Intranasal corticosteroids for allergic rhinitis - Superior relief?

Whether first-line pharmacological treatment of allergic rhinitis should be antihistamines or intranasal corticosteroids has been discussed for severa l years. First-generation antihistamines are rarely used in the treatment o f allergic rhinitis, mainly because of sedative and anticholinergic adverse effects. On the basis of clinical evidence of efficacy, no second-generati on antihistamine seems preferable to another. Similarly, comparisons of top ical and oral antihistamines have been unable to demonstrate superior effic acy for one method of administration over the other. Current data documents no striking differences in efficacy and safety param eters between intranasal corticosteroids. When the efficacy of antihistamines and intranasal corticosteroids are comp ared in patients with allergic rhinitis, present data favours intranasal co rticosteroids. Interestingly, data do not show antihistamines as superior f or the treatment of conjunctivitis. Safety data from comparative studies in patients with allergic rhinitis do not indicate differences between antihi stamines and intranasal corti-costeroids. Combining antihistamines and intr anasal corticosteroids in the treatment of allergic rhinitis does not provi de any additional effect to intranasal corticosteroids alone. On the basis of current data, intranasal corticosteroids seem to offer superior relief i n allergic rhinitis than antihistamines.