Effectiveness of allergic rhinitis treatments in real-life with a focus on MP-AzeFlu

ABSTRACT

For any allergic rhinitis (AR) treatment, it is crucial to provide evidence not only of efficacy (assessed in randomized controlled trials (RCTs)) but also of effectiveness in real-life. Observational studies provide valuable data on the use and results associated with interventions prescribed in real-life. However, real-life evidence supporting available AR treatment options is sparse with effectiveness only established for oral antihistamines (desloratadine, ebastine), intranasal corticosteroids (mometasone furoate, fluticasone propionate (FP)), allergen immunotherapy and omalizumab. A novel intranasal formulation of azelastine hydrochloride and FP in a single spray (MP-AzeFlu) shows great promise, with the effectiveness observed in real-life exceeding that noted in RCTs. This review summarises real-life data on MP-AzeFlu, which provides rapid and sustained symptom control irrespective of patient age, AR phenotype or disease severity. We call for high quality real-life research in addition to RCTs to inform future AR treatment guidelines.

KEY WORDS:

• Allergic rhinitis
• effectiveness
• MP-AzeFlu
• real-life

Financial and competing interests disclosure

L Klimek has Board membership with MEDA Pharma, Germany, Bencard Allergie, Germany. Consultancy: ALK-Abelló, Denmark, Allergopharma, Deutschland, Bionorica, Germany, Boehringer Ingelheim, Germany, GSK, Great Britain, Lofarma, Italy, Novartis, Switzerland, MEDA Pharma, Germany, MSD, USA, Phadia/Thermofisher, Sweden, Optima, Germany. Grants/grants pending: ALK-Abelló, Denmark, Allergopharma, Germany, Artu-Biologicals, Netherlands, Bencard, Great Britain, Bionorica, Germany, Biomay, Austria, Cytos, Switzerland, HAL, Netherlands, Hartington, Spain, GSK, Great Britain, Leti, Spain, Lofarma, Italy, Novartis, Switzerland, Roxall, Germany. Payment for lectures including service on speakers bureaus: ALK-Abelló, Denmark, Allergopharma, Germany, Bionorica, Germany, Boehringer Ingelheim, Germany, GSK, Great Britain, Lofarma, Italy, Novartis, Switzerland, MEDA Pharma, Germany, MSD, USA, Phadia/Thermofisher, Sweden, Optima, Germany. Payment for manuscript preparation: MEDA Pharma, Germany, Dr. Pfleger, Germany, Bionorica, Germany. P Demoly is a consultant (and a speaker) for Stallergenes, Circassia, ALK, DBV and Chiesi and was a speaker for Merck, Astra Zeneca, Pierre Fabre Medicaments, Menarini, Allergopharma, Allergy Therapeutics Ltd., ThermoFischer Scientific and GlaxoSmithKline. D Price has board membership with Aerocrine, Almirall, Amgen, AstraZeneca, Boehringer Ingelheim, Chiesi, Meda, Mundipharma, Napp, Novartis, and Teva Pharmaceuticals; consultancy with Almirall, Amgen, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Meda, Mundipharma, Napp, Novartis, and Teva Pharmaceuticals; grants and unrestricted funding for investigator-initiated studies from UK National Health Service, British Lung Foundation, Aerocrine, AKL Ltd, Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi, Eli Lilly, GlaxoSmithKline, Meda, Merck, Mundipharma, Napp, Novartis, Orion, Pfizer, Respiratory Effectiveness Group, Takeda, Teva Pharmaceuticals, and Zentiva; payments for lectures/speaking from Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, GlaxoSmithKline, Kyorin, Meda, Merck, Mundipharma, Novartis, Pfizer, SkyePharma, Takeda, and Teva Pharmaceuticals; payment for manuscript preparation from Mundipharma and Teva Pharmaceuticals; patents (planned, pending or issued) from AKL Ltd; payment for the development of educational materials from GlaxoSmithKline and Novartis; stock/stock options from AKL Ltd which produces phytopharmaceuticals; owns 80% of Research in Real Life Ltd and its subsidiary social enterprise Optimum Patient Care; received payment for travel/accommodations/meeting expenses from Aerocrine, Boehringer Ingelheim, Mundipharma, Napp, Novartis, and Teva Pharmaceuticals; funding for patient enrolment or completion of research from Almirral, Chiesi, Teva Pharmaceuticals, and Zentiva; and peer reviewer for grant committees of the Medical Research Council (2014), Efficacy and Mechanism Evaluation programme (2012), HTA (2014). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Writing assistance was utilized in the production of this manuscript and performed by Ruth Murray and Nidhi Nair of Med Script Ltd., Dundalk, Ireland and funded by an unrestricted educational grant from MEDA.