medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-18-118-124medsovet-6560Research ArticleШКОЛА ОТОРИНОЛАРИНГОЛОГАTHE SCHOOL’S OF OTORHINOLARYNGOLOGISTНовые возможности в терапии аллергического ринитаNew opportunities in the allergic rhinitis therapyhttps://orcid.org/0000-0002-4164-4094ПавловаК. С.PavlovaK. S.

Павлова Ксения Сергеевна – кандидат медицинских наук, ведущий научный сотрудник отделения бронхиальной астмы.

115478, Москва, Каширское шоссе, д. 24.

Ksenia S. Pavlova - Cand. Sci. (Med.), Leading Researcher of the Department of Bronchial Asthma, National Research Center - Institute of Immunology.

24, Kashirskoye Shosse, Moscow, 115478.

ksenimedical@gmail.comhttps://orcid.org/0000-0002-7375-1759МдинарадзеД. С.MdinaradzeD. S.

Мдинарадзе Дарья Семеновна - аспирант кафедры клинической иммунологии и аллергологии, младший научный сотрудник отделения бронхиальной астмы.

115478, Москва, Каширское шоссе, д. 24.

Darya S. Mdinaradze - Postgraduate Student of the Department of Clinical Immunology and Allergology, Junior Researcher of the Department of Bronchial Asthma, National Research Center - Institute of Immunology.

24, Kashirskoye Shosse, Moscow, 115478.

darya.mdinaradze@yandex.ruГосударственный научный центр «Институт иммунологии»РоссияNational Research Center - Institute of ImmunologyRussian Federation202101122021018118124Copyright © Павлова К.С., Мдинарадзе Д.С., 20212021Павлова К.С., Мдинарадзе Д.С.Pavlova K.S., Mdinaradze D.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6560

Аллергический ринит (АР) является одним из самых распространенных аллергических заболеваний, особенно в экономически развитых странах, включая Россию. Основной целью терапии АР являются достижение контроля над симптомами заболевания, минимизация рисков будущих обострений и побочных эффектов от терапии. Антигистаминные и глюкокортикостероидные (ГКС) средства являются основными классами препаратов, используемых для лечения всех аллергических заболеваний, в т. ч. АР. Согласно федеральным клиническим рекомендациями по АР, начиная со второй ступени терапии рекомендовано применение интраназальных ГКС в сочетании с антигистаминными средствами. Оба класса препаратов обладают взаимодополняющим действием на основных этапах патогенеза аллергического воспаления. Местное использование ГКС и антигистаминных препаратов позволяет осуществить доставку лекарственного средства непосредственно в область воспаления. Современные топические ГКС обладают высоким сродством с ГКС-рецептором, обеспечивая высокую эффективность при использовании низких концентраций препарата, и низкую системную биодоступность. В обзоре представлены ключевые характеристики назального спрея олопатадина и мометазона фуроата в фиксированной комбинации, который недавно был зарегистрирован на территории РФ. Данная комбинация рекомендована к назначению у взрослых и детей старше 12 лет, страдающих АР. Описаны фармакологические характеристики каждого компонента назального спрея, включая механизм действия. Представлены результаты основных клинических исследований с применением данной комбинации у пациентов с АР, подтвердившие высокую эффективность и безопасность олопатадина / мометазона фуроата. Использование фиксированной комбинации олопатадина и мометазона фуроата обеспечивает наступление быстрого и продолжительного эффекта с минимальными рисками развития нежелательных реакций, что повышает приверженность к терапии и приводит к достижению контроля над симптомами АР.

