Clinical use of oral antihistamines and intranasal corticosteroids in patients with allergic rhinitis.

BACKGROUND

Second-generation oral antihistamines (AH) and intranasal corticosteroids (ICS) are the most widely used drugs for allergic rhinitis (AR).

OBJECTIVE

To obtain information on the preferences for and applications of these drugs under conditions of routine clinical practice.

METHODS

We performed a multicenter multidisciplinary observational study. Participating physicians completed a questionnaire with information on preferences for and application of drugs for AR, patient characteristics, and physician/patient satisfaction with the treatment provided (visual analog scale).

RESULTS

A total of 1008 physicians participated in the study (primary care physicians, 53%; ear, nose, and throat specialists, 28%; allergologists, 19%). Treatment preferences in AR were AH combined with ICS (7.68), AH (7.25), and ICS (6.94). AH and ICS were used continuously by 58% and 71% of patients, respectively. Physicians reported having a good knowledge of the Allergic Rhinitis and its Impact on Asthma guidelines (93%), and 90% claimed to follow the guidelines. A total of 4040 patients were recruited (52% females, mean [SD] age 34 [14] years). The findings for AR were as follows: mean (SD) duration, 9 (8) years; persistent AR, 52%; mild AR, 72%; moderate AR, 7%; and severe AR, 1%. Patients considered the disorder to be well controlled/almost controlled (79%). As for treatment, 77% followed the regimen recommended by the physician. Oral treatment (41%) and intranasal treatment (22%) were preferred, while 35% showed no preference for any given administration route. The treatments prescribed were AH combined with ICS (66%), AH (20%), ICS (11%), other antihistamines (4%), and other drugs (6%). Combination treatment was the preferred therapy, regardless of the type of rhinitis.

CONCLUSIONS

Physicians prefer and more often use combination treatment with oral AH and ICS, regardless of the frequency and intensity of AR.