Seasonal allergic rhinitis: impact of the disease and considerations for its management


  • Conflicts of interest: The author has declared no conflicts of interest.

Nobuhisa Terada, E.N.T. Alliance, Ojima E.N.T. Clinic, Surgicenter Tokyo, 4th Floor Central Plaza Ojima, 5-10-10 Ojima, Koto-ku, Tokyo 136-0072, Japan.


Many changes to our medical care services are expected to occur in the next several years, and these will substantially affect the treatment of pollinosis. Patients with pollinosis are becoming increasingly dependent on over-the-counter (OTC) medicines; today, as many as 25–30% of patients with allergic rhinitis report using these agents. This trend will be further accelerated if switched OTC medicines such as ketotifen and azelastine are sold at general retailers as well as pharmacies and drug stores under new laws. We conducted three surveys on the prescription pattern of drugs against pollinosis during the high pollen count season in 1998, 2003, and 2009. Whereas the use of chemical mediator-release inhibitors tended to decrease, that of second-generation antihistamines increased during the period examined. Especially, use of anti-leukotrienes and prostaglandin D2/chemoattractant receptor-homologous molecule expressed on Th2 cells antagonists either alone or in combination increased rapidly after their launch in 2000. Despite many successful advances in treatment, however, many patients still remain dissatisfied with their anti-pollinosis therapy. Therefore, it is essential that physicians keep abreast of what medications are to be switched to OTC status and to maintain patient satisfaction by the appropriate use of good prescription drugs.