Allergic rhinitis associated with bronchial asthma: The importance and management of rhinitis

Abstract

The prevalence of allergic rhinitis in asthmatic patients is high. It is also known that allergic rhinitis could be a risk factor for the onset and exacerbation of asthma. Many oral and topical medicines for allergic rhinitis are expected to ameliorate symptoms of asthma indirectly by improving allergic inflammation in the nose. However, some first-generation antihistamines are contraindicated for asthma. When administering intranasal corticosteroids to patients using inhaled steroids, those with low systemic bioavailability should be chosen. Leukotrienes receptor antagonists are used not only for treatment of allergic rhinitis but also for control of asthma. Anti-human IgE antibodies with expanded indications for some of severe Japanese cedar pollinosis are also expected to be effective in the patients with asthma caused by IgE-related allergic inflammation. In Japan, the subcutaneous allergen immunotherapy is indicated for allergic rhinitis and asthma, and the sublingual method is indicated only for allergic rhinitis. It is recommended for the patients with allergic rhinitis accompanied by asthma related to house dust mite antigens. It is necessary to understand the indication of immunotherapy for asthma, to share information about patients with other physicians, and to control asthma.