Allergy Relief: Astelin Edges Zyrtec
Nasal Antihistamine Works Fast, Gets High Marks From Patients
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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
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."