Comparing available treatments for pollen-induced allergic rhinitis in children

ABSTRACT

Introduction

Pollen-induced allergic rhinitis (PIAR) is a widespread disease in children, and its prevalence is rapidly evolving. In addition, it may be associated with other atopic diseases, in particular asthma. In most cases, PIAR can be treated effectively by avoiding exposure to responsible allergens and using symptomatic treatments, including intranasal/oral antihistamines or/and nasal corticosteroids, according to ARIA guidelines. In recent decades, new medicines have been studied and developed: allergen-specific immunotherapy (AIT), anti-IgE antibodies, and probiotics. In addition, nutraceuticals have also been used as add-on treatments. This review aims to discuss and compare the old and new therapeutic strategies for PIAR in children.

Areas covered

Allergic rhinitis is a type 2 inflammatory disease. The management of patients with PIAR entails medications, AIT, and ancillary therapies. In addition, children with PIAR and associated severe asthma may be inclusively treated with biologics. Namely, subjects with allergic comorbidities could benefit from biological agents. However, AIT presently remains the unique causal treatment for PIAR.

Expert opinion

New strategies may include combined treatments, mainly concerning fixed associations with antihistamines and corticosteroids, nutraceutical products, and new AIT formulations.

KEYWORDS:

• Allergic rhinitis
• pollen allergy
• children
• antihistamines
• intranasal corticosteroids
• allergen-specific immunotherapy
• nutraceuticals

Article highlights

• Pollen-induced allergic rhinitis is a common disease characterized by typical symptoms and inflammatory reaction.

• Different therapeutic strategies are available, including antihistamines, corticosteroids, allergen immunotherapy, and nutraceuticals.

• Pharmacologic treatments are effective and generally safe but are not a resolutive strategy.

• Allergen-specific immunotherapy is the only curative therapy still now.

• Nutraceuticals could represent an attractive add-on therapy.

Author contributions

A Klain, C Indolfi, G Dinardo, F Decimo, M Miraglia Del Giudice participated in the article’s writing, G Ciprandi revised and edited the paper. All authors reviewed and approved the final version of the manuscript to be published.

Declaration of interest

The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.