Połączenie azelastyny i flutykazonu w leczeniu alergicznego nieżytu nosa – dlaczego warto? Artykuł przeglądowy
##plugins.themes.bootstrap3.article.sidebar##
Opublikowane:
kwi 23, 2025
Słowa kluczowe:
alergiczny nieżyt nosa, leczenie, azelastyna, flutykazon, AzeFlu
##plugins.themes.bootstrap3.article.main##
Abstrakt
Alergiczny nieżyt nosa to najczęstsza postać choroby alergicznej, która istotnie wpływa na jakość życia chorego. Kluczowym elementem postępowania z pacjentem jest odpowiednio dobrana, spersonalizowana terapia zgodna z obowiązującymi rekomendacjami. Lek stanowiący połączenie chlorowodorku azelastyny i propionianu flutykazonu w jednej formulacji (AzeFlu) to uniwersalne rozwiązanie terapeutyczne, które dzięki synergistycznemu działaniu składowych skutecznie kontroluje wszystkie objawy alergii górnych dróg oddechowych. W wytycznych ARIA-GRADE (Allergic Rhinitis and its Impact on Asthma – Grading of Recommendations Assessment, Development and Evaluation) spozycjonowany jest on wysoko, zarówno wśród leków pierwszego wyboru u chorych dotychczas nieleczonych, jak i wśród włączanych w celu intensyfikacji terapii. Artykuł przedstawia wyniki wielu badań i metaanaliz, przeprowadzonych zgodnie z zasadami medycyny opartej na faktach (EBM), potwierdzających szybki i silny efekt terapeutyczny w leczeniu alergicznego nieżytu nosa oraz jego korzystny profil bezpieczeństwa.
Pobrania
Dane pobrania nie są jeszcze dostepne
##plugins.themes.bootstrap3.article.details##
Jak cytować
Lipiec, A. (2025). Połączenie azelastyny i flutykazonu w leczeniu alergicznego nieżytu nosa – dlaczego warto? . Alergoprofil, 21(1), 19-26. https://doi.org/10.24292/01.AP.211230425
Numer
Dział
THERAPY
Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
Bibliografia
1. Samoliński B, Raciborski R, Lipiec A et al. Epidemiologia chorób alergicznych w Polsce ECAP. Alergol Pol Pol J Allergol. 2014; 1(1): 10-8.
2. Bousquet J, Van Cauwenberge P, Khaltaev N; Aria Workshop Group, World Health Organization. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001; 108(5 Suppl): S147-334.
3. Bousquet J, Khalataev N, Alvaro A et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008. Alergia Astma Immunologia Kliniczna. 2008; 13(1): 3-39.
4. Brożek JL, Bousquet J, Agache I et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017; 140(4): 950-8.
5. Samoliński B, Arcimowicz M (eds.). Polskie Standardy Leczenia Nieżytów Nosa (PoSLeNN). Stanowisko Panelu Ekspertów Polskiego Towarzystwa Alergologicznego. Alergol Pol. 2013; 1: 1-167.
6. Klimek R, Bergmann KC, Biedermann T et al. Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care: Position Paper of the German Society of Allergology (AeDA) and the German Society of Allergy and Clinical Immunology (DGAKI), ENT Section, in collaboration with the working group on Clinical Immunology, Allergology and Environmental Medicine of the German Society of Otorhinolaryngology, Head and Neck Surgery (DGHNOKHC). Allergo J Int. 2017; 26: 16-24.
7. Mullol J, del Cuvillo A, Lockey RF. Rhinitis Phenotypes. J Allergy Clin Immunol Pract. 2020; 8: 1492-503.
8. Świerczyńska-Krępa M, Rogala B, Brożek J et al. Choroby alergiczne układu oddechowego. Alergiczny nieżyt nosa. In: Alergologia. Podręcznik specjalistyczny. Biblioteka Interny Szczeklika. Jahnz-Różyk K, Kupczyk M, Gajewski P. (eds.). Medycyna Praktyczna, Kraków 2024: 199-210.
