A novel and effective approach to treating rhinitis with nasal antihistamines.

OBJECTIVES

To review existing treatments for rhinitis and summarize data available on the use of a nasal antihistamine (azelastine) in treating allergic and nonallergic vasomotor rhinitis.

DATA SOURCES: Relevant articles and references published between 1995 and 2007 regarding the treatment of allergic and vasomotor rhinitis were identified from PubMed, review articles, meta-analyses, and practice guidelines.

STUDY SELECTION: All key relevant articles were reviewed and the most relevant selected for inclusion in this review.

RESULTS

The efficacy and safety of azelastine nasal spray in treating allergic rhinitis and vasomotor rhinitis have been determined in a number of U.S. multicenter, randomized, double-blind, placebo-controlled trials. In all trials, azelastine was associated with a rapid onset of action and a sustained improvement over time in rhinitis, congestion, and other symptoms. In patients with allergic rhinitis, the combination of azelastine and nasal corticosteroids increased treatment efficacy by more than 40% compared with either product alone.

CONCLUSIONS

Intranasal antihistamine therapy represents an effective mode of drug delivery in patients with allergic and nonallergic vasomotor rhinitis and is an important option for rhinitis therapy, particularly if rapid symptom relief is required or if congestion is a major symptom. Use of azelastine plus nasal corticosteroids is effective in both allergic rhinitis and vasomotor rhinitis, suggesting that this combination represents an effective treatment strategy for all patients with either allergic or nonallergic vasomotor rhinitis.