Allergic rhinitis (AR) is one of the most common allergic diseases, especially in economically developed countries, including Russia. The main goal of AR therapy is the control achievement over the disease symptoms, the minimizing of the future exacerbations risks and side effects. Antihistamines and glucocorticosteroids are the main classes of medicines used in all allergic diseases, including AR. According to the Federal Clinical Guidelines for Allergic rhinitis the use of the intranasal corticosteroids in combination with antihistamines is recommended on the second stage of therapy and higher. Both classes of medicines have a complementary effect on the allergic inflammation pathogenesis main stages. The intranasal corticosteroids and antihistamines using allows the delivery of the medicines to the allergic inflammation area directly. Modern intranasal corticosteroids have a high affinity that provides the high efficacy in the low concentrations using and the insignificant systemic bioavailability. The review presents the key characteristics of the olopatadine and mometasone furoate nasal spray in a fixed combination, which registered in the Russian Federation recently. This combination is recommend for use in adults and children over 12 y.o. with allergic rhinitis. The pharmacological characteristics of the nasal spray components including the action mechanism described. The main clinical studies results presented, that confirmed the high efficacy and safety of olopatadine/mometasone furoate combination in AR patients. The olopatadine and mometasone furoate fixed combination ensures the rapid onset and the long-lasting effect with minimal adverse events risks that increases compliance and leads to the control achievement over the AR symptoms.

