Improvement in quality of Life after management of Allergic Rhinitis

Allergic rhinitis (AR) is associated with disturbed sleep and subsequent functioning, and an impaired quality of life (QoL). The symptoms of allergic rhinitis exhibit prominent circadian variations, with symptoms being more common at the night-time or early morning.

A recent review studied the efficacy of cetirizine, a second-generation antihistamine, and selective H1-receptor antagonist, in relation to improvement in the quality of life of the patients, addressing the sleep disturbances and circadian variations in the symptoms of Allergic rhinitis in clinical practice, and establishing its role as a contemporary antihistamine for the management of Allergic rhinitis compared to newer antihistamines. The findings are published in the Journal of the Association of Physicians of India JAPI.

A systematic literature review of the databases was conducted from PubMed/MEDLINE, Google Scholar, and the Cochrane Central Register of Controlled Trials from 1990 to 2020. The symptoms of Allergic rhinitis exhibited a circadian variation, with symptoms being worse during the night and early morning. The patients with Allergic rhinitis encountered several sleep-related symptoms, including poor sleep quality, daytime somnolence, fatigue, and impaired productivity and quality of life. Impaired quality of life in Allergic rhinitis was related to the disease severity.

Administration of cetirizine at bedtime provides effective control of sleep impairment and symptoms of Allergic rhinitis, besides improving the quality of life. The efficacy of cetirizine has been demonstrated to be superior or comparable to the newer second-generation antihistamines. Cetirizine exhibits a tolerability profile comparable to the newer antihistamines.

Researchers concluded that With long years of clinical experience and a good tolerability profile, cetirizine represents a valuable therapeutic option for the management of Allergic rhinitis, even 30 years after its introduction. Cetirizine is included in the National List of Essential Medicines of India for the management of allergic disorders in view of its established efficacy and safety profile as well as being a cost-effective option.

Reference: Vikas K Agrawal, Suheb Patel, Anup U Petare, Krishna C Veligandla

"Improving the Quality of Life in the Management of Allergic Rhinitis: New Perspective on Cetirizine"; Volume issue:70, JAPI.