Optimising the management of allergic rhinitis: an Australian perspective.

Allergic rhinitis (AR) is one of the most prevalent medical conditions. It has significant effects on quality of life and can have considerable socioeconomic effects. The traditional classification of perennial and seasonal rhinitis does not distinguish between provoking factors, nor does it indicate the most appropriate treatment. A more useful classification is based on symptoms, which may be intermittent or persistent, and vary widely in severity. The goal of management is to achieve optimal symptom control. Therapeutic options include allergen avoidance, pharmacotherapy and immunotherapy. Antihistamines and intranasal corticosteroids (INCS) have become the cornerstones of therapy. A variety of effective treatments are available for consumers to self-select, without the advice of a doctor or pharmacist. INCS are widely recognised as the most effective pharmacotherapy for AR, in both adults and children. The efficacy of various preparations is similar, but those with low systemic bioavailability are preferred for children and for patients who are also receiving inhaled, topical or systemic corticosteroids.

The Chinese herbal formulation biminne in management of perennial allergic rhinitis: a randomized, double-blind, placebo-controlled, 12-week clinical trial.

BACKGROUND: Herbal therapies have been widely used in allergic rhinitis (AR), but none have been shown to be effective in controlled scientific clinical trials. OBJECTIVE: The aim of this study was to test the effects of the Chinese herbal formulation Biminne in patients with moderate to severe perennial AR. METHODS: In a randomized, double-blind, placebo-controlled clinical trial, 58 patients were randomized to receive either Biminne capsules (n = 26) or placebo (n = 32) in doses of five capsules twice a day for 12 weeks. Main outcomes were measured by changes in symptom diaries, quality of life scores, patients' evaluations of improvement on visual analog scores, and physicians' overall evaluation. Total serum immunoglobulin E was measured in all patients without knowledge of which group they were in. After 1 year we performed a randomized, double-blind, dose-response study in 22 patients who had previously received placebo. RESULTS: The trial outcomes evaluated by four instruments showed a statistically significant improvement in some of the symptoms of AR, whereas others exhibited a positive trend that did not reach statistical significance. Followup 1 year after completion of the trial suggested that benefit of the treatment persisted. A pilot dose-response study showed both half and full strengths were effective. Total serum immunoglobulin E was reduced after the herbal treatment. CONCLUSIONS: Our results suggest the Biminne formulation is effective in treatment of perennial AR. Its mode of action is unknown.