Skip to main content
NCBI home page
The Journal of the Royal College of General Practitioners logoLink to The Journal of the Royal College of General Practitioners
. 1989 Jul;39(324):292–296.

Treatment of hay fever.

S F Wood
PMCID: PMC1711909  PMID: 2556545

Abstract

The range of treatments for hay fever available to the general practitioner has changed considerably in recent years. New antihistamines have addressed the problem of sedation and moved towards one daily dose; nasally applied corticosteroids avoid the need for systemic steroid therapy and its potential adverse effect; and regulatory decisions have set a trend away from immunotherapy in general practice. However, knowledge about the mechanism of action of immunotherapy is increasing and new developments with improved safety profiles include allergen polymers, allergoids, oral immunotherapy and nasal immunotherapy. Choice of treatment depends, as always, on the individual circumstances of the patient and his or her disease.

Full text

PDF
292

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bousquet J., Frank E., Soussana M., Hejjaoui A., Maasch H. J., Michel F. B. Double-blind, placebo-controlled immunotherapy with a high-molecular-weight, formalinized allergoid in grass pollen allergy. Int Arch Allergy Appl Immunol. 1987;82(3-4):550–552. doi: 10.1159/000234277. [DOI] [PubMed] [Google Scholar]
  2. Bousquet J., Hejjaoui A., Skassa-Brociek W., Guérin B., Maasch H. J., Dhivert H., Michel F. B. Double-blind, placebo-controlled immunotherapy with mixed grass-pollen allergoids. I. Rush immunotherapy with allergoids and standardized orchard grass-pollen extract. J Allergy Clin Immunol. 1987 Oct;80(4):591–598. doi: 10.1016/0091-6749(87)90013-3. [DOI] [PubMed] [Google Scholar]
  3. Boyd G., Langan C. E., Langan J. J. Beclomethasone dipropionate in seasonal allergic rhinitis. A comparison of two preparations. Practitioner. 1985 Sep;229(1407):823–825. [PubMed] [Google Scholar]
  4. Chung K. F., Barnes P. J. Respiratory and allergic disease. I. Br Med J (Clin Res Ed) 1988 Jan 2;296(6614):29–33. doi: 10.1136/bmj.296.6614.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. D'Souza M. F., Tooley M., Charlton J. R. Hay fever treatments--which should be tried first? J R Coll Gen Pract. 1987 Jul;37(300):296–300. [PMC free article] [PubMed] [Google Scholar]
  6. Druce H. M., Kaliner M. A. Allergic rhinitis. JAMA. 1988 Jan 8;259(2):260–263. [PubMed] [Google Scholar]
  7. Georgitis J. W., Nickelsen J. A., Wypych J. I., Barde S. H., Clayton W. F., Reisman R. E. Local intranasal immunotherapy with high-dose polymerized ragweed extract. Int Arch Allergy Appl Immunol. 1986;81(2):170–173. doi: 10.1159/000234127. [DOI] [PubMed] [Google Scholar]
  8. Georgitis J. W., Nickelsen J. A., Wypych J. I., Kane J. H., Reisman R. E. Local nasal immunotherapy: efficacy of low-dose aqueous ragweed extract. J Allergy Clin Immunol. 1985 Apr;75(4):496–500. doi: 10.1016/s0091-6749(85)80023-3. [DOI] [PubMed] [Google Scholar]
