Continuous versus on-demand pharmacotherapy of allergic rhinitis: evidence and practice
Continuous versus on-demand pharmacotherapy of allergic rhinitis: evidence and practice
This review aims to compare continuous with on-demand pharmacotherapy of allergic rhinitis by focusing on pharmacodynamic, pharmacokinetic, safety, effectiveness, cost and cost-effectiveness considerations. A working party of experts reviewed and discussed the literature and guidelines, and conducted a qualitative analysis of the Summary of Product Characteristics of specific medicines. With respect to medicines, the working party limited itself to antihistamines, nasal corticosteroids and leukotriene antagonists. Based on a review of the evidence from a multidisciplinary perspective, this article makes pharmacotherapeutic recommendations that are easy, functional and applicable to daily practice in primary care. The pharmacotherapeutic evidence for continuous versus on-demand treatment of allergic rhinitis was limited. Clearly, for corticosteroids, their mechanism of action in allergic rhinitis of reducing allergic inflammation requires continuous therapy at least for the duration of symptoms. For H(1)-antihistamines, some trials suggest that continuous treatment is preferable but more studies are needed to confirm this conclusion. For both H(1)-antihistamines and nasal corticosteroids safety data indicate that continuous treatment may be given without fears of adverse consequences, although a distinction can be made between the first and the second generation antihistamines. With regard to the cost and cost-effectiveness implications of continuous therapy versus on-demand therapy, more studies are necessary before definitive conclusions may be made
Laekeman, Gert
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Simoens, Steven
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Buffels, Johan
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Gillard, Michel
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Robillard, Thibert
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Strolin Benedetti, Margherita
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Watelet, Jean-Baptiste
cc8cfbaf-8ff7-4e03-ab3b-d350bc63ab60
Liekendael, Georges
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Church, Martin K.
dad189d5-866e-4ae1-b005-0d87f74282b8
Ghys, Liesbet
f524c677-ece0-4725-b887-35549837adfd
15 February 2010
Laekeman, Gert
307ee44c-0888-4397-b9c5-db56af3a28eb
Simoens, Steven
5910c0fc-2a40-4a4c-b105-d0387e6d361b
Buffels, Johan
13c6bea7-3d2f-46fd-8cdc-f040a74843d0
Gillard, Michel
56bd2536-a08e-4c40-b0cf-7242d1826fb3
Robillard, Thibert
e28b0588-d589-491c-95f1-e012f7695456
Strolin Benedetti, Margherita
4dffc980-2f11-4f1a-85ce-dd6034a6b3ab
Watelet, Jean-Baptiste
cc8cfbaf-8ff7-4e03-ab3b-d350bc63ab60
Liekendael, Georges
107a67e9-b69a-476c-a9f2-f4529ab6e65e
Ghys, Liesbet
f524c677-ece0-4725-b887-35549837adfd
Church, Martin K.
dad189d5-866e-4ae1-b005-0d87f74282b8
Laekeman, Gert, Simoens, Steven, Buffels, Johan, Gillard, Michel, Robillard, Thibert, Strolin Benedetti, Margherita, Watelet, Jean-Baptiste, Liekendael, Georges and Church, Martin K.
,
Ghys, Liesbet
(ed.)
(2010)
Continuous versus on-demand pharmacotherapy of allergic rhinitis: evidence and practice.
Respiratory Medicine.
(doi:10.1016/j.rmed.2010.01.006).
Abstract
This review aims to compare continuous with on-demand pharmacotherapy of allergic rhinitis by focusing on pharmacodynamic, pharmacokinetic, safety, effectiveness, cost and cost-effectiveness considerations. A working party of experts reviewed and discussed the literature and guidelines, and conducted a qualitative analysis of the Summary of Product Characteristics of specific medicines. With respect to medicines, the working party limited itself to antihistamines, nasal corticosteroids and leukotriene antagonists. Based on a review of the evidence from a multidisciplinary perspective, this article makes pharmacotherapeutic recommendations that are easy, functional and applicable to daily practice in primary care. The pharmacotherapeutic evidence for continuous versus on-demand treatment of allergic rhinitis was limited. Clearly, for corticosteroids, their mechanism of action in allergic rhinitis of reducing allergic inflammation requires continuous therapy at least for the duration of symptoms. For H(1)-antihistamines, some trials suggest that continuous treatment is preferable but more studies are needed to confirm this conclusion. For both H(1)-antihistamines and nasal corticosteroids safety data indicate that continuous treatment may be given without fears of adverse consequences, although a distinction can be made between the first and the second generation antihistamines. With regard to the cost and cost-effectiveness implications of continuous therapy versus on-demand therapy, more studies are necessary before definitive conclusions may be made
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Published date: 15 February 2010
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Local EPrints ID: 145667
URI: http://eprints.soton.ac.uk/id/eprint/145667
PURE UUID: e859ab55-152f-4b46-bb13-ce3a991402eb
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Date deposited: 19 Apr 2010 12:40
Last modified: 14 Mar 2024 00:51
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Contributors
Author:
Gert Laekeman
Author:
Steven Simoens
Author:
Johan Buffels
Author:
Michel Gillard
Author:
Thibert Robillard
Author:
Margherita Strolin Benedetti
Author:
Jean-Baptiste Watelet
Author:
Georges Liekendael
Editor:
Liesbet Ghys
Author:
Martin K. Church
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