Table 2. Allergy treatments and their impact on throat symptoms Table 2. Allergy treatments and their impact on throat symptoms Table 2. Allergy treatments and their impact on throat symptoms Table 2. Allergy treatments and their impact on throat symptoms Table 2. Allergy treatments and their impact on throat symptoms
Study description Allergic population Allergy therapy Outcomes reported Recommendation
Systematic review of RCTs [72]
AR / AC
nsH1RAs
Only 3 RCTs were identified to include validated cough measures at baseline and post treatment. All reported significant improvements in subjective cough scores; atopic cough (relative improvement in cough frequency score: 36.6 8.4%) seasonal allergic rhinitis-associated cough (cough frequency score: 44.0 7.3% and cough intensity score: 65.7 8.3%); allergic rhinitis patients with comorbid asthma (4.0 1.3%)
Few clinical trials examining the benefits of nsH1RAs on chronic cough outcomes have been conducted. There may be a subgroup of patients, particularly those with seasonal AR related cough or atopic cough, whose cough may improve with nsH1RA treatment. Further research is required.
Prospective case series [63]
AR
INCS and Loratadine
Improvement in both subjective and objective voice parameters during pollen season.
The voice quality of patients with AR is improved with medical treatment.
Korean cough guidelines [73]
UACS (AR)
Various
For patients with suspected UACS - Intranasal steroid can be considered in order to improve cough (evidence, very low; recommendation, weak). - Oral anti-histamine is recommended to improve cough (evidence, very low; recommendation, strong). - Nasal decongestant monotherapy is not recommended to improve cough (evidence, expert opinion; recommendation, strong). - Intranasal antihistamine is not considered to improve cough (evidence, very low; recommendation, weak). - Antibiotics are not recommended to improve cough (evidence, expert opinion; recommendation, strong).
Prospective case series 50]
AR
Nasal saline nasopharyngeal irrigation (NSNPI) OR fluticasone propionate nasal spray (FPNS)
Patients with suspected AR to house-dust mite reported less cough symptoms after both interventions. VAS and nasal lavage inflammatory markers showed significant improvement or change in both. Overall, a better relief of the cough symptom after 30 days of treatment with NSNPI compared with FPNS
NSPI reduces chronic cough in AR, more so than FNPS treatment
Prospective cohort study [74] UACS (AR) Montelukast 10mg daily Cough symptoms were significantly reduced in patients with UACS or LPR, but not asthma. Treatment led to reductions in lactoferrin and ECP levels, but not MPO. Pulmonary function was not affected by treatment, Monteleukast treatment improves cough in patients with UACS but not asthma
ARIA clinical guidelines [75] UACS (AR) Various Patients with UACS should be prescribed a trial of nasal corticosteroids and/or antihistamines for at least 4 weeks