Dr. Hadley: I agree. Better awareness of the disease burden will improve the patient-clinician discussion and thereby improve the patient-physician relationship. This will enable physicians to better guide their patients through proposed treatment plans.
Another important topic is patient preference. We have discussed that most patients would like a pill that has no side effects or that they can take once a day, perhaps once a week, or a patch that they don’t have to deal with. Unfortunately, we need to recognize that such a medication does not yet exist. Patients who have a problem with the inflammatory process should be seen by the clinician and steered toward the most effective medication, and I personally believe that the topical nasal steroids are the best choice to reduce the inflammatory process as much as possible. There are new aerosol formulations of topical nasal steroids that will bring more treatment options for allergic rhinitis.
Dr. Meltzer: We should also note that these new developments with regards to new delivery systems address expanding patient choice. There are also a number of combination agents and biologics in development that may also improve pharmacotherapeutic outcomes. Advances in immunotherapy will also help treat the basic cause of allergic disease. I think many of these options will become available within the next few years.
Dr. Stoloff: I concur. The other point that we have made, and I think it’s important to reiterate, allergic rhinitis is not in a silo. It is associated with, for most of the population, comorbid diseases. When clinicians look for comorbidities, they often gain a far better appreciation of the value of treating the allergic rhinitis and therefore improving their outcome for other health issues such as asthma. But this needs to be taken in the context of communicating with the patient, always taking patient needs and goals into consideration, and working within the economic health care system that we now face.