  9. Girard J. P., Sommacal-Schopf D., Bigliardi P., Henauer S. A. Double-blind comparison of astemizole, terfenadine and placebo in hay fever with special regard to onset of action. J Int Med Res. 1985;13(2):102–108. doi: 10.1177/030006058501300205. [DOI] [PubMed] [Google Scholar]
  10. Grammer L. C., Shaughnessy M. A., Finkle S. M., Shaughnessy J. J., Patterson R. A double-blind placebo-controlled trial of polymerized whole grass administered in an accelerated dosage schedule for immunotherapy of grass pollinosis. J Allergy Clin Immunol. 1986 Dec;78(6):1180–1184. doi: 10.1016/0091-6749(86)90269-1. [DOI] [PubMed] [Google Scholar]
  11. Grammer L. C., Shaughnessy M. A., Finkle S. M., Shaughnessy J. J., Patterson R. Safety and immunogenicity of immunotherapy with polymerized tree, grass, and ragweed in patients with multiple inhalant sensitivities. J Allergy Clin Immunol. 1986 Jan;77(1 Pt 1):53–58. doi: 10.1016/0091-6749(86)90322-2. [DOI] [PubMed] [Google Scholar]
  12. Guill M. F., Buckley R. H., Rocha W., Jr, Kemp J. P., Segal A. T., Shirley L. R., Tinkelman D. G., Shaath-Schwen Z., Dietrich K. K., Wille L. J. Multicenter, double-blind, placebo-controlled trial of terfenadine suspension in the treatment of fall-allergic rhinitis in children. J Allergy Clin Immunol. 1986 Jul;78(1 Pt 1):4–9. doi: 10.1016/0091-6749(86)90107-7. [DOI] [PubMed] [Google Scholar]
  13. Holgate S. T., Howarth P. H. Treating hay fever. Br Med J (Clin Res Ed) 1985 Jul 13;291(6488):92–92. doi: 10.1136/bmj.291.6488.92. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Howarth P. H., Holgate S. T. Comparative trial of two non-sedative H1 antihistamines, terfenadine and astemizole, for hay fever. Thorax. 1984 Sep;39(9):668–672. doi: 10.1136/thx.39.9.668. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Juniper E. F., O'Connor J., Roberts R. S., Evans S., Hargreave F. E., Dolovich J. Polyethylene glycol-modified ragweed extract: comparison of two treatment regimens. J Allergy Clin Immunol. 1986 Nov;78(5 Pt 1):851–856. doi: 10.1016/0091-6749(86)90229-0. [DOI] [PubMed] [Google Scholar]
  16. Kemp J. P., Buckley C. E., Gershwin M. E., Buchman E., Cascio F. L., Chretien J. H., Foster T. S., Gordon W. E., Jakle C., Klemawesch S. J. Multicenter, double-blind, placebo-controlled trial of terfenadine in seasonal allergic rhinitis and conjunctivitis. Ann Allergy. 1985 Jun;54(6):502–509. [PubMed] [Google Scholar]
  17. Kjellman N. I., Andersson B. Terfenadine reduces skin and conjunctival reactivity in grass pollen allergic children. Clin Allergy. 1986 Sep;16(5):441–449. doi: 10.1111/j.1365-2222.1986.tb01979.x. [DOI] [PubMed] [Google Scholar]
  18. Leff S. A survey of the prevalence and treatment of asthma and hayfever in a small town in East Sussex. Public Health. 1986 Jul;100(4):205–207. doi: 10.1016/s0033-3506(86)80067-1. [DOI] [PubMed] [Google Scholar]
  19. Linder A. Symptom scores as measures of the severity of rhinitis. Clin Allergy. 1988 Jan;18(1):29–37. doi: 10.1111/j.1365-2222.1988.tb02840.x. [DOI] [PubMed] [Google Scholar]
  20. Mansfield J. R. The clinical diagnosis and treatment of rhinitis. Practitioner. 1983 Aug;227(1382):1305–1311. [PubMed] [Google Scholar]