9. Rondon C, Canto G, Blanca M. Local allergic rhinitis: a new entity, characterization and further studies. Curr Opin Allergy Clin Immunol. 2010; 10: 1-7.
10. Rodon C, Campo P, Galindo L et al. Prevalence and clinical relevance of local allergic rhinitis. Allergy. 2012; 67: 1282-8.
11. Bousquet J, Schunemann HJ, Hellings PW et al. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis. J Allergy Clin Immunol. 2016; 138: 367-74.
12. Samoliński B, Krzych-Falta E, Piekarska B et al. ARIA 2019 – zintegrowana opieka w alergicznym nieżycie nosa. Alergol Pol Pol J Allergol. 2019; 6(4): 111-26.
13. Bousquet J, Schunemann HJ, Togias A et al. Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2020; 145(1): 70-80.
14. Samoliński B, Nowicka A, Wojas O et al. Intranasal glucocorticosteroid – not only in allergic rhinitis In the 40th anniversary of intranasal glucocorticosteroids’ introduction. Otolaryngol Pol. 2014; 68(2): 51-64.
15. Wise SK, Damask C, Roland LT et al. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis 2023. Int Forum Allergy Rhinol. 2023; 13(4): 293-859.
16. Zhong Z, Xun Y, Shi X et al. Clinical efficacy and safety of MP-AzeFlu for the treatment of allergic rhinitis: a meta-analysis. Eur Arch Otorhinolaryngol. 2022; 279(5): 2457-64.
17. Klimek L, Berger WE, Bousquet J et al. MP-AzeFlu in Moderate- to-Severe Allergic Rhinitis: A Literature Review. Int Arch Allergy Immunol. 2021; 182(11): 1026-35.
18. Meltzer E, Ratner P, Bachert C et al. Clinically relevant effect of a new intranasal therapy (MP29-00302) in allergic rhinitis assessed by responder analysis. Int Arch Allergy Immunol. 2013; 161(4): 369-77.
19. Debbaneh PM, Bareiss AK, Wise SK et al. Intranasal Azelastine and Fluticasone as Combination Therapy for Allergic Rhinitis: Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. 2019; 161(3): 412-8.
20. Berger WE, Mustakov TB, Kralimarkova TZ et al. Treatment with azelastine hydrochloride and fluticasone propionate in a single delivery device of young children and adolescents with allergic rhinitis. Allergy Asthma Proc. 2020; 41(4): 232-9.
21. Bousquet J, Meltzer EO, Couroux P et al. Onset of Action of the Fixed Combination Intranasal Azelastine-Fluticasone Propionate in an Allergen Exposure Chamber. J Allergy Clin Immunol Pract. 2018; 6(5): 1726-32.
22. Marth K, Renner A, Langmayr G et al. An Observational Study to Determine the Real‑Life Effectiveness of MP‑AzeFlu® in Austrian Patients with Persistent Allergic Rhinitis. Drugs – Real World Outcomes. 2024; 11: 231-40.
23. Stjarne P, Ngujen DT, Kuhl HC. Real-Life Effectiveness of MP-AzeFlu (Dymista®) in Swedish Patients with Persistent Allergic Rhinitis, Assessed by the Visual Analogue Scale. Pragmat Obs Res. 2023; 14: 1-11.
24. Kaulsay R, Nguyen DT, Kuhl HC. Real-life effectiveness of MP-AzeFlu in Irish patients with persistent allergic rhinitis assessed by visual analogue scale and endoscopy. Immun Inflamm Dis. 2018; 6(4): 456-64.
25. Sousa-Pinto B, Schünemann HJ, Sá-Sousa A et al. Comparison of rhinitis treatments using MASK-air® data and considering the minimal important difference. Allergy. 2022; 77(10): 3002-14.
26. Canonica GW, Klimek L, Acaster S et al. Burden of allergic rhinitis and impact of MP-AzeFlu from the patient perspective: pan European patient survey. Med Res Opin. 2021; 37(7): 1259-72.
