Can we predict how much benefit patients will get from ESS with a novel monoclonal antibody

Mepolizumab (Nucala) is a humanised IgG1 monoclonal antibody that acts as an IL-5 antagonist. It has been shown to be highly effective in treating severe asthma. It is hypothesised that it will be effective for patients with recalcitrant CRSwNP. This...

Prevention better than cure?

This systematic review looks at methods of ‘barrier protection’ or ‘barrier-enforcing’ to minimise allergic rhinitis symptoms, using 15 RCTs. Whilst the authors admit that patient numbers were small in a number of these studies, generally it seems that barrier techniques...

Allergic rhinitis, the usual suspects

Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...

A trial of house dust mite sublingual tablet in children with allergic rhinitis

The house dust mite (HDM) is one of the commonest causative agents in allergic rhinitis (AR), affecting patients across all demographics. Recently, sublingual immunotherapy (SLIT) has been shown in clinical trials and meta-analysis to be effective compared to placebo in...

Is non-allergic rhinitis as bad as allergic?

Non-allergic rhinitis (NAR) occurs when rhinitis symptoms are not associated with allergic, infective or anatomical reason. It is responsible for almost half of all cases of rhinitis and affects around 300 million worldwide. Assessing NAR patients’ quality of life (QoL)...

Puberty and rhinitis

While asthma and rhinitis are more common in boys compared to girls in childhood, whether this trend persists after puberty or not is not yet clear. Authors inspected the European Commission funded MeDALL (Mechanisms of the Development of ALLergy) to...

The hot nose

Capsaicin nasal spray can offer moderate to significant symptomatic relief to 70-80% of patients with idiopathic rhinitis (IR). Efficacy was also shown in lab studies. Nasal hyper reactivity (NHR), absence of allergy / infective rhinosinusitis, age limits (18-60), no anatomical...

Allergen immunotherapy and allergic rhinitis – EAACI guideline 2017

Allergic rhinitis (AR) is a common chronic childhood disease with considerable social burden and impact on quality of life, frequently necessitating treatment with various combinations of antihistamines and corticosteroids. The allergen immunotherapy (AIT), sometimes known as desensitisation therapy, can modify...

Prostaglandin versus leukotriene receptor-antagonists in treatment of seasonal allergic rhinitis RCT phase II

Seasonal allergic rhinitis is very common. Failure to control the disease with mono-therapy leads to dual therapy treatment with less compliance and reduced quality of life. A prostaglandin receptor antagonist (ONO-4053) showed some efficacy in controlling allergic rhinitis in animal...

Precision medicine in allergic rhinitis and chronic rhinosinusitis

Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...

Poor allergic rhinitis control increases the overall costs

Allergic rhinitis and asthma are common and can have significant effects on quality of life. However, not many studies have focused on the economic effects. The authors of this study performed a large-scale (over 60,000 patients) observational study to analyse...

Sublingual house dust mite immunotherapy

House dust mite immunotherapy in allergic rhinitis was shown to be effective in trials with a relatively small number of participants. The authors of this study performed a multicentre double-blind randomised controlled trial to investigate effects of house dust mite...

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