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首页> 外文期刊>Clinical & experimental allergy reviews >Positioning of antihistamines in the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines
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Positioning of antihistamines in the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines

机译：抗组胺药在变应性鼻炎中的位置及其对哮喘的影响（ARIA）指南

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Allergic rhinitis (AR) is a major health problem with high and ever-increasing prevalence worldwide. At least one-fifth of adults in industrialized countries are estimated to have AR, defined as nasal and eye symptoms that are sufficiently severe to have a substantial negative impact on the quality of life (QoL). The former classification of AR comprised seasonal AR (SAR) and perennial AR (PAR), which did not adequately reflect the presentation and clinical course of the disease. The Allergic Rhinitis and its Impact on Asthma (ARIA) classification is based on the duration of symptoms and the disease severity. Both intermittent AR (IAR: symptoms ≤ 4 days/week or ≤ 4 consecutive weeks) and persistent AR (PER: symptoms 4 days/week and 4 consecutive weeks) may be mild, moderate, or severe based on the QOL impairment (sleep, daily activities/leisure, work productivity/school performance) and bothersome symptoms. Despite its disabling effects, AR remains a condition where affected individuals do not seek appropriate treatment, are undertreated and do not adhere well to treatment, which all lead to low disease control and high societal costs. The four pillars of AR treatment are allergen and pollutant avoidance, patient education, pharmacotherapy and allergen-specific immunotherapy. Oral antihistamines, together with intranasal corticosteroids and leucotriene antagonists, constitute important pharmacological options for the treatment of AR at all levels of severity. New second-generation antihistamines are H 1-receptor antagonists with high efficacy (rapid onset of action for AR symptoms, sometimes even on nasal congestion, improvement of QoL and additional anti-allergic effects) and safety (low sedation rates). Although new antihistamines have been studied and approved for SAR and PAR, only some of them have been reported to show efficacy and safety for treatment of AR under the ARIA classification: levocetirizine (high efficacy) and rupatadine (dual antihistamine and anti-PAF effects) for PER, and desloratadine (high safety) for both IAR and PER.
机译：过敏性鼻炎（AR）是一个主要的健康问题，在世界范围内患病率高且呈不断上升的趋势。据估计，在工业化国家中至少有五分之一的成年人患有AR，即被定义为足以严重影响生活质量（QoL）的鼻和眼症状。以前的AR分类包括季节性AR（SAR）和多年生AR（PAR），但不能充分反映疾病的表现和临床过程。过敏性鼻炎及其对哮喘的影响（ARIA）分类基于症状的持续时间和疾病的严重程度。基于QOL损害，间歇性AR（IAR：症状≤4天/周或≤4个连续周）和持续性AR（PER：症状> 4天/周且≥4个连续周）均可能为轻度，中度或重度（睡眠，日常活动/休闲，工作效率/学校表现）和烦人的症状。尽管有致残作用，AR仍然是一种状况，受影响的个体没有得到适当的治疗，未得到充分的治疗并且对治疗的依从性不佳，所有这些都会导致疾病控制和社会成本降低。 AR治疗的四个支柱是避免过敏原和污染物，患者教育，药物治疗和过敏原特异性免疫疗法。口服抗组胺药与鼻内皮质类固醇和白三烯拮抗剂一起构成了治疗各种严重程度的AR的重要药理选择。新的第二代抗组胺药是H 1受体拮抗剂，具有高效（对AR症状起效迅速，有时甚至对鼻充血，QoL改善和其他抗过敏作用）和安全性（镇静率低）。尽管已经研究并批准了新的抗组胺药可用于SAR和PAR，但在ARIA分类中，仅报道了一些抗组胺药对AR的疗效和安全性：左西替利嗪（高效）和卢帕他定（双重抗组胺药和抗PAF药作用）对于PER，对于IAR和PER均使用地氯雷他定（高度安全）。

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