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Allergy Relief: Astelin Edges Zyrtec

Nasal Antihistamine Works Fast, Gets High Marks From Patients

Patients With Runny Noses but Without Allergies

Corren, an allergist, says that about half of the patients who come to see him for runny noses and nasal congestion aren't really suffering from allergies. They are suffering from nonallergic rhinitis, he says. And those patients may do better on Astelin, which is the only antihistamine approved for nonallergic rhinitis.

But for people who truly have serious seasonal allergies, Corren and Meltzer agree that the best initial treatment is not an antihistamine at all. Steroid nasal sprays, they say, tend to be most effective.

"For people that have mild to moderate symptoms, particularly those without nasal congestion or who have intermittent symptoms, either an oral antihistamine or a topical antihistamine like Astelin would be proper," Corren says. "But when you move into a patient population like in this study, with moderate to severe symptoms -- particularly when congestion is present -- a nasal steroid is preferable."

"If you ask the question, 'What is the first-line treatment for people with persistent seasonal disease' -- defined as lasting at least four weeks with symptoms on most days -- my first choice is intranasal corticosteroids," Meltzer says. "For people with an intermittent problem, antihistamines work well."

Meltzer notes that another head-to-head clinical trial is also pitting Astelin against Zyrtec. He would not be surprised if the next time, with different patients, there are different results. But the most important point, he says, is not that one antihistamine does slightly better than another.

"What is important is in 2005 there are good treatments available for seasonal allergy," Meltzer says. "Nobody has to suffer. It's like going to Baskin-Robbins -- you have a lot of good options."


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