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.