What are the treatments for allergic reactions to environmental allergens (Environmental Allergies)?

From the Guidelines

Environmental allergies can be effectively managed through a combination of avoidance strategies, medications, and immunotherapy, with the goal of reducing symptoms and improving quality of life, as supported by the most recent clinical practice guideline on immunotherapy for inhalant allergy 1. The management of environmental allergies involves a multi-faceted approach, including:

• Avoidance of known allergens, such as pollen, dust mites, and pet dander
• Use of medications, such as:
  • Over-the-counter antihistamines, like cetirizine (Zyrtec) 10mg, loratadine (Claritin) 10mg, or fexofenadine (Allegra) 180mg, taken once daily
  • Nasal corticosteroids, such as fluticasone (Flonase) or triamcinolone (Nasacort), used as 1-2 sprays per nostril daily
  • Eye drops, like ketotifen (Zaditor) or olopatadine (Pataday), for eye symptoms
• Immunotherapy, which can provide long-term desensitization, as described in the clinical practice guideline on immunotherapy for inhalant allergy 1 The choice of treatment should be individualized, taking into account the patient's age, symptoms, and medical history, as well as the severity and frequency of symptoms, as recommended in the clinical practice guideline on allergic rhinitis 1. Immunotherapy, either subcutaneous (SCIT) or sublingual (SLIT), is a highly effective treatment option for patients with severe or persistent allergies, and can provide long-term desensitization, as supported by the clinical practice guideline on immunotherapy for inhalant allergy 1. It is essential to note that the treatment plan should be developed jointly with the patient and family, taking into account their preferences, lifestyle, and ability to adhere to the treatment regimen, as recommended in the clinical practice guideline on the diagnosis and management of rhinitis 1. Environmental controls, such as keeping windows closed during high pollen seasons, using HEPA air purifiers, washing bedding weekly in hot water, and showering before bed to remove allergens, are also crucial in managing environmental allergies, as recommended in the clinical practice guideline on allergic rhinitis 1.

From the FDA Drug Label

CLINICAL TRIALS A total of 13 randomized, double-blind, parallel-group, multicenter, vehicle placebo-controlled clinical trials were conducted in the United States in adults and pediatric patients (4 years of age and older) to investigate regular use of Fluticasone Propionate Nasal Spray, USP, in patients with seasonal or perennial allergic rhinitis INDICATIONS AND USAGE PredniSONE Tablets are indicated in the following conditions: ... 5 Allergic States Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: Seasonal or perennial allergic rhinitis

• Treatments for Environmental Allergies:
  • Fluticasone Propionate Nasal Spray, USP is used to treat seasonal or perennial allergic rhinitis.
  • Prednisone is used to control severe or incapacitating allergic conditions, including seasonal or perennial allergic rhinitis, intractable to adequate trials of conventional treatment 2 3.
• Key Points:
  • Fluticasone Propionate Nasal Spray, USP can be used as a regular treatment or as-needed for seasonal allergic rhinitis.
  • Prednisone can be used for severe or incapacitating allergic conditions, including environmental allergies.

From the Research

Treatments for Environmental Allergies

• Avoidance of allergens is a key method in preventing and treating environmental allergies, as supported by studies 4, 5, 6.
• This approach involves avoiding exposure to indoor allergens such as house dust mites, pets, and cockroaches, which can help reduce symptoms of allergic diseases 6.
• Environmental control measures, including air filtration, chemicals, and frequently washing pets, can effectively reduce levels of allergens in the home 7.
• A holistic approach, involving the simultaneous introduction of several avoidance methods, can bring beneficial effects for patients with environmental allergies 4.
• Medications such as second-generation H1 antihistamines, intranasal antihistamines, and intranasal corticosteroids can also be used to treat allergic rhinitis, depending on the severity and frequency of symptoms 8.
• Patient education and involvement in controlling their own disease are crucial in managing environmental allergies 6, 7.
• A multifaceted environmental approach, aimed at routinely and systematically reducing exposure to allergens over time, can achieve the greatest benefits for patients with allergic rhinitis 7.