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When a patient’s upper respiratory symptoms are confirmed
to have an atopic component, the clinician is advised to consider
the spectrum and severity of symptoms, the cost of therapy, and the
resulting quality of life.1 Disease
management should be individualized to control the specific allergens
involved, and to select treatments that target the underlying allergic
response or help to relieve symptoms. More severe disease may require
multiple medications or specialist referral.2
When atopy is present, avoidance or environmental control is
considered the number-one therapeutic approach by leading allergy
associations such as the American Academy of Allergy, Asthma & Immunology
(AAAAI)3 and
the American Academy of Otolaryngic Allergy (AAOA).4 Identification
of the offending allergens is indispensable for appropriate patient
management. Avoidance of identified allergens can lessen an individual's
allergic load, bringing it under the allergy threshold and
reducing or eliminating symptoms and obviating pharmacotherapy. Newer
anti-IgE medication may also be beneficial, but guidelines recommend
specific IgE testing prior to use, as this medication works only
on the truly allergic patient.
There are 3 management options for allergy and allergy-related disease:
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