There is New Hope in the Treatment of Allergy.
Allergies New Treatment
A new allergy treatment from Hungary used intranasal phototherapy as an effective treatment in allergic rhinitis. What they did was to irradiate the nasal tissue with a combination of low-dose UVB/UVA invisible light 3 times a week for 2 weeks. The nasal symptoms scores showed that the patients who had used intranasal phototherapy had a significant decrease in sneezing, rhino rhea, nasal itching, and nasal obstruction. Obviously there needs to be long-term studies to know the safety and efficacy of phototherapy, but this is kind of a unique, different treatment approach.
Yet another approach is to use intranasal non-inhaled carbon dioxide. This approach provided rapid relief of seasonal allergic rhinitis nasal symptoms, suggesting that an application of carbon dioxide to the nasal mucosa may, in effect, help decrease nasal allergy symptoms.
Another promising treatment for allergic rhinitis is intranasal antihistamines. Olopatadine is not yet available in the United States, but may be in the near future. Using olopatadine has shown efficacy and safety in the treatment of perennial allergic rhinitis.
There were several studies done on a new intranasal corticosteroid called ciclesonide. Although the precise way it works is unknown, the drug is a corticosteroid. Corticosteroids are hormone-like drugs that suppress the immune response.
This study examined patients with perennial allergic rhinitis. patients were given intranasal ciclesonide 200 mcg once a day. They looked at efficacy, quality of life, and safety. The results showed that the patients using ciclesonide intranasally had a decrease in both morning and evening total nasal symptoms score. They also showed that the subjects using ciclesonide had improvement in quality of life by using the Juniper rhinitis quality-of-life questionnaire. And very importantly, the frequency of adverse events was similar among patients either taking ciclesonide or placebo. In conclusion, the authors found that ciclesonide was very effective in patients with perennial allergic rhinitis.
Another study looked at patients with seasonal allergic rhinitis with this same medication and showed efficacy with no significant side effects. Ratner and associates studied patients with seasonal allergic rhinitis to Western Red Cedar pollen. Their results showed that the patients who had received ciclesonide did significantly better than those who had received placebo. In addition, ciclesonide was well tolerated, and the safety profile was comparable to placebo, with a low incidence of nasal bleeding associated with the medication.
One of the most important developments as far as allergic rhinitis is study looking at the coadministration of intranasal ciclesonide, with inhaled beclomethasone dipropionate for asthma, and the effect on cortisol suppression. We know that many of our patients with asthma are on inhaled corticosteroids to treat their condition. Most asthma patients also have allergic rhinitis and need intranasal corticosteroids for proper management. The question has been: Does using both intranasal and inhaled corticosteroids in the same patient increase the risk for systemic side effects? This study, also by Paul Ratner, MD examined asthma patients who were on beclomethasone dipropionate 320 mcg twice a day for their asthma. A 24-hour plasma and urinary cortisol levels were assessed prior to and at the end of the treatment period of 43 days. They found that by adding ciclesonide intranasally concomitantly with inhaled beclomethasone dipropionate, there was no additive inhibitory effect on cortisol. This indicates that this new steroid, ciclesonide, can be used for allergic rhinitis in conjunction with inhaled corticosteroids for asthma without risk for increased cortisol suppression.
Update: Allergies New Treatment FDA Approves New Treatment for Allergies
The Food and Drug Administration (FDA) has approved Omnaris (ciclesonide) nasal spray, a new drug for the treatment of nasal symptoms associated with seasonal and perennial allergic rhinitis, commonly known as hay fever, in adults and children 12 years of age and older.
Allergic rhinitis is the medical term for the inflamed, runny nose that's the main symptom of allergies. Seasonal allergic rhinitis is the most common allergic disease. About 35 million Americans suffer from this condition. The ailment’s classic symptoms are watery nasal discharge, and fits of sneezing, and itching that can affect not just the nose but the roof of the mouth, throat and the Eustachian tubes which connect the middle ear to the back of the throat. The safety and efficacy of Omnaris nasal spray were studied in four randomized placebo controlled clinical trials ranging in duration from two weeks to a year. The studies assessed how well Omnaris treated symptoms (runny nose, nasal itching, sneezing, and nasal congestion) in patients with hay fever. The results of these trials showed that patients treated with Omnaris nasal spray had an 8-10 percent greater reduction in nasal symptoms compared to placebo. The difference between Omnaris nasal spray and placebo was significant. The most common side effects in clinical studies were headache, nosebleeds, and inflammation of the nose and throat linings.
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