Differentiated approach to the choice of agents for pathogenetic drug therapy in patients with allergic rhinitis

Allergic rhinitis (AR) is one of the most common allergic diseases. Achievement of AR control is a priority goal of the disease’s treatment. Objective. To analyze the effectiveness of combined use of intranasal glucocorticosteroids (InGCs) and intranasal antihistamines (InAHs) or systemic antihistamine drugs (sAHDs) In patients with moderate AR and to substantiate the need for a differentiated approach to the choice of pathogenetic drug therapy agents for the disease. Patients and methods. During the study 47 patients with moderate AR were examined and divided into 2 groups: patients of the 1st group used a fixed combination of InGCs/InAHs, patients of the 2nd group — a free combination of InGCs and second-generation sAHDs. The visual analogue scale, total nasal (TNSS) and ocular symptom (TOSS) score scales were used to assess treatment effectiveness. Quality of life evaluation was carried out using the SNOT-22 questionnaire. The method of anterior active rhinomanometry was used in order to objectify the parameters of the nasal patency. Results. The positive effect of therapy was observed in both groups based on the obtained data. Control of AR, according to the VAS, was achieved in patients from both groups as well. However, a statistically significant improvement by the objective parameters of nasal breathing function has been noted only in patients of the 2nd group, which can be explained by the presence of intranasal deformities in the vast majority of examined (73 and 95% of patients. respectively) and the systemic action of the sAHDs used per os. Conclusions. The revealed structural deformities of the nasal cavity in patients with AR are essential in choosing the means of pathogenetic therapy, and the preferred treatment option in this case may be a free combination of InGCs and sAHDs II.