  21. Möller C., Dreborg S. Cross-reactivity between deciduous trees during immunotherapy. I. In vivo results. Clin Allergy. 1986 Mar;16(2):135–143. doi: 10.1111/j.1365-2222.1986.tb00757.x. [DOI] [PubMed] [Google Scholar]
  22. Möller C., Dreborg S., Einarsson R. Immunotherapy to deciduous tree pollens: specific IgE and IgG antibody patterns. Clin Allergy. 1987 Nov;17(6):551–562. doi: 10.1111/j.1365-2222.1987.tb02051.x. [DOI] [PubMed] [Google Scholar]
  23. Naclerio R. M., Bartenfelder D., Proud D., Togias A. G., Meyers D. A., Kagey-Sobotka A., Norman P. S., Lichtenstein L. M. Theophylline reduces histamine release during pollen-induced rhinitis. J Allergy Clin Immunol. 1986 Nov;78(5 Pt 1):874–876. doi: 10.1016/0091-6749(86)90233-2. [DOI] [PubMed] [Google Scholar]
  24. Nickelsen J. A., Georgitis J. W., Mueller U. R., Kane J., Wypych J. I., Goldstein S., Reisman R. E., Arbesman C. E. Local nasal immunotherapy for ragweed-allergic rhinitis. III. A second year of treatment. Clin Allergy. 1983 Nov;13(6):509–519. doi: 10.1111/j.1365-2222.1983.tb02632.x. [DOI] [PubMed] [Google Scholar]
  25. Orgel H. A., Meltzer E. O., Kemp J. P., Welch M. J. Clinical, rhinomanometric, and cytologic evaluation of seasonal allergic rhinitis treated with beclomethasone dipropionate as aqueous nasal spray or pressurized aerosol. J Allergy Clin Immunol. 1986 Jun;77(6):858–864. doi: 10.1016/0091-6749(86)90384-2. [DOI] [PubMed] [Google Scholar]
  26. Pipkorn U., Enerbäck L. Nasal mucosal mast cells and histamine in hay fever. Effect of topical glucocorticoid treatment. Int Arch Allergy Appl Immunol. 1987;84(2):123–128. doi: 10.1159/000234410. [DOI] [PubMed] [Google Scholar]
  27. Pipkorn U., Proud D., Lichtenstein L. M., Kagey-Sobotka A., Norman P. S., Naclerio R. M. Inhibition of mediator release in allergic rhinitis by pretreatment with topical glucocorticosteroids. N Engl J Med. 1987 Jun 11;316(24):1506–1510. doi: 10.1056/NEJM198706113162403. [DOI] [PubMed] [Google Scholar]
  28. Pécoud A., Zuber P., Kolly M. Effect of a new selective H1 receptor antagonist (levocabastine) in a nasal and conjunctival provocation test. Int Arch Allergy Appl Immunol. 1987;82(3-4):541–543. doi: 10.1159/000234274. [DOI] [PubMed] [Google Scholar]
  29. Rak S., Håkansson L., Venge P. Eosinophil chemotactic activity in allergic patients during the birch pollen season: the effect of immunotherapy. Int Arch Allergy Appl Immunol. 1987;82(3-4):349–350. doi: 10.1159/000234224. [DOI] [PubMed] [Google Scholar]
  30. Rands D. A. Anaphylactic reaction to desensitisation for allergic rhinitis and asthma. Br Med J. 1980 Sep 27;281(6244):854–854. doi: 10.1136/bmj.281.6244.854. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Reilly D. T., Taylor M. A., McSharry C., Aitchison T. Is homoeopathy a placebo response? Controlled trial of homoeopathic potency, with pollen in hayfever as model. Lancet. 1986 Oct 18;2(8512):881–886. doi: 10.1016/s0140-6736(86)90410-1. [DOI] [PubMed] [Google Scholar]
  32. Ruhno J., Denburg J., Dolovich J. Intranasal nedocromil sodium in the treatment of ragweed-allergic rhinitis. J Allergy Clin Immunol. 1988 Mar;81(3):570–574. [PubMed] [Google Scholar]