27. van Weissenbruch R, Klimek L, Galffy G et al. MP-AzeFlu Improves the Quality-of-Life of Patients with Allergic Rhinitis. J Asthma Allergy. 2020; 13: 633-45.
28. De Jong HJI, Voorham J, Scadding GK et al. Evaluating the real-life effect of MP-AzeFlu on asthma outcomes in patients with allergic rhinitis and asthma in UK primary care. World Allergy Organ J. 2020; 13(12): 100490.
29. Price D, Klimek L, Gálffy G et al. Allergic rhinitis and asthma symptoms in a real-life study of MP-AzeFlu to treat multimorbid allergic rhinitis and asthma. Clin Mol Allergy. 2020; 18: 15.
30. Berger WE, Shah S, Lieberman P et al. Long-term, randomized safety study of MP29-02 (a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate in an advanced delivery system) in subjects with chronic rhinitis. J Allergy Clin Immunol Pract. 2014; 2: 179-85.
31. van Galen KA, Nellen JF, Nieuwkerk PT. The effect on treatment adherence of administering drugs as fixed-dose combinations versus as separate pills: systematic review and meta-analysis. AIDS Res Treat. 2014; 2014: 967073.
2. Bousquet J, Van Cauwenberge P, Khaltaev N; Aria Workshop Group, World Health Organization. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001; 108(5 Suppl): S147-334.
3. Bousquet J, Khalataev N, Alvaro A et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008. Alergia Astma Immunologia Kliniczna. 2008; 13(1): 3-39.
4. Brożek JL, Bousquet J, Agache I et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017; 140(4): 950-8.
5. Samoliński B, Arcimowicz M (eds.). Polskie Standardy Leczenia Nieżytów Nosa (PoSLeNN). Stanowisko Panelu Ekspertów Polskiego Towarzystwa Alergologicznego. Alergol Pol. 2013; 1: 1-167.
6. Klimek R, Bergmann KC, Biedermann T et al. Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care: Position Paper of the German Society of Allergology (AeDA) and the German Society of Allergy and Clinical Immunology (DGAKI), ENT Section, in collaboration with the working group on Clinical Immunology, Allergology and Environmental Medicine of the German Society of Otorhinolaryngology, Head and Neck Surgery (DGHNOKHC). Allergo J Int. 2017; 26: 16-24.
7. Mullol J, del Cuvillo A, Lockey RF. Rhinitis Phenotypes. J Allergy Clin Immunol Pract. 2020; 8: 1492-503.
8. Świerczyńska-Krępa M, Rogala B, Brożek J et al. Choroby alergiczne układu oddechowego. Alergiczny nieżyt nosa. In: Alergologia. Podręcznik specjalistyczny. Biblioteka Interny Szczeklika. Jahnz-Różyk K, Kupczyk M, Gajewski P. (eds.). Medycyna Praktyczna, Kraków 2024: 199-210.
9. Rondon C, Canto G, Blanca M. Local allergic rhinitis: a new entity, characterization and further studies. Curr Opin Allergy Clin Immunol. 2010; 10: 1-7.
10. Rodon C, Campo P, Galindo L et al. Prevalence and clinical relevance of local allergic rhinitis. Allergy. 2012; 67: 1282-8.
11. Bousquet J, Schunemann HJ, Hellings PW et al. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis. J Allergy Clin Immunol. 2016; 138: 367-74.
12. Samoliński B, Krzych-Falta E, Piekarska B et al. ARIA 2019 – zintegrowana opieka w alergicznym nieżycie nosa. Alergol Pol Pol J Allergol. 2019; 6(4): 111-26.
13. Bousquet J, Schunemann HJ, Togias A et al. Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2020; 145(1): 70-80.
14. Samoliński B, Nowicka A, Wojas O et al. Intranasal glucocorticosteroid – not only in allergic rhinitis In the 40th anniversary of intranasal glucocorticosteroids’ introduction. Otolaryngol Pol. 2014; 68(2): 51-64.
15. Wise SK, Damask C, Roland LT et al. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis 2023. Int Forum Allergy Rhinol. 2023; 13(4): 293-859.
