In 2015, a multi-professional group of clinicians met in Stirling, Scotland, to development a simplified allergic rhinitis (AR) treatment algorithm for use in primary and secondary care, incorporating current knowledge and recently available treatments.
The primary objective of the panel was to promote better management of AR patients, improve diagnosis and treatment in primary care and to facilitate transition of difficult-to-treat patients into secondary care. Adherence to this care pathway has the potential to reduce AR management costs in the UK by avoiding unnecessary treatments and investigations, and avoiding the need for costly referrals to secondary care for the majority of AR cases.
The combination of intranasal azelastine hydrochloride and fluticasone propionate in a single device (Dymista® [AZ/FP]) may be used second line after failure of topical intranasal corticosteroids (INCS) after checking for correct use and compliance with the medication. If incorrect use or non-compliance is found, re-education followed by repeat trial of topical INCS is recommended before AZ/FP (single device) prescription.
AZ/FP (single device) may be used first line in certain cases in which the GP considers that monotherapy is more likely to fail, if they consider it warranted in their professional opinion, in accordance with the labelled product indication.
AH: anti-histamine; AZE: azelastine; IgE: immunoglobulin E; INCS: intranasal corticosteroid; LTRA: leukotriene receptor antagonist; OAH: oral antihistamine; OC: oral corticosteroid; Rx: treatment; SPT: skin prick test; Sx: symptoms.
*You may consider the addition of an OAH to INCS. However, scientific evidence shows that adding an OAH to INCS provides no additional benefit over INCS alone.
Adapted from Lipworth B, et al. 2017.1
Across the website you will find news, blogs and product information.
Please note that the website contains promotional and non-promotional material including educational content and resources to help you and your patients.
REGISTER NOW
