Management of Allergic Rhinitis Symptoms

Allergic rhinitis is an IgE-mediated inflammatory disorder of the nasal mucosa characterised by sneezing, rhinorrhoea, nasal congestion and itching. Effective management combines patient education, allergen avoidance and a tailored pharmacotherapeutic strategy guided by disease severity and patient preference. First-line options for mild disease include second-generation oral antihistamines and intranasal H1-receptor antagonists, offering rapid symptom relief with minimal sedation. Moderate-to-severe presentations are best controlled with intranasal corticosteroids, which target both early and late phases of the allergic cascade to reduce mucosal inflammation and nasal obstruction. Adjunctive therapies include leukotriene receptor antagonists, oral decongestants and combination sprays that merge antihistamine and corticosteroid action. Allergen immunotherapy delivered subcutaneously or sublingually remains the only disease-modifying approach, promoting long-term tolerance and reduction in symptom recurrence. Emerging biologics and novel delivery systems aim to enhance control and address unmet needs. Shared decision-making, quality-of-life assessment and adherence monitoring are essential, given the global burden of allergic rhinitis and its impact on productivity, sleep and comorbid asthma.

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Management of Allergic Rhinitis Symptoms publication trend

The graph below shows the total number of articles in management of allergic rhinitis symptoms across all publications each year (not limited to Nature Index journals).

Technical terms

Intranasal corticosteroids (INCS): Anti-inflammatory agents delivered to the nasal mucosa to reduce mucosal swelling, vascular permeability and mucus production.
Leukotriene receptor antagonists (LTRAs): Oral medications that inhibit leukotriene receptors, diminishing bronchoconstriction and nasal airway inflammation.
Allergen immunotherapy (AIT): Gradual administration of allergen extracts via subcutaneous (SCIT) or sublingual (SLIT) routes to induce long-term immunological tolerance.
Fixed-dose combination (FDC): Pharmaceutical formulation that combines two or more active substances in a single dosage form to improve adherence and therapeutic synergy.

References

1. Enhanced Stability and Compatibility of Montelukast and Levocetirizine in a Fixed-Dose Combination Monolayer Tablet. Pharmaceutics (2024).
2. A systematic review and meta-analysis of loratadine combined with montelukast for the treatment of allergic rhinitis. Frontiers in Pharmacology (2023).
3. Towards definitive management of allergic rhinitis: best use of new and established therapies. Allergy, Asthma & Clinical Immunology (2020).
4. Allergic rhinitis. Allergy, Asthma & Clinical Immunology (2018).