| Continuous versus on-demand pharmacotherapy of allergic rhinitis: evidence and practice. | |
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MedLine Citation:
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PMID: 20163944 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This review aims to compare continuous with on-demand pharmacotherapy of allergic rhinitis by focusing on pharmacodynamic, pharmacokinetic, safety, effectiveness, cost and cost-effectiveness considerations. A working party of experts reviewed and discussed the literature and guidelines, and conducted a qualitative analysis of the Summary of Product Characteristics of specific medicines. With respect to medicines, the working party limited itself to antihistamines, nasal corticosteroids and leukotriene antagonists. Based on a review of the evidence from a multidisciplinary perspective, this article makes pharmacotherapeutic recommendations that are easy, functional and applicable to daily practice in primary care. The pharmacotherapeutic evidence for continuous versus on-demand treatment of allergic rhinitis was limited. Clearly, for corticosteroids, their mechanism of action in allergic rhinitis of reducing allergic inflammation requires continuous therapy at least for the duration of symptoms. For H(1)-antihistamines, some trials suggest that continuous treatment is preferable but more studies are needed to confirm this conclusion. For both H(1)-antihistamines and nasal corticosteroids safety data indicate that continuous treatment may be given without fears of adverse consequences, although a distinction can be made between the first and the second generation antihistamines. With regard to the cost and cost-effectiveness implications of continuous therapy versus on-demand therapy, more studies are necessary before definitive conclusions may be made. |
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Authors:
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Gert Laekeman; Steven Simoens; Johan Buffels; Michel Gillard; Thibert Robillard; Margherita Strolin Benedetti; Jean-Baptiste Watelet; Georges Liekendael; Liesbet Ghys; Martin Church |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review Date: 2010-02-16 |
Journal Detail:
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Title: Respiratory medicine Volume: 104 ISSN: 1532-3064 ISO Abbreviation: Respir Med Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-03 Completed Date: 2010-10-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8908438 Medline TA: Respir Med Country: England |
Other Details:
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Languages: eng Pagination: 615-25 Citation Subset: IM |
Affiliation:
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Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit Leuven, Onderwijs en Navorsing 2, Herestraat 49, Leuven, Belgium. gert.laekeman@pharm.kuleuven.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Intranasal Administration, Oral Adrenal Cortex Hormones / administration & dosage* Anti-Allergic Agents / administration & dosage* Cost-Benefit Analysis Drug Administration Schedule Evidence-Based Medicine Histamine H1 Antagonists / administration & dosage* Humans Leukotriene Antagonists / administration & dosage* Rhinitis, Allergic, Perennial / drug therapy* |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 0/Anti-Allergic Agents; 0/Histamine H1 Antagonists; 0/Leukotriene Antagonists |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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