Meta-analysis of azelastine nasal spray for the treatment of allergic rhinitis.
ABSTRACT To systematically review the efficacy of azelastine nasal spray for the treatment of allergic rhinitis.
Meta-analysis of published randomized controlled trials reported in English.
Published literature from the PubMed-MEDLINE database.
Patients aged at least 12 (United States) or 16 years (Europe) with allergic rhinitis or nonallergic vasomotor rhinitis.
A global assessment of efficacy was used to estimate the number needed to treat for azelastine nasal spray compared with placebo or active comparators. The total symptom score was used to compare the effect size between azelastine and placebo. In five comparisons of azelastine and placebo, azelastine was most efficacious, with a summary number needed to treat of 5.0 (95% confidence interval [CI] 3.3-10.0). In reviewing 11 studies of azelastine versus active comparators, we found no significant difference between azelastine and active comparators (number needed to treat 66.7, 95% CI 14.3 to infinity to 25). Azelastine was more efficacious than placebo in terms of total symptom score (effect size of 0.36, 95% CI 0.26-0.46).
Azelastine nasal spray was more efficacious than placebo in the treatment of allergic rhinitis. No significant differences were observed between azelastine and active comparators for the treatment of allergic rhinitis; however, when azelastine was compared with oral antihistamines as monotherapy, the trend favored azelastine. Because azelastine appears to be as efficacious as oral antihistamines, the choice of treatment for seasonal allergic rhinitis should depend on the patient's preference regarding the route of administration, adverse effects, and the cost of the drug.
- New England Journal of Medicine 01/2015; 372(5):456-63. DOI:10.1056/NEJMcp1412282 · 54.42 Impact Factor
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ABSTRACT: Background Pharmacotherapy for allergic rhinitis is a mainstay of treatment for patients with mild to severe nasal allergy symptoms. A wide array of medical treatment options is available for both episodic relief and prevention of symptoms. Treatment regimens can be tailored to individual patients based on nasal symptoms, severity, and associated atopic disorders. The purposes of this review are to identify available pharmacotherapies for allergic rhinitis, to discuss the benefits and limitations of each treatment option, and to help guide practitioners in providing optimal medical treatment for patients with allergic rhinitis. MethodsA comprehensive review of pharmacotherapies for allergic rhinitis was performed using a PubMed search. Secondary sources within indexed studies were also compiled to review current medication options for patients with allergic rhinitis. The benefits and limitations of each class of allergy medication were reviewed to provide information on selecting the optimal treatment regimen for patients with allergic rhinitis. ResultsPharmacotherapies for allergic rhinitis that are currently used in clinical practice include antihistamines, corticosteroids, leukotriene modifiers, mast cell stabilizers, expectorants, and decongestants. Symptoms of nasal congestion, itching, sneezing, and rhinorrhea can be targeted with specific therapies that modulate the acute-phase or late-phase allergic reactions. Associated atopic disorders, including conjunctivitis and asthma, can help guide medication selection. Conclusion Pharmacotherapies for allergic rhinitis offer numerous options that are safe, effective, and readily available to target specific nasal symptoms. Symptom-based selection of allergy medications can result in optimal treatment for patients with allergic rhinitis. (C) 2014 ARS-AAOA, LLC.International Forum of Allergy and Rhinology 09/2014; 4 Suppl 2(S2):S35-40. DOI:10.1002/alr.21381 · 2.37 Impact Factor
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ABSTRACT: Antihistamines have been used in the treatment of rhinitis since ancient times. Antihistamines can be used via oral or topical route for the treatment of allergic rhinitis, as well as nonallergic forms of rhinitis. The topical formulation of medications is the preferred treatment route used for many diseases. This article will investigate the differences in the route of antihistamines in the treatment of allergic rhinitis. A review of the literature was performed to investigate the differences between the use of oral and topical antihistamines in the treatment of allergic rhinitis. Antihistamines inhibit the mediators of inflammation that worsen the symptoms of allergic rhinitis. Intranasal and oral antihistamines are important options in the therapy of allergic rhinitis, and topical use may result in unexpected benefits to patients with allergic rhinitis.Allergy and Asthma Proceedings 11/2009; 30(6):584-8. DOI:10.2500/aap.2009.30.3289 · 3.35 Impact Factor