Comprehensive treatment method for children with allergic rhinitis
DOI: 10.32364/2587-6821-2021-5-5-348-352
A.I. Asmanov1, N.G. Konyukova2, N.D. Pivneva1, Yu.V. Grebennikova1, A.N. Pampura1
1Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian
National Research Medical University, Moscow, Russian Federation
2Center of Medical Prevention of Department of Health of Moscow, Moscow,
Russian Federation
Allergic rhinitis (AR) is a common childhood disease. At the same time, there is an underdiagnosis of this condition in the clinical practice and its significant impact on the life quality of the patient and his family. The article describes a modern stepwise approach in complex AR therapy in children. This approach involves the choice of drug therapy in accordance with the disease course. In this case, it is necessary, in particular, to take into account the clinically significant sensitization profile, the presence of concomitant allergic and non-allergic pathology, the patterns of the expected exposure of relevant allergens, the disease course severity, the patient’s age, response to therapy, etc. The current problems of conservative treatment are discussed. Information on the pharmacological drug groups for the AR treatment is presented: H1-antagonists, antileukotriene drugs, intranasal glucocorticosteroids. The main effects and the most common adverse events of their usage are considered. Practical issues of AR treatment tactics, relevant for pediatricians, allergists and otorhinolaryngologists, are highlighted. The prescription of drug combinations of different groups is substantiated, providing a simultaneous effect on different links of the pathogenetic process. The importance of elimination measures and allergen-specific immunotherapy is noted.
Keywords: allergic rhinitis, sensitization, H1-antagonists, leukotriene receptor antagonists, glucocorticosteroids, children.
For citation: Asmanov A.I., Konyukova N.G., Pivneva N.D. et al. Comprehensive treatment method for children with allergic rhinitis. Russian Medical Inquiry. 2021;5(5):348–352 (in Russ.). DOI: 10.32364/2587-6821-2021-5-5-348-352.
About the authors:
Alan I. Asmanov — C. Sc. (Med.), Head of the Department of Acute and Chronic Pathology of the Ear, Throat and Nose, Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University; 2, Taldomskaya str., Moscow, 125412, Russian Federation; ORCID iD 0000-0002-3116-644.
Natalia G. Konyukova — C. Sc. (Med.), Head of the Department of Allergology, Center of Medical Prevention of Department of Health of Moscow; 39, Marshal Biryuzov str., Moscow, 123060, Russian Federation.
Natalia D. Pivneva — Senior Researcher, Head of the Department of Acute and Chronic Pathology of the
Ear, Throat and Nose, Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University; 2, Taldomskaya str., Moscow, 125412, Russian Federation; ORCID iD 0000-0003-
3673-9272.
Yulia V. Grebennikova — allergist-immunologist, Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University;
2, Taldomskaya str., Moscow, 125412, Russian Federation; ORCID iD 0000-0002-2211-7758.
Alexander N. Pampura — Dr. Sc. (Med.), Head of the Department of Allergology and Clinical Immunology, Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University; 2, Taldomskaya str., Moscow, 125412, Russian Federation; ORCID iD 0000-0001-
5039-8473.
Contact information: Alexander N. Pampura, e-mail: apampura@pedklin.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 29.06.2021.
Revised 22.07.2021.
Accepted 16.08.2021.
2. Tsarev S.V. Allergic rhinitis: current assessment of medical and social aspects and methods of treatment. Intranasal corticosteroids in the treatment of rhinitis. Medical Council. 2018;(17):187–192 (in Russ.). DOI: 10.21518/2079-701X-2018-17-187-191.
3. Astaieva N.G., Baranov A.A., Vishneva E.A. et al. Allergic rhinitis. Russian rhinology. 2020;28(4):246–256 (in Russ.). DOI: 10.17116/rosrino202028041246.
4. Bousquet J., van Cauwenberge P., Khaltaev N. Aria Workshop Group; World Health Organization Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001;108(Suppl. 5):S147–334. DOI: 10.1067/mai.2001.118891.
5. Kurbacheva O.M., Polner S.A., Smirnov D.S. Allergic rhinitis. Perpetual problem and current solutions. Medical Council. 2015;(3):84–91 (in Russ.). DOI: 10.21518/2079-701X-2015-3-84-91.
6. IIyenkova N.A. Allergic rhinitis in children. Vestnik klinicheskoy bol’nitsy № 51. 2008;2:20–27 (in Russ.).
7. Yanai K., Rogala B., Chugh K. et al. safety considerations in the management of allergic diseases: focus on antihistamines. Curr Med Res Opin. 2012;28(4):623–642. DOI: 10.1185/03007995.2012.672405.
8. Pampura A.N., Papadopoulos N.G., Špičák V., Kurzawa R. Evidence for clinical safety, efficacy, and parent and physician perceptions of levocetirizine for the treatment of children with allergic disease. Int Arch Allergy Immunol. 2011;155(4):367–378. DOI: 10.1159/000321181.
9. Pampura A.N. The value of lipid mediators of inflammation in concomitant atopic lesions of the skin and gastrointestinal tract in the justification of therapy: thesis. M.; 1995 (in Russ.).
10. Koning H., Baert M.R.M., Oranje A.P. et al. Development of immune functions related to allergic mechanisms in young children. Pediatr Res. 1996;40(3):363–375. DOI: 10.1203/00006450-199609000-00001.
11. Barnes K.C. Evidence for common genetic elements in allergic disease. J Allergy Clin Immunol. 2000;106:192–200. DOI: 10.1067/mai.2000.110150.
12. Karpova E.P. Treatment of Allergic Rhinitis in Children: A Guide for Physicians. M.: GEOTAR-Media; 2007:22–23 (in Russ.).
13. Scadding G. Optimal management of nasal congestion caused by allergic rhinitis in children: safety and efficacy of medical treatments. Paediatr Drugs. 2008;10:151–162. DOI: 10.2165/00148581-200810030-00004.
14. Zharkikh M., Yablonsky S., Mokronosova M. Leukotrienes and antileukotriene drugs in allergic rhinitis. Pediatric pharmacology. 2009;6(5):20–29 (in Russ.).
15. Shaw R.J., Fitzharris P., Cromwell O. et al. Allergen-induced 914 release of sulphidopeptide leukotrienes (SRS-A) and LTB4 in allergic rhinitis. Allergy. 1985;40:1–6.
16. Churyukina E.V. Role and place of intranasal corticosteroids in the treatment of allergic rhinitis at the present stage. RMJ. 2019;3:51–56 (in Russ.).
17. Nathan R.A. The pathophysiology, clinical impact, and management of nasal congestion in allergic rhinitis. Clin Ther. 2008;30(4):573–586. DOI: 10.1016/j.clinthera.2008.04.011.
18. Gupta V., Matreja P.S. Efficacy of montelukast and levocetirizine as treatment for allergic rhinitis. J Allergy Ther. 2010;1:103. DOI: 10.4172/2155-6121.1000103.
19. Kurbacheva O.M., Galitskaya M.A. The place of Omalizumab in the treatment of allergic diseases. Medical Council. 2019;(15):38–49 (in Russ.).
20. Pavlova K.S. New opportunities allergen immunotherapy. (Suppl. Consilium Medicum). 2017;4:56–58 (in Russ.).
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