аллергический ринитинтраназальные глюкокортикостероидымометазона фуроатинтраназальные антигистаминные препаратыолопатадина гидрохлоридназальный спрейallergic rhinitisintranasal corticosteroidsmometasone furoateintranasal antihistaminesolopatadine hydrochlorideReferencesАстафьева Н.Г., Баранов А.А., Вишнева Е.А., Дайхес Н.А., Жестков А.В., Ильина Н.И. и др. Аллергический ринит: клинические рекомендации. М.; 2020. 84 с. Режим доступа: https://raaci.ru/dat/pdf/allergic_rhinitis.pdf.Astafieva N.G., Baranov A.A., Vishneva E.A., Daikhes N.A., Zhestkov A.V., Ilyina N.I. et al. Allergic rhinitis: clinical guidelines. Moscow; 2020. 84 p. (In Russ.) Available at: https://raaci.ru/dat/pdf/allergic_rhinitis.pdf.Козулина И.Е., Курбачева О.М., Ильина Н.И. Аллергия сегодня. Анализ новых эпидемиологических данных. Российский аллергологический журнал. 2014;11(3):3-10. https://doi.org/10.36691/RJA483.Kozulina I.E., Kurbacheva O.M., Ilina N.I. Allergy today. Analysis of new epidemiological data. Rossiyskiy allergologicheskiy zhurnal = Russian Journal of Allergy. 2014;11(3):3-10. (In Russ.) https://doi.org/10.36691/RJA483.Bauchau V., Durham S.R. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J. 2004;24(5):758-64. https://doi.org/10.1183/09031936.04.00013904.Bauchau V., Durham S.R. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J. 2004;24(5):758-64. https://doi.org/10.1183/09031936.04.00013904.Bousquet P.J., Bachert C., Canonica G.W., Casale T.B., Mullol J., Klossek J.M. et al. Uncontrolled allergic rhinitis during treatment and its impact on quality of life: a cluster randomized trial. J Allergy Clin Immunol. 2010;126(3):666-668.e1-5. https://doi.org/10.1016/j.jaci.2010.06.034.Bousquet P.J., Bachert C., Canonica G.W., Casale T.B., Mullol J., Klossek J.M. et al. Uncontrolled allergic rhinitis during treatment and its impact on quality of life: a cluster randomized trial. J Allergy Clin Immunol. 2010;126(3):666-668.e1-5. https://doi.org/10.1016/j.jaci.2010.06.034.Asher M.I., Montefort S., Bjorksten B., Lai C.K., Strachan D.P., Weiland S.K. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368(9537):733-743. https://doi.org/10.1016/S0140-6736(06)69283-0.Asher M.I., Montefort S., Bjorksten B., Lai C.K., Strachan D.P., Weiland S.K. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368(9537):733-743. https://doi.org/10.1016/S0140-6736(06)69283-0.Bousquet J., Schunemann HJ., Togias A., Bachert C., Erhola M., Hellings P.W. et al. Allergic Rhinitis and Its Impact on Asthma Working Group. Nextgeneration 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.e3-80.e3. https://doi.org/10.1016/j.jaci.2019.06.049.Bousquet J., Schunemann HJ., Togias A., Bachert C., Erhola M., Hellings P.W. et al. Allergic Rhinitis and Its Impact on Asthma Working Group. Nextgeneration 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.e3-80.e3. https://doi.org/10.1016/j.jaci.2019.06.049.Bousquet J., Khaltaev N., Cruz A.A., Denburg J., Fokkens W.J., Togias A. et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2) LEN and AllerGen). Allergy. 2008;63(86 Suppl.):8-160. https://doi.org/10.1111/j.1398-9995.2007.01620.x.Bousquet J., Khaltaev N., Cruz A.A., Denburg J., Fokkens W.J., Togias A. et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2) LEN and AllerGen). Allergy. 2008;63(86 Suppl.):8-160. https://doi.org/10.1111/j.1398-9995.2007.01620.x.Corren J. The impact of allergic rhinitis on bronchial asthma. J Allergy Clin Immunol. 1998;101(2 Pt 2):S352-S356. https://doi.org/10.1016/s0091-6749(98)70218-0.Corren J. The impact of allergic rhinitis on bronchial asthma. J Allergy Clin Immunol. 1998;101(2 Pt 2):S352-S356. https://doi.org/10.1016/s0091-6749(98)70218-0.Guerra S., Sherrill D.L., Martinez F.D., Barbee R.A. Rhinitis as an independent risk factor for adult-onset asthma. J Allergy Clin Immunol. 2002;109(3):419-425. https://doi.org/10.1067/mai.2002.121701.Guerra S., Sherrill D.L., Martinez F.D., Barbee R.A. Rhinitis as an independent risk factor for adult-onset asthma. J Allergy Clin Immunol. 2002;109(3):419-425. https://doi.org/10.1067/mai.2002.121701.Vignola A.M., Chanez P., Godard P., Bousquet J. Relationships between rhinitis and asthma. Allergy. 1998;53(9):833-839. https://doi.org/10.1111/j.1398-9995.1998.tb03988.x.Vignola A.M., Chanez P., Godard P., Bousquet J. Relationships between rhinitis and asthma. Allergy. 