An algorithm recommendation for the pharmacological management of allergic rhinitis in Ukraine: a consensus statement from an expert panel

llergic rhinitis (AR) is increasing at an alarming rate in Ukraine. The clinical picture of AR in modern conditions is changing towards more severe and mixed forms. Allergic rhinitis, especially moderate to-severe, has a negative impact on patient quality of life, productivity, direct, and indirect costs. Achieving adequate symptom control is essential for successful AR management, and relies mostly on pharmacotherapy. Most patients use multiple medications to control symptoms faster and better, but symptoms may persist. With the advent of new combination therapies, such as the intranasal formulation of azelastine hydrochloride and fluticasone propionate in a single device (MP-AzeFlu) like Dymista®, most AR symptoms can be treated effectively. MP-AzeFlu acts synergistically and blocks two important pathophysiological pathways involved in the early- and late-phase reactions of the disease, providing rapid relief from all AR-associated symptoms. A total of 13 experts from Ukraine, Germany, and India participated in the development of this consensus statement. The lead author drafted the questions pertaining to diagnosis, management, treatment adherence, and real-life evidence of AR in Ukraine, and was agreed with the co-authors and expert panel. This consensus is obtained through guiding statements and recommendations based on literature evidences (recent research outcomes, randomized, and comparative studies), clinical practices and personal experience of using MP-AzeFlu in AR by allergist/ immunologists/ otolaryngologists from Ukraine. This consensus statement aimed to assist practitioners in selecting the appropriate treatment strategies, facilitate optimum use of MP-AzeFlu and provide symptomatic relief for patients with AR in the in Ukraine