16. Zhong Z, Xun Y, Shi X et al. Clinical efficacy and safety of MP-AzeFlu for the treatment of allergic rhinitis: a meta-analysis. Eur Arch Otorhinolaryngol. 2022; 279(5): 2457-64.
17. Klimek L, Berger WE, Bousquet J et al. MP-AzeFlu in Moderate- to-Severe Allergic Rhinitis: A Literature Review. Int Arch Allergy Immunol. 2021; 182(11): 1026-35.
18. Meltzer E, Ratner P, Bachert C et al. Clinically relevant effect of a new intranasal therapy (MP29-00302) in allergic rhinitis assessed by responder analysis. Int Arch Allergy Immunol. 2013; 161(4): 369-77.
19. Debbaneh PM, Bareiss AK, Wise SK et al. Intranasal Azelastine and Fluticasone as Combination Therapy for Allergic Rhinitis: Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. 2019; 161(3): 412-8.
20. Berger WE, Mustakov TB, Kralimarkova TZ et al. Treatment with azelastine hydrochloride and fluticasone propionate in a single delivery device of young children and adolescents with allergic rhinitis. Allergy Asthma Proc. 2020; 41(4): 232-9.
21. Bousquet J, Meltzer EO, Couroux P et al. Onset of Action of the Fixed Combination Intranasal Azelastine-Fluticasone Propionate in an Allergen Exposure Chamber. J Allergy Clin Immunol Pract. 2018; 6(5): 1726-32.
22. Marth K, Renner A, Langmayr G et al. An Observational Study to Determine the Real‑Life Effectiveness of MP‑AzeFlu® in Austrian Patients with Persistent Allergic Rhinitis. Drugs – Real World Outcomes. 2024; 11: 231-40.
23. Stjarne P, Ngujen DT, Kuhl HC. Real-Life Effectiveness of MP-AzeFlu (Dymista®) in Swedish Patients with Persistent Allergic Rhinitis, Assessed by the Visual Analogue Scale. Pragmat Obs Res. 2023; 14: 1-11.
24. Kaulsay R, Nguyen DT, Kuhl HC. Real-life effectiveness of MP-AzeFlu in Irish patients with persistent allergic rhinitis assessed by visual analogue scale and endoscopy. Immun Inflamm Dis. 2018; 6(4): 456-64.
25. Sousa-Pinto B, Schünemann HJ, Sá-Sousa A et al. Comparison of rhinitis treatments using MASK-air® data and considering the minimal important difference. Allergy. 2022; 77(10): 3002-14.
26. Canonica GW, Klimek L, Acaster S et al. Burden of allergic rhinitis and impact of MP-AzeFlu from the patient perspective: pan European patient survey. Med Res Opin. 2021; 37(7): 1259-72.
27. van Weissenbruch R, Klimek L, Galffy G et al. MP-AzeFlu Improves the Quality-of-Life of Patients with Allergic Rhinitis. J Asthma Allergy. 2020; 13: 633-45.
28. De Jong HJI, Voorham J, Scadding GK et al. Evaluating the real-life effect of MP-AzeFlu on asthma outcomes in patients with allergic rhinitis and asthma in UK primary care. World Allergy Organ J. 2020; 13(12): 100490.
29. Price D, Klimek L, Gálffy G et al. Allergic rhinitis and asthma symptoms in a real-life study of MP-AzeFlu to treat multimorbid allergic rhinitis and asthma. Clin Mol Allergy. 2020; 18: 15.
30. Berger WE, Shah S, Lieberman P et al. Long-term, randomized safety study of MP29-02 (a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate in an advanced delivery system) in subjects with chronic rhinitis. J Allergy Clin Immunol Pract. 2014; 2: 179-85.
31. van Galen KA, Nellen JF, Nieuwkerk PT. The effect on treatment adherence of administering drugs as fixed-dose combinations versus as separate pills: systematic review and meta-analysis. AIDS Res Treat. 2014; 2014: 967073.