1998;53(9):833-839. https://doi.org/10.1111/j.1398-9995.1998.tb03988.x.Tohidinik H.R., Mallah N., Takkouche B. History of allergic rhinitis and risk of asthma; a systematic review and meta-analysis. World Allergy Organ J. 2019;12(10):100069. https://doi.org/10.1016/j.waojou.2019.100069.Tohidinik H.R., Mallah N., Takkouche B. History of allergic rhinitis and risk of asthma; a systematic review and meta-analysis. World Allergy Organ J. 2019;12(10):100069. https://doi.org/10.1016/j.waojou.2019.100069.Agache I., Akdis C.A. (eds.). Global atlas of allergy. 2nd ed. European Academy of Allergy and Clinical Immunology; 2021. 356 p. Available at: https://eaaci.org/documents/focusmeetings/ISAF2021/AsthmaAtlas%20II%20v1.pdf.Agache I., Akdis C.A. (eds.). Global atlas of allergy. 2nd ed. European Academy of Allergy and Clinical Immunology; 2021. 356 p. Available at: https://eaaci.org/documents/focusmeetings/ISAF2021/AsthmaAtlas%20II%20v1.pdf.Jutel M., Agache I., Bonini S., Burks A.W., Calderon M., Canonica W. et al. International consensus on allergy immunotherapy. J Allergy Clin Immunol. 2015;136(3):556-568. https://doi.org/10.1016/j.jaci.2015.04.047.Jutel M., Agache I., Bonini S., Burks A.W., Calderon M., Canonica W. et al. International consensus on allergy immunotherapy. J Allergy Clin Immunol. 2015;136(3):556-568. https://doi.org/10.1016/j.jaci.2015.04.047.Bousquet J., Schunemann H.J., Hellings P.W., Arnavielhe S., Bachert C., Bedbrook A. et al. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis. J Allergy Clin Immunol. 2016;138(2): 367.e2-374.e2. https://doi.org/10.1016/j.jaci.2016.03.025.Bousquet J., Schunemann H.J., Hellings P.W., Arnavielhe S., Bachert C., Bedbrook A. et al. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis. J Allergy Clin Immunol. 2016;138(2): 367.e2-374.e2. https://doi.org/10.1016/j.jaci.2016.03.025.Akdis C., Jutel M., Akdis M. Regulatory effects of histamine and histamine receptor expression in human allergic immune responses. Chem Immunol Allergy. 2008;94:67-82. https://doi.org/10.1159/000154858.Akdis C., Jutel M., Akdis M. Regulatory effects of histamine and histamine receptor expression in human allergic immune responses. Chem Immunol Allergy. 2008;94:67-82. https://doi.org/10.1159/000154858.Naclerio R.M. The effect of antihistamines on the immediate allergic response: a comparative review. Otolaryngol Head Neck Surg. 1993;108(6):723-730. https://doi.org/10.1177/019459989310800615.Naclerio R.M. The effect of antihistamines on the immediate allergic response: a comparative review. Otolaryngol Head Neck Surg. 1993;108(6):723-730. https://doi.org/10.1177/019459989310800615.Sher E.R., Ross J.A. Intranasal corticosteroids: the role of patient preference and satisfaction. Allergy Asthma Proc. 2014;35(1):24-33. https://doi.org/10.2500/aap.2014.35.3725.Sher E.R., Ross J.A. Intranasal corticosteroids: the role of patient preference and satisfaction. Allergy Asthma Proc. 2014;35(1):24-33. https://doi.org/10.2500/aap.2014.35.3725.Al Sayyad J.J., Fedorowicz Z., Alhashimi D., Jamal A. Topical nasal steroids for intermittent and persistent allergic rhinitis in children. Cochrane Database Syst Rev. 2007;2007(1):CD003163. https://doi.org/10.1002/14651858.CD003163.pub4.Al Sayyad J.J., Fedorowicz Z., Alhashimi D., Jamal A. Topical nasal steroids for intermittent and persistent allergic rhinitis in children. Cochrane Database Syst Rev. 2007;2007(1):CD003163. https://doi.org/10.1002/14651858.CD003163.pub4.Penagos M., Compalati E., Tarantini F., Baena-Cagnani C.E., Passalacqua G., Canonica G.W. Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta-analysis of randomized, double-blind, placebo-controlled, clinical trials. Allergy. 2008;63(10):1280-1291. https://doi.org/10.1111/j.1398-9995.2008.01808.x.Penagos M., Compalati E., Tarantini F., Baena-Cagnani C.E., Passalacqua G., Canonica G.W. Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta-analysis of randomized, double-blind, placebo-controlled, clinical trials. Allergy. 2008;63(10):1280-1291. https://doi.org/10.1111/j.1398-9995.2008.01808.x.Rodrigo G.J., Neffen H. Efficacy of fluticasone furoate nasal spray vs. placebo for the treatment of ocular and nasal symptoms of allergic rhinitis: a systematic review. Clin Exp Allergy. 