Allergic rhinitis and the patient with Asthma A guide for health professionals

Contents Treat allergic rhinitis to manage asthma Patterns of allergic rhinitis Diagnosis Management I  - Allergen avoidance  - Consider nasal irrigation Management II  - Pharmacological treatment  - Other agents and adjuncts Management III  - Pregnant women  - Young children  - Patients with allergic rhinitis and asthma Management IV  - Immunomodulatory therapy Review Levels of evidences References

Summary of evidence

• Effective treatment of allergic rhinitis improves asthma control and lung function.^{<Level II>}

• Measures that have consistently been reported effective in reducing mite exposure include hot (>55 degrees C) washing of all bedding and the use of mite-proof cases for mattresses and pillows.^{<Level II>}

• Intranasal corticosteroids are more effective than antihistamines in controlling symptoms of allergic rhinitis as well as non-allergic rhinitis.^{<Level I>}

• Long-term use of newer intranasal corticosteroids does not appear to affect the hypothalamic–pituitary–adrenal (HPA) axis or cause mucosal atrophy.^{<Level II>}

• Specific allergen immunotherapy is effective in the management of rhinitis and asthma and can achieve a durable remission of allergic symptoms. ^{<Level I>}

• Specific allergen immunotherapy may reduce the risk of childhood rhinitis progressing to asthma.^{<Level II>}

Note

This information paper is intended to provide information on the clinical interrelationship between asthma and allergic rhinitis for GPs, asthma educators, practice nurses and pharmacists. For more information on the diagnosis and management of allergic rhinitis in primary care, see: Australasian Society of Clinical Immunology and Allergy. Asthma and Allergy. Australian Government Department of Health and Ageing 2005 (available at: www.nationalasthma.org.au).

Acknowledgements

This brochure has been proudly sponsored by

National Asthma Council Australia
ABN 61 058 044 634
1 Palmerston Crescent,
South Melbourne VIC 3205
Tel: 03 8699 0476
Fax: 03 8699 0400
Email: nac@nationalasthma.org.au
www.nationalasthma.org.au September 2006

Disclaimer

Although all care has been taken, this information paper is a general guide only which is not intended to be a substitute for individual medical advice/treatment. The National Asthma Council expressly disclaims all responsibility (including for negligence) for any loss, damage or personal injury resulting from reliance on the information contained.