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Allergic rhinitis - Management
Basis for recommendation

  • Basis for recommending intranasal corticosteroids:
    • Good evidence indicates that intranasal corticosteroids are the most effective treatment option for all-round symptom relief of allergic rhinitis.
  • Basis for recommending oral corticosteroids for severe symptoms:
  • Basis for recommending antihistamines for people preferring 'as-required' treatment for occasional symptoms:
    • This is a pragmatic recommendation supported by experts, based on evidence of the comparative efficacy of oral antihistamines compared with other treatments for allergic rhinitis.
  • Basis for recommending intranasal ipratropium bromide:
    • Randomized controlled trials that have shown that it is effective in controlling watery nasal discharge [ARIA, 2001a].
  • Basis for recommending an intranasal decongestant:
    • Many experts consider that in the short term, intranasal decongestants are effective in the treatment of nasal obstruction [ARIA, 2001a; Scadding et al, 2008].
  • Basis for NOT recommending leukotriene receptor antagonists:
    • Experts do not recommend their use as first–line treatment for allergic rhinitis. Feedback from some expert reviewers supports their use as an add on treatment for people with allergic rhinitis and asthma when symptoms are poorly controlled with other treatments. However, there is a lack of evidence for their effectiveness as an add on treatment and their clinical role remains uncertain.

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