2011;41(2):160-170. https://doi.org/10.1111/j.1365-2222.2010.03654.x.Rodrigo G.J., Neffen H. Efficacy of fluticasone furoate nasal spray vs. placebo for the treatment of ocular and nasal symptoms of allergic rhinitis: a systematic review. Clin Exp Allergy. 2011;41(2):160-170. https://doi.org/10.1111/j.1365-2222.2010.03654.x.Yanez A., Rodrigo GJ. Intranasal corticosteroids versus topical H1 receptor antagonists for the treatment of allergic rhinitis: a systematic review with meta-analysis. Ann Allergy Asthma Immunol. 2002;89(5):479-484. https://doi.org/10.1016/S1081-1206(10)62085-6.Yanez A., Rodrigo GJ. Intranasal corticosteroids versus topical H1 receptor antagonists for the treatment of allergic rhinitis: a systematic review with meta-analysis. Ann Allergy Asthma Immunol. 2002;89(5):479-484. https://doi.org/10.1016/S1081-1206(10)62085-6.Bielory L., Chun Y., Bielory B.P., Canonica G.W. Impact of mometasone furoate nasal spray on individual ocular symptoms of allergic rhinitis: a metaanalysis. Allergy. 2011;66(5):686-693. https://doi.org/10.1111/j.1398-9995.2010.02543.x.Bielory L., Chun Y., Bielory B.P., Canonica G.W. Impact of mometasone furoate nasal spray on individual ocular symptoms of allergic rhinitis: a metaanalysis. Allergy. 2011;66(5):686-693. https://doi.org/10.1111/j.1398-9995.2010.02543.x.Watson W.T., Becker A.B., Simons F.E. Treatment of allergic rhinitis with intranasal corticosteroids in patients with mild asthma: effect on lower airway responsiveness. J Allergy Clin Immunol. 1993;91(1 Pt 1):97-101. https://doi.org/10.1016/0091-6749(93)90301-u.Watson W.T., Becker A.B., Simons F.E. Treatment of allergic rhinitis with intranasal corticosteroids in patients with mild asthma: effect on lower airway responsiveness. J Allergy Clin Immunol. 1993;91(1 Pt 1):97-101. https://doi.org/10.1016/0091-6749(93)90301-u.Debbaneh P.M., Bareiss A.K., Wise S.K., McCoul E.D. Intranasal Azelastine and Fluticasone as Combination Therapy for Allergic Rhinitis: Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. 2019;161(3):412-418. https://doi.org/10.1177/0194599819841883.Debbaneh P.M., Bareiss A.K., Wise S.K., McCoul E.D. Intranasal Azelastine and Fluticasone as Combination Therapy for Allergic Rhinitis: Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. 2019;161(3):412-418. https://doi.org/10.1177/0194599819841883.Roberts G., Pfaar O., Akdis C.A., Ansotegui I.J., Durham S.R., Gerth van Wijk R. EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. Allergy. 2018;73(4):765-798. https://doi.org/10.1111/all.13317.Roberts G., Pfaar O., Akdis C.A., Ansotegui I.J., Durham S.R., Gerth van Wijk R. EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. Allergy. 2018;73(4):765-798. https://doi.org/10.1111/all.13317.Meltzer E.O., Farrar J.R., Sennett C. Findings from an Online Survey Assessing the Burden and Management of Seasonal Allergic Rhinoconjunctivitis in US Patients. J Allergy Clin Immunol Pract. 2017;5(3):779.e6-789.e6. https://doi.org/10.1016/j.jaip.2016.10.010.Meltzer E.O., Farrar J.R., Sennett C. Findings from an Online Survey Assessing the Burden and Management of Seasonal Allergic Rhinoconjunctivitis in US Patients. J Allergy Clin Immunol Pract. 2017;5(3):779.e6-789.e6. https://doi.org/10.1016/j.jaip.2016.10.010.Valovirta E., Myrseth S.E., Palkonen S. The voice of the patients: allergic rhinitis is not a trivial disease. Curr Opin Allergy Clin Immunol. 2008;8(1):1-9. https://doi.org/10.1097/ACI.0b013e3282f3f42f.Valovirta E., Myrseth S.E., Palkonen S. The voice of the patients: allergic rhinitis is not a trivial disease. Curr Opin Allergy Clin Immunol. 2008;8(1):1-9. https://doi.org/10.1097/ACI.0b013e3282f3f42f.Brozek J.L., Bousquet J., Agache I., Agarwal A., Bachert C., Bosnic-Anticevich S., Brignardello-Petersen R. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2016 revision. J Allergy Clin Immunol. 2017;140(4). https://doi.org/10.1016/j/jaci.2017.03.050.Brozek J.L., Bousquet J., Agache I., Agarwal A., Bachert C., Bosnic-Anticevich S., Brignardello-Petersen R. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2016 revision. J Allergy Clin Immunol. 2017;140(4). https://doi.org/10.1016/j/jaci.2017.03.050.Meltzer E.O., Wallace D., Dykewicz M., Shneyer L. Minimal Clinically Important Difference (MCID) in Allergic Rhinitis: Agency for Healthcare Research and Quality or Anchor-Based Thresholds? J Allergy Clin Immunol Pract. 