Disclosure of potential conflict of interest K. Niespodziana receives grant support (grant no. P29398) from the Austrian Science Foundation (FWF). K. F. Chung has received honoraria for participating in advisory board meetings of GlaxoSmithKline (GSK), AstraZeneca, Novartis, Merck, Boehringer Ingelheim, and Teva regarding treatments for asthma and chronic obstructive pulmonary disease and has also been renumerated for speaking engagements. A. Custovic reports personal fees from Novartis,

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Background: The novel intranasal formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP) in a single spray (MP-AzeFlu) was compared with a first-line intranasal antihistamine spray (AZE) in Russian seasonal allergic rhinitis (SAR) patients. Methods: Moderate-to-severe SAR/rhinoconjunctivitis patients (n = 149; aged 18–65 years) were randomized to receive MP-AzeFlu (137/50 μg AZE/FP per spray) or AZE (137 μg/spray), both as 1 spray/nostril twice daily, in a multicenter, open-label, 14-day, parallel-group trial. The primary outcome was change from baseline in morning and evening reflective total nasal symptom score (rTNSS). Secondary end points included: change from baseline in reflective total ocular symptom score (rTOSS), reflective total of 7 symptom scores (rT7SS), 28-item Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) overall score, and EuroQol-5D (EQ-5D) questionnaire score. Results: When compared with AZE-treated patients, those treated with MP-AzeFlu experienced significantly greater reductions in rTNSS (difference: –2.47; 95% confidence interval [CI] –3.65 to –1.30; p < 0.001), rTOSS (difference: –1.62; 95% CI –2.32 to –0.92; p < 0.001), and rT7SS (difference: –4.34; 95% CI –5.98 to –2.70; p < 0.001). Superior relief observed on day 2 with MP-AzeFlu versus AZE was sustained throughout the study. MP-AzeFlu-treated patients experienced a greater improvement in QoL than AZE-treated patients as measured by overall RQLQ score (mean ± SD 2.91 ± 1.08 vs. 2.05 ± 1.15) and EQ-5D score (mean ± SD 87.4 ± 10.3 vs. 83.0 ± 12.8). MP-AzeFlu was well tolerated. Conclusions: MP-AzeFlu was superior to AZE in reducing moderate-to-severe SAR symptoms, providing earlier and more complete symptom relief.

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The increase in the frequency and unfavorable outcomes of anaphylactic shock in recent decades determines the need for the development of clear and clear definitions, diagnosis and treatment of both shock and prevention of possible complications associated with it. The article provides options for the course of anaphylactic shock, algorithms for diagnosis and treatment.