Avoidance Measures for Patients with Allergic Rhinitis: A Scoping Review

Abstract

Environmental allergen control is recommended as an essential part of allergic rhinitis (AR) management guidelines. In this scoping review, our objective is to identify measures of allergen avoidance and to evaluate their effectiveness in the management of AR. We conducted systematic searches for randomized controlled trials and observational studies in PubMed, the Cochrane Central Register of Controlled Trials, and the Web of Science databases. We included all types of control measures based on allergen eviction or reduction in exposure. Overall, 18 studies satisfied our criteria and were thus included for further analysis. The majority of the studies (15 out of 18) reported decreases in overall AR symptom scores, improvements in quality of life, or reductions in medication usage. However, due to the low number of participants and the limitations in study designs, it is not possible to make a definitive recommendation on the use of these interventions in the management of AR. A multifaceted approach, including treatment, prevention, and eradication of allergens from the environment, may be necessary to effectively reduce symptoms.

A Comprehensive Review Exploring Allergic Rhinitis With Nasal Polyps: Mechanisms, Management, and Emerging Therapies

“…It entails avoiding foods or medications containing substances triggering allergic reactions, which demands meticulous attention to identifying hidden allergens [ 44 ]. Although allergen avoidance measures aim to reduce sensitizing allergen exposure and alleviate AR symptoms, their efficacy has been questioned, lacking a definitive demonstration of effectiveness [ 45 ]. While most preventive measures effectively decrease allergen exposure, and some surpass placebo in reducing AR episodes and improving patients' quality of life, their overall efficacy remains uncertain [ 45 ].…”

“…Although allergen avoidance measures aim to reduce sensitizing allergen exposure and alleviate AR symptoms, their efficacy has been questioned, lacking a definitive demonstration of effectiveness [ 45 ]. While most preventive measures effectively decrease allergen exposure, and some surpass placebo in reducing AR episodes and improving patients' quality of life, their overall efficacy remains uncertain [ 45 ]. Environmental control measures may be inefficient against airborne pollens, necessitating identifying allergy triggers.…”

Asthma, classical conditioning, and the autonomic nervous system – a hypothesis for why children wheeze

“…Authors of British Thoracic Society (BTS) asthma guidelines do not recommend allergen avoidance to treat asthma symptoms and highlight the paradoxical effects of removing cats and dogs from the homes of children with evidence of sensitisation to their pets 9. Metanalyses of allergen avoidance confirm a lack of evidence for the benefits of allergen control in treating asthma and allergic rhinitis 10 11. Such findings suggest that while allergically triggered symptoms might be important in initiating asthma, they are less important as an ongoing cause of symptoms.…”