Drug Therapy, Combination ; Humans ; Rhinitis, Allergic ; drug therapy

Evidence-Based Medicine ; Humans ; Rhinitis, Allergic, Perennial ; drug therapy ; Rhinitis, Allergic, Seasonal ; drug therapy

Biological Products ; Chronic Disease ; Humans ; Nasal Polyps/drug therapy* ; Rhinitis/drug therapy* ; Sinusitis/drug therapy*

The allergen specific immunotherapy is the only valuable method to modify a natural course of disease in the treatment of allergic rhinitis. This has been used for the treatment of allergic diseases such as rhinitis and asthma since the beginning of the 20th century. Many different methods have been developed and are being developing in the immunotherapy field. But classical allergen specific injection immunotherapy is still the most widely used one in the world. And the mechanism of this therapy has been revealed by a lot of research, which has been concluded to modify the T cell response to allergen exposure. It generally is indicated for patients who have a clinically relevant IgE-mediated disease, especially in whom environmental control and pharmacotherapy inadequately treat the symptoms. Recently, the indications of immunotherapy are getting wider. The efficacy and duration is not standardized yet. And newly discovered antigen and alteration of allergen should be considered as important factors to evaluate the patients and initiate the immunotherapy. The development of standardization of extract and well-organized schedules of injection reduce the risk of complications of immunotherapy. The scope of this review is to highlight the recent information and practical approach of the allergen specific injection immunotherapy.
Appointments and Schedules ; Asthma ; Drug Therapy ; Humans ; Immunotherapy* ; Rhinitis*

Chronic Disease ; Humans ; Rhinitis ; drug therapy ; surgery ; Sinusitis ; drug therapy ; surgery

Anti-Allergic Agents ; therapeutic use ; Chronic Disease ; Humans ; Rhinitis, Allergic, Perennial ; drug therapy ; Sinusitis ; drug therapy

Anti-Bacterial Agents ; therapeutic use ; Chronic Disease ; Humans ; Rhinitis ; drug therapy ; Sinusitis ; drug therapy

Glucocorticoids (GC) are increasingly being used to treat chronic rhinosinusitis, its efficacy and safety are the focus of attention. This article will be divided into chronic rhinosinusitis with nasal polyps and without nasal polyps two subtypes discussed nasal and oral glucocorticoids in the clinical therapeutic efficacy and medication safety.
Chronic Disease ; Glucocorticoids ; therapeutic use ; Humans ; Rhinitis ; drug therapy ; Sinusitis ; drug therapy

The articles involving Xiangju Capsules were retrieved, and qualitative research and quantitative research methods were combined to evaluate the evidence of the safety, effectiveness, economy, innovation, suitability, accessibility, and characteristics of traditional Chinese medicine( "6+1" dimensions) of this drug. Multi-criteria decision analysis(MCDA) model and CSC v2.0 software were used to comprehensively evaluate the clinical value of Xiangju Capsules in the treatment of rhinosinusitis and clarify the precise clinical positioning. The dimensions are graded A, B, C, or D. Multi-source safety evidence showed that the main adverse reactions were gastrointestinal reactions, rash, itching, dizziness, and headache. Based on the available studies, the risk is controllable and the safety is grade A. Meta-analysis showed that Xiangju Capsules + conventional western medicine could recover the Lund-Kennedy score, Lund-Mackay score, and CT score, relieve headache, nasal congestion, olfactory disturbance, and facial pain, with the effectiveness is grade B. The incremental cost-effectiveness ratio of Xiangju Capsules + conventional western medicine compared with conventional western medicine alone in the treatment of chronic rhinosinusitis was 263.71 yuan, about 0.82% of the per capita disposable income. The results of sensitivity analysis showed that the research results were relatively robust. Based on the assumption that the per capita disposable income in 2020 will be the threshold of patients' willingness to pay, it is more economical to use Xiangju Capsules + conventional western medicine. The drug belongs to grade A of the national medical insurance, with an average daily cost of 3.06 yuan, and the economy is grade B. This formula is modified from classic formulas and characteristic empirical formulas, be capable of improving immunity and preventing repeated attacks. It can be used for acute and chronic rhinitis-rhinosinusitis. It had a wide range of applicability, especially for the patients with head and face tenderness. Service innovation was reflected in the measures to guarantee supply, capacity, scalability, and coverage of grass-roots sales channels. The industrial innovation was improved through the management of medicinal resources, pharmaceutical industry, production technology, quality control, scientific research and development, and this formula won three national invention patents. Comprehensively, the innovation of Xiangju Capsules is grade B. According to the survey of 188 medical practitioners and 196 patients in 20 provinces, municipalities, and autonomous regions of China, the drug was characterized by easy preparation and administration, individualized medication, simple technology and management, convenient use, storage, and transport, and controllable adverse reactions, with the suitability is grade B. Xiangju Capsules showed the cost of 45.9 and 275.4 yuan for treatment of acute and chronic rhinitis-rhinosinusitis, respectively, being well affordable. It was sold in 35 000 medical institutions in China. The dosage form was suitable for transportation, storage, and grass-root application. With rich, sustainable, and available medicinal resources, the accessibility of Xiangju Capsules is grade A. This drug can be used for both acute and chronic rhinitis-rhinosinusitis, clearing heat and expelling pus, and strengthening the exterior to prevent relapse. After this drug was available on the market, over 4 000 cases were studied, with rich experience in human use accumulated, and characteristics of traditional Chinese medicine is grade B. Overall, the clinical value of Xiangju Capsules is class B. It is suggested that Xiangju Capsules should be used in accordance with the relevant policies of basic clinical drug administration to play its role.
Humans ; Rhinitis/drug therapy* ; Sinusitis/drug therapy* ; Medicine, Chinese Traditional ; Headache ; China ; Capsules

Chronic rhinosinusitis with nasal polyps （CRSwNP） remains the most difficult-to-treat subtype in the world. Biologics have shown positive results, especially in reducing nasal polyp size and improving patient-reported outcomes. The development of biologics has the potential to fulfill the unmet medical needs of treatment.
Humans ; Biological Products/therapeutic use* ; Rhinitis/drug therapy* ; Nasal Polyps/drug therapy* ; Sinusitis/drug therapy* ; Cytokines ; Chronic Disease