  33. Rökenes H. K., Andersson B., Rundcrantz H. Effect of terfenadine and placebo on symptoms after nasal allergen provocation. Clin Allergy. 1988 Jan;18(1):63–69. doi: 10.1111/j.1365-2222.1988.tb02844.x. [DOI] [PubMed] [Google Scholar]
  34. Santoni P., Perdona B., Read B. H. Seasonal allergic rhinitis. Practitioner. 1984 May;228(1391):460–462. [PubMed] [Google Scholar]
  35. Shuster S. Comparative trial of two non-sedative H1 antihistamines, terfenadine and astemizole, for hay fever. Thorax. 1986 Aug;41(8):654–654. doi: 10.1136/thx.41.8.654. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Sipilä P., Sorri M., Pukander J. Double-blind comparison of nedocromil sodium (1% nasal spray) and placebo in rhinitis caused by birch pollen. Clin Otolaryngol Allied Sci. 1987 Oct;12(5):365–370. doi: 10.1111/j.1365-2273.1987.tb00218.x. [DOI] [PubMed] [Google Scholar]
  37. Skassa-Brociek W., Bousquet J., Montes F., Verdier M., Schwab D., Lherminier M., Michel F. B. Double-blind placebo-controlled study of loratadine, mequitazine, and placebo in the symptomatic treatment of seasonal allergic rhinitis. J Allergy Clin Immunol. 1988 Apr;81(4):725–730. doi: 10.1016/0091-6749(88)91045-7. [DOI] [PubMed] [Google Scholar]
  38. Taudorf E., Laursen L. C., Lanner A., Björksten B., Dreborg S., Søborg M., Weeke B. Oral immunotherapy in birch pollen hay fever. J Allergy Clin Immunol. 1987 Aug;80(2):153–161. doi: 10.1016/0091-6749(87)90124-2. [DOI] [PubMed] [Google Scholar]
  39. Van Niekerk C. H., De Wet J. I. Efficacy of grass-maize pollen oral immunotherapy in patients with seasonal hay-fever: a double-blind study. Clin Allergy. 1987 Nov;17(6):507–513. doi: 10.1111/j.1365-2222.1987.tb02046.x. [DOI] [PubMed] [Google Scholar]
  40. Vanzieleghem M. A., Juniper E. F. A comparison of budesonide and beclomethasone dipropionate nasal aerosols in ragweed-induced rhinitis. J Allergy Clin Immunol. 1987 Jun;79(6):887–892. doi: 10.1016/0091-6749(87)90237-5. [DOI] [PubMed] [Google Scholar]
  41. Welsh P. W., Stricker W. E., Chu C. P., Naessens J. M., Reese M. E., Reed C. E., Marcoux J. P. Efficacy of beclomethasone nasal solution, flunisolide, and cromolyn in relieving symptoms of ragweed allergy. Mayo Clin Proc. 1987 Feb;62(2):125–134. doi: 10.1016/s0025-6196(12)61882-5. [DOI] [PubMed] [Google Scholar]
  42. Wheatley D. Ketotifen in hay fever and allergic rhinitis. Practitioner. 1984 Jul;228(1393):685–686. [PubMed] [Google Scholar]
  43. Wood S. F. Astemizole and terfenadine compared in hay fever. Practitioner. 1986 Jan;230(1411):41–44. [PubMed] [Google Scholar]
  44. Wood S. F. Hay fever. 2. Clinical features, diagnosis, investigation and treatment. Fam Pract. 1986 Jun;3(2):120–125. doi: 10.1093/fampra/3.2.120. [DOI] [PubMed] [Google Scholar]
  45. Wood S. F. Oral antihistamine or nasal steroid in hay fever: a double-blind double-dummy comparative study of once daily oral astemizole vs twice daily nasal beclomethasone dipropionate. Clin Allergy. 1986 May;16(3):195–201. doi: 10.1111/j.1365-2222.1986.tb00766.x. [DOI] [PubMed] [Google Scholar]

Articles from The Journal of the Royal College of General Practitioners are provided here courtesy of Royal College of General Practitioners

RESOURCES