Therapeutic considerations

Treatment modalities recommended for patients with AR. According to the ARIA guidelines, the management strategies include four components: 

1) Patient education; 

2) Prevention of exposure to environmental allergens and irritants; 3) Pharmacological therapies; and 

4) Immunotherapy.

The effective first line drugs for AR are non-sedating antihistamines and intranasal corticosteroids. Other drugs with favorable efficacy and safety profiles include leukotriene receptor antagonists, chromones, and topical and oral decongestants. Subcutaneous immunotherapy and sublingual immunotherapy are effective and have preventative as well as long lasting effects on the disease.

In developing countries, there are limitations for the adequate treatment of AR, such as little access to specialized diagnosis and treatment, the small number of allergists, lack of confirmatory in vivo and in vitro diagnostic tests, and the cost of medications or immunotherapy

Co-morbidities, and especially asthma, must be treated concomitantly with AR. The ARIA guidelines strongly recommend that patients with AR be evaluated for asthma, and that patients with asthma be assessed for AR.

Unmet Needs 

• To define control of AR. 

• To define severe AR. 

• To define phenotypes and disease heterogeneity. 

• Additional therapies for unresponsive patients. 

• Pharmaco-economic studies. 

• Increased access to diagnosis and treatment, including allergen-specific immunotherapy, in developing countries.

Allergic Conjunctivitis

Key Statements 

• Allergic conjunctivitis is an increasingly prevalent allergic disease, with the same clinical gravity as allergic asthma and allergic rhinitis. 

• The umbrella term “allergic conjunctivitis” includes distinct clinical entities, from mild but disturbing forms due to IgE sensitization to aeroallergens, to forms of keratoconjunctivitis where the severe allergic inflammation, with corneal involvement, is more difficult to diagnose and treat, and may lead to permanent ocular damage and even loss of vision.

Introduction 

Allergic conjunctivitis is the most common cause of a red eye, affecting more than one billion people globally. There are several clinical forms of allergic conjunctivitis; intermittent or seasonal (SAC), persistent or perennial (PAC), vernal (VKC), atopic (AKC) and induced by contact lenses (CLC).