, Bousquet J, Boulet LP, Hedgecock S, Blogg M, et al. Efficacy and tolerability of anti-immunoglobulin E therapy with omalizumab in patients with concomitant allergic asthma and persistent allergic rhinitis: SOLAR. Allergy. 2004;59:709–717
  126. Talbot AR, Herr TM, Parsons DS. Mucociliary clearance and buffered hypertonic saline solution. Laryngoscope. 1997;107:500–503
  127. Garavello W, Di Beradio F, Romagnoli M, Sambataro G, Gaini RM. Nasal rinsing with hypertonic solution: an adjunctive treatment for pediatric seasonal allergic rhinoconjunctivitis. Int Arch Allergy Immunol. 2005;137:310–314
  128. Tomooka LT, Murphy C, Davidson TM. Clinical study and literature review of nasal irrigation. Laryngoscope. 2000;110:1189–1193
  129. Storms W, Bodman SF, Nathan RA, Chervinsky P, Banov CH, Dockhorn RJ, et al. SCH 434: a new antihistamine/decongestant for seasonal allergic rhinitis. J Allergy Clin Immunol. 1989;83:1083–1090
  130. Sussman GL, Mason J, Compton D, Stewart J, Ricard N. The efficacy and safety of fexofenadine HCl and pseudoephedrine, alone and in combination, in seasonal allergic rhinitis. J Allergy Clin Immunol. 1999;104:100–106
  131. Moinuddin R, deTineo M, Maleckar B, Naclerio RM, Baroody FM. Comparison of the combinations of fexofenadine-pseudoephedrine and loratadine-montelukast in the treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2004;92:73–79
  132. Meltzer EO, Malmstrom K, Lu S, Prenner BM, Wei LX, Weinstein SF, et al. Concomitant montelukast and loratadine as treatment for seasonal allergic rhinitis: a randomized, placebo-controlled clinical trial. J Allergy Clin Immunol. 2000;105:917–922
  133. Kurowski M, Kuna P, Gorski P. Montelukast plus cetirizine in the prophylactic treatment of seasonal allergic rhinitis: influence on clinical symptoms and nasal allergic inflammation. Allergy. 2004;59:280–288
  134. Wilson AM, Orr LC, Coutie WJ, Sims EJ, Lipworth BJ. A comparison of once daily fexofenadine versus the combination of montelukast plus loratadine on domiciliary nasal peak flow and symptoms in seasonal allergic rhinitis. Clin Exp Allergy. 2002;32:126–132

 (Supported by an unrestricted educational grant from Genentech, Inc. and Novartis Pharmaceuticals Corporation)Series editor: Harold S. Nelson, MDDisclosure of potential conflict of interest: A. N. Greiner has received grant support from Alcon, Allux, Altana, AstraZeneca, Clay-Park Labs, Critical Therapeutics, Genentech, GlaxoSmithKline, Hoffman-La Roche, Medicinova, MedPointe, Merck, Novartis, Pharmaxis, Rigel, Sanofi-Aventis, Schering-Plough, and Wyeth and is on the speakers' bureau for AstraZeneca KOS, Pfizer, and Sanofi-Aventis. E. O. Meltzer has received grant support from Alcon, Allux, AstraZeneca, Clay-Park Labs, Critical Therapeutics, Genentech, GlaxoSmithKline, Hoffmann-La Roche, Medicinova, MedPointe, Merck, Novartis, Pharmaxis, Rigel, Sanofi-Aventis, Schering-Plough, and Wyeth; has consultant arrangements with Abbott, Adelphi, Alcon, Allux, Altana, Amgen, AstraZeneca, Capnia, Critical Therapeutics, Dey, Evolutec, Genentech, GlaxoSmithKline, Greer, Inspire, KOD, MedPointe, Merck, Novartis, Pfizer, Rigel, Sanofi-Aventis, Schering-Plough, Shionogi, Verus, and Wyeth; and is on the speakers' bureau for AstraZeneca, Alcon, Altana, Genentech, Genesis, GlaxoSmithKline, MedPointe, Merck, Novartis, Pfizer, Sanofi-Aventis, Schering-Plough, and Verus.

PII: S0091-6749(06)01380-7

doi: 10.1016/j.jaci.2006.06.029

The Journal of Allergy and Clinical Immunology
Volume 118, Issue 5 , Pages 985-996 , November 2006

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