Allergic Rhinitis Overview

Woman with sinus

At GSK we are committed to helping your patients with respiratory allergies feel better and to reducing their symptom burden and adverse consequences.

What is an allergy?

An allergy is an excessive or abnormal adaptive immune response directed against non-infectious, often inert environmental substances (allergens), including non-infectious components of certain infectious organisms. 1

Allergic disorders, which include anaphylaxis, allergic rhinitis/hay fever, eczema, and asthma, afflict approximately 25% of people in the developed world. For people with allergies, persistent or repetitive exposure to allergens, which are typically innocuous substances, results in chronic allergic inflammation. 1

In Norway around 20% of the population suffers from severe pollen allergy. 16

Among younger schoolchildren app. 10–20% suffer from pollen allergy, while app. 15– 30% of teenagers. In total app. 1 mill Norwegians suffer from pollen allergy. 16

In turn, this can produce long-term changes in the structure of the affected organs and substantial abnormalities in their function. 1

  • Triggers

    Woman with a dog

    Allergy triggers

    Where are patients encountering these allergens? Some allergens are more obvious than others.

    Some common allergens are3:

    • Tree, grass, and weed pollen
    • Dust mites
    • Mold
    • Pet dander

    Some less obvious allergens are4:

    • Dirty pillows
    • Carpeting
    • Back yard leaf piles
  • Allergy signs & symptoms

    What is allergic rhinitis?

    Allergic rhinitis (AR) is defined as an IgE antibody-mediated, inflammatory disease characterized by one or more of the following symptoms: nasal congestion, rhinorrhea (runny nose), and sneezing and itching2.

    There are several AR classification characteristics that can be helpful to determine appropriate patient treatment strategies, including2:

    1. Temporal pattern and context of exposure to a triggering allergen: a) Seasonal (eg, pollens) or perennial (year-round exposures such as house dust mites), or b) Episodic environmental (from allergen exposures not normally encountered in the patient’s home or occupational environment, eg, visiting a home with pets not present in an individual’s home)
    2. Frequency and duration of symptoms
    3. Severity of symptoms

    AR has traditionally been categorized as seasonal AR (SAR) or perennial AR (PAR), both of which are conditions recognized as having similar pathophysiologic and end-organ manifestations. In general, the differences between the two conditions are primarily based on the causes and duration of disease.2

    Third type of allergic rhinitis, vasomotoric AR (VAR) is an inflammation of the nasal mucosa of unknown cause.

  • Management

    Doctor with patient image

    Management of allergic rhinitis (AR)

    In addition to oral antihistamines and intranasal corticosteroids, first‐line treatment for allergies also involves the avoidance of triggers that may cause an allergic reaction6.

    Avoidance strategies include6:

    • Use of allergen‐impermeable covers for bedding
    • Maintaining relative humidity in the home below 50% to inhibit mite growth
    • Reducing pollen exposure by keeping windows closed, using air conditioning, and limiting the amount of time spent outside during peak pollen season
    • Avoiding exposure to or ownership of pets

    Unfortunately, while avoidance is ideal, it is not always realistic.

    Mode of action of antihistamines

    Antihistamines work by binding to the H1 receptor, therefore inhibiting histamine (a mediator of the inflammatory response) from binding to the H1 receptor. This hinders the body’s response when exposed to an allergen, thus preventing symptoms such as wheezing, sneezing, coughing, itchy nose and eyes, runny nose, and shortness of breath7

    MOA of intranasal corticosteroids (INSs)

    INSs, often used as treatment for patients with mild persistent or moderate‐to‐severe symptoms, work locally in the nasal mucosa to block multiple mediators involved in the allergic cascade, including histamine, cytokines, leukotrienes, chemokines, prostaglandins, and tryptase. 10-13


    • Act on both early and late phases of the inflammation process, therefore relieving the symptoms they cause
    • Provide relief of nasal congestion and itching, runny nose and sneezing, and itchy, watery eyes.
  • Impact on patient quality of life

    Family running in a park

    Quality of life impact

    Many patients will “suffer in silence” without talking about their symptoms. They may be purposefully diminishing their allergy symptoms and the impact they have on their quality of life for a variety of reasons 14:

    • They believe allergies aren’t that serious or are not a “real disease,” but more of a nuisance 15
    • They may not know that while allergies may seem benign, they can still significantly impact their quality of life 14
    • They may be unaware that untreated allergies can increase the risk for more serious diseases, such as anaphylaxis, asthma, sinusitis, altered mood, and cognitive impairment 14,16

    Patients may not recognize some symptoms as being related to allergies. In addition to these more obvious symptoms, there are a few other surprising symptoms that may be due to allergies, namely 5:

    • Chronic fatigue
    • Asthma
    • Upper respiratory infection
    • Bronchitis
    • Sinus infection
    • Depression
    • Sleeping problems
    • Difficulty concentrating
    • Lack of exercise endurance

You can help patients with allergic rhinitis by making an effective recommendation.

Women in lab

Educational resources

Find out more about Respiratory Health educational resources and studies.

Access resources



Our overviews cover the causes, signs and symptoms, and management mechanisms behind respiratory health issues.

Read more

Register now

Register now

Join the community.

Register now

Women pharmacists

Learning Lab

Access educational resources to build your knowledge and skills.

Access resources



Find out how our products can help your patients suffering from respiratory health issues and conditions.

Read more

Patient resources icon

Patient care resources

Download resources for your patients.

Find out more