Feature Article

Allergic rhinitis: an update on management

Adrian Y.S. Lee, Mittal N. Patel, JO A. DOUGLASS




Allergic rhinitis is a common manifestation of atopy that significantly reduces quality of life. A careful history and examination, along with appropriate investigations, are needed to determine the most likely allergens and to direct treatment. Recent advances in allergen immunotherapy show promise and the ‘thunderstorm asthma’ phenomenon emphasises the need for action plans for patients with comorbid asthma.

Key Points

  • Allergic rhinitis creates a significant burden for affected individuals and reduces their quality of life.
  • There are a broad range of differential diagnoses for allergic rhinitis, and an allergic cause for symptoms should be confirmed to direct treatment accordingly.
  • There is limited evidence for the efficacy of allergen-avoidance strategies, but this may be due to the heterogeneity of the advice.
  • Intranasal corticosteroids and oral antihistamines are considered first-line therapies.
  • If symptoms are poorly controlled with simple strategies, referral to an allergist for possible allergen immunotherapy should be considered.