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The search for the holy grail of rhinosinusitis: another step towards phenotyping in CRS wNP?

For many years, scientists and clinicians have been trying to understand the infinite variability within the term ‘rhinosinusitis’ using radiology, basic science, epidemiology and then using their insights to solve the riddle of management: how to explain why some patients...

Intranasal steroids in COVID-19

COVID-19 in patients with allergic conditions does not seem to take more severe course. The Global Initiative for Asthma recommended that asthmatic patients who are on prescribed inhaled or oral steroids should continue to take them. Contradictions between guidelines in...

Is non-allergic rhinitis as bad as allergic?

Non-allergic rhinitis (NAR) occurs when rhinitis symptoms are not associated with allergic, infective or anatomical reason. It is responsible for almost half of all cases of rhinitis and affects around 300 million worldwide. Assessing NAR patients’ quality of life (QoL)...

Precision medicine in allergic rhinitis and chronic rhinosinusitis

Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...

Sublingual house dust mite immunotherapy

House dust mite immunotherapy in allergic rhinitis was shown to be effective in trials with a relatively small number of participants. The authors of this study performed a multicentre double-blind randomised controlled trial to investigate effects of house dust mite...

Medical control of allergic rhinitis in children

The authors of this randomised trial aim to answer an important question – which is better: daily versus on demand use of intranasal steroids (fluticasone probionate) or antihistamines (levocetirizine dihydrochloride) for symptomatic control of allergic rhinoconjunctivitis secondary to pollen? The...

Is the lack of sunshine the reason behind allergic rhinitis?

Deficiency in Vitamin D, an in vogue immunomodulator, has been shown in emerging data to have a substantial pathogenetic role in allergic related diseases, particularly asthma. The concept of a shared upper and lower airway has allowed the natural extrapolation...

Mobile phones to assess productivity in rhinitis

Uncontrolled and moderate to severe allergic rhinitis (AR) has significant negative impact on work productivity. Work Productivity and Activity Impairment Allergic Specific Questionnaire (WPAI:AS) used to measure that impact showed this. Work productivity seems to improve when AR is treated....

Combined sprays for allergic rhinitis maintenance

This meta-analysis looked at the reported efficacy for allergic rhinitis control of various topical sprays, particularly comparative studies. There were fewer ‘head to head’ studies than we would have hoped to exist. This review included intranasal anti-histamines, intranasal steroids and...

To montelukast or not to montelukast

Both histamine and cysteinyl leukotrienes play an important role in both seasonal allergic rhinoconjunctivitis (SARC) and asthma. A combination therapy against both was shown to give benefit both in vitro and in vivo. Authors wanted to test the efficacy of...

A trial of house dust mite sublingual tablet in children with allergic rhinitis

The house dust mite (HDM) is one of the commonest causative agents in allergic rhinitis (AR), affecting patients across all demographics. Recently, sublingual immunotherapy (SLIT) has been shown in clinical trials and meta-analysis to be effective compared to placebo in...

Omalizumab for CRSwNP: a monoclonal antibody

A prospective study from London, evaluating the response of chronic rhinosinusitis patients with nasal polyposis who were being treated with monoclonal antibody against IgE for severe allergic asthma. Thirteen patients were treated with Omalizumab, according to UK guidelines for their...