Novel Combination Product Captisol-Enabled® Budesonide + Azelastine HCl Provides Fast, Long-lasting Relief of Allergic Rhinitis Symptoms (Total Nasal Symptom Score (TNSS) and Individual Nasal Symptoms Scores (NSS)) in Ragweed Allergic Patients Studied in an Environmental Exposure Chamber (EEC) Model

Azelastine and olopatadine in the treatment of allergic rhinitis

OBJECTIVE

To review the literature supporting current recommendations for nasal antihistamines as first-line therapy for allergic rhinitis.

DATA SOURCES

Published articles in the peer-reviewed medical literature.

STUDY SELECTION

Clinical trials focusing on the efficacy, safety, and recommended uses of the currently approved nasal antihistamines in the United States: azelastine nasal spray, 0.1%, and olopatadine nasal spray, 0.6%.

RESULTS

Azelastine nasal spray, 0.1%, and olopatadine nasal spray, 0.6%, have rapid onsets of action, are well tolerated, and have clinical efficacy for treating allergic rhinitis that is equal or superior to oral second-generation antihistamines. Both also have a clinically significant effect on nasal congestion. Azelastine is also approved for nonallergic rhinitis. Although older data suggest that intranasal steroids have greater clinical efficacy than nasal antihistamines, more recent comparisons in patients with mild to moderate disease have shown equal or noninferior efficacy. In addition, in contrast to oral antihistamines or leukotriene antagonists, the combination of a nasal antihistamine and intranasal steroid may provide additive benefits for treating patients with more severe disease.

CONCLUSION

The data support current recommendations for nasal antihistamines as first-line therapy for allergic rhinitis. Future studies should address possible as needed use, the use of premixed antihistamine-steroid combinations, and the treatment of mixed rhinitis.