Don't bother with hayfever tablets

For people with hayfever, opting for a nasal spray only strategy may be better than adding hayfever tablets to the mix, according to US experts.

The researchers analysed previous studies and recommended treating hayfever with a corticosteroid nasal spray (such as Rhinocort or Beconase) without also taking an antihistamine tablet since they don’t seem to add an extra benefit but may cause drowsiness. For serious sufferers, the researchers recommend using a combo of corticosteroid and antihistamine (such as Azep and Zyrtec) sprays.

Allergy specialists groups release guidelines for treating seasonal allergic rhinitis

The Joint Task Force on Practice Parameters (Joint Task Force) has issued three recommendations for drug treatment of seasonal allergies for people 12 years old or older. The recommendations support intranasal corticosteroids over other drug therapies or in combination with another drug. A synopsis of the recommendations is published in Annals of Internal Medicine.

Most patients who consult an allergy and immunology specialist have already tried many over-the-counter monotherapies without success and are seeking more effective treatment. No consensus exists about whether a particular medication should be used for initial treatment or about the benefit of using two or more medications concurrently for initial treatment.

The Joint Task Force developed the following evidence-based guidelines to inform treatment of seasonal allergic rhinitis in patients aged 12 and older:

1. For initial treatment of people 12 years old or older, the Joint Task Force recommends treatment with an intranasal corticosteroid alone, rather than in combination with an oral antihistamine. The Joint Task Force did not find evidence proving a benefit of adding an oral antihistamine to an intranasal corticosteroid and recognised that oral antihistamines, mainly first generation, may cause sedation and other adverse effects.
2. For initial treatment of people 15 years old or older, the Joint Task Force recommends treatment with an intranasal corticosteroid over a leukotriene receptor antagonist. The Joint Task Force found evidence clearly showing that an intranasal corticosteroid was more effective than a leukotriene receptor antagonist for nasal symptom reduction.
3. For treatment of moderate to severe seasonal allergies in persons 12 years old or older, the clinician may recommend the combination of an intranasal corticosteroid and an intranasal antihistamine for initial treatment, the Joint Task Force advises. The evidence showed that the addition of an intranasal antihistamine to an intranasal corticosteroid in patients with moderate-to-severe seasonal allergic rhinitis provides additional benefit, in contrast to combination therapy with an intranasal corticosteroid and an oral antihistamine.

The Joint Task Force comprises volunteers from the American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology. 

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