Current aspects of allergic rhinitis therapy

Pchelenok E.V., Lyaskanova L.V.

Department of Otolaryngology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia

Allergic rhinitis is a common condition that impairs quality of life, impacts social life and education, reduces productivity, and is associated with significant economic costs. Allergic rhinitis is caused by IgE-mediated reactions to inhaled allergens. It is classified into intermittent and persistent forms of mild, moderate, or severe severity. Diagnosis is based on complaints, symptoms, a detailed medical history, ENT examination data, as well as allergy diagnostic tests and specific IgE serological tests for seasonal and year-round allergens. This review summarizes current approaches to the diagnosis and treatment of allergic rhinitis according to current international (ARIA EAACI 2024–2025) and Russian clinical guidelines. A search of international and domestic literature using the PubMed/MEDLINE and OpenEvidence databases was conducted. The article’s main goal is to justify stepwise pharmacotherapy: for mild forms, oral or intranasal second-generation H1 antihistamines are preferred; for persistent moderate to severe cases, intranasal corticosteroids or their fixed-dose combinations with antihistamines are recommended. Among the second-generation systemic antihistamines, ebastine stands out, demonstrating high efficacy (including for nasal obstruction), a prolonged action of up to 48 hours, a favorable safety profile (absence of sedation and cardiotoxicity), and additional anti-inflammatory effects. For uncontrolled allergic rhinitis, despite optimized pharmacotherapy, as well as for secondary prevention of bronchial asthma, allergen-specific immune therapy is indicated. Thus, modern treatment of allergic rhinitis requires individualized drug selection based on the severity, comorbidities, and patient preferences. Ebastine is an effective and 
safe first-line agent.

For citations: Pchelenok E.V., Lyaskanova L.V. Current aspects of allergic rhinitis therapy. Pharmateca. 2026;33(6):46-52. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.6.46-52

Authors’ contribution: All authors made an equivalent contribution to the preparation of the publication.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.

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About the Authors

Ekaterina V. Pchelenok, Cand. Sci. (Med.), Associate Professor, Department of Otolaryngology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; epchelenok@yandex.ru (corresponding author)
Lada V. Lyaskanova, Department of Otolaryngology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia

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