Features of the modern antihistamines use in the treatment of allergic rhinitis

Abstract

Allergic rhinitis remains one of the most relevant problems of modern otorhinolaryngology. The widespread prevalence, late diagnosis, underestimation of the possible risks of disease progression, the development of complications (including asthma) prompts the development and improvement of new treatment options for allergic rhinitis. Allergic rhinitis is a heterogeneous disease that presents with various clinical phenotypes, and therefore the severity of nasal symptoms can vary from mild malaise to severe disease.. Today, pharmacotherapy remains the most frequently used treatment tactic for patients with allergic rhinitis. While prescribing therapy the doctor develops an individual treatment plan based on the principles of personalized medicine, considering: the dominant symptoms, anamnesis data on previous therapy and the effect of treatment, the type of inflammation (Th2-type, mixed inflammation), concomitant diseases (conjunctivitis, asthma, etc.) etc.) and patient preferences. The tissue effects of the histamine mediator lead to the development of symptoms during the course of the disease, which determines the wide-spread use of antihistamines in the treatment of rhinitis. Antihistamines of the second generation are devoid of sedative effects, have a long-lasting effect and a good safety profile. One of the modern II generation antihistamines is bilastine. The research results proved the high antihistaminic activity of bilastine 20 mg in vitro and in vivo, the absence of cardiac and sedative side effects on the central nervous system, the ability to eliminate the nasal and ocular symptoms of disease and improve the quality of life of patients with allergic rhinitis. Thus, bilastine fully complies with current EAACI / WAO ARIA requirements for drugs used to treat AR. The paper presents a clinical case of a patient with chronic persistent allergic rhinitis, household sensitization with a slight uncontrolled course. The oral antihistamine bilastine was added to intranasal glucocorticosteroids, which help to relieve symptoms of the disease, stabilize the condition and prepare the patient for subsequent allergen-specific immunotherapy.