2016;4(4):682.e6-688.e6. https://doi.org/10.1016/j.jaip.2016.02.006.Meltzer E.O., Wallace D., Dykewicz M., Shneyer L. Minimal Clinically Important Difference (MCID) in Allergic Rhinitis: Agency for Healthcare Research and Quality or Anchor-Based Thresholds? J Allergy Clin Immunol Pract. 2016;4(4):682.e6-688.e6. https://doi.org/10.1016/j.jaip.2016.02.006.Stoloff S.W. The National Allergy Survey Assessing Limitations (NASAL): patient and health care professional perspectives in allergic rhinitis. J Fam Pract. 2012;61(2 Suppl.):S1-S4. Available at: https://www.mdedge.com/familymedicine/article/59490/immunology/introduction.Stoloff S.W. The National Allergy Survey Assessing Limitations (NASAL): patient and health care professional perspectives in allergic rhinitis. J Fam Pract. 2012;61(2 Suppl.):S1-S4. Available at: https://www.mdedge.com/familymedicine/article/59490/immunology/introduction.Patel P., Salapatek A.M., Talluri R.S., Tantry S.K. Pharmacokinetics of intranasal mometasone in the fixed-dose combination GSP301 versus two monotherapy intranasal mometasone formulations. Allergy Asthma Proc. 2018;39(3):232-239. https://doi.org/10.2500/aap.2018.39.4134.Patel P., Salapatek A.M., Talluri R.S., Tantry S.K. Pharmacokinetics of intranasal mometasone in the fixed-dose combination GSP301 versus two monotherapy intranasal mometasone formulations. Allergy Asthma Proc. 2018;39(3):232-239. https://doi.org/10.2500/aap.2018.39.4134.Hampel F.C., Pedinoff A.J., Jacobs R.L., Caracta C.F., Tantry S.K. Olopatadine-mometasone combination nasal spray: Evaluation of efficacy and safety in patients with seasonal allergic rhinitis. Allergy Asthma Proc. 2019;40(4):261-272. https://doi.org/10.2500/aap.2019.40.4223.Hampel F.C., Pedinoff A.J., Jacobs R.L., Caracta C.F., Tantry S.K. Olopatadine-mometasone combination nasal spray: Evaluation of efficacy and safety in patients with seasonal allergic rhinitis. Allergy Asthma Proc. 2019;40(4):261-272. https://doi.org/10.2500/aap.2019.40.4223.Segall N., Prenner B., Lumry W., Caracta C.F., Tantry S.K. Long-term safety and efficacy of olopatadine-mometasone combination nasal spray in patients with perennial allergic rhinitis. Allergy Asthma Proc. 2019;40(5):301-310. https://doi.org/10.2500/aap.2019.40.4233.Segall N., Prenner B., Lumry W., Caracta C.F., Tantry S.K. Long-term safety and efficacy of olopatadine-mometasone combination nasal spray in patients with perennial allergic rhinitis. Allergy Asthma Proc. 2019;40(5):301-310. https://doi.org/10.2500/aap.2019.40.4233.Patel P., Salapatek A.M., Tantry S.K. Effect of olopatadine-mometasone combination nasal spray on seasonal allergic rhinitis symptoms in an environmental exposure chamber study. Ann Allergy Asthma Immunol. 2019;122(2):160.e1-166.e1. https://doi.org/10.1016/j.anai.2018.10.011.Patel P., Salapatek A.M., Tantry S.K. Effect of olopatadine-mometasone combination nasal spray on seasonal allergic rhinitis symptoms in an environmental exposure chamber study. Ann Allergy Asthma Immunol. 2019;122(2):160.e1-166.e1. https://doi.org/10.1016/j.anai.2018.10.011.Andrews C.P., Mohar D., Salhi Y., Tantry S.K. Efficacy and safety of twice-daily and once-daily olopatadine-mometasone combination nasal spray for seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2020;124(2): 171.e2-178.e2. https://doi.org/10.1016/j.anai.2019.11.007.Andrews C.P., Mohar D., Salhi Y., Tantry S.K. Efficacy and safety of twice-daily and once-daily olopatadine-mometasone combination nasal spray for seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2020;124(2): 171.e2-178.e2. https://doi.org/10.1016/j.anai.2019.11.007.Gross G.N., Berman G., Amar N.J., Caracta C.F., Tantry S.K. Efficacy and safety of olopatadine-mometasone combination nasal spray for the treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2019;122(6): 630.e3-638.e3. https://doi.org/10.1016/j.anai.2019.03.017.Gross G.N., Berman G., Amar N.J., Caracta C.F., Tantry S.K. Efficacy and safety of olopatadine-mometasone combination nasal spray for the treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2019;122(6): 630.e3-638.e3. https://doi.org/10.1016/j.anai.2019.03.017.

The authors declare that there are no conflicts of interest present.