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ABSTRACT: BACKGROUND: There are few studies which analyse the characteristics of allergic respiratory disease according to profiles of sensitisation to different allergens. This study describes the clinical features and therapeutic approaches, according to the sensitisation profile to relevant aeroallergens, in a sample of adult patients with a first-time diagnosis of respiratory allergy (rhinitis and/or asthma). METHODS: 1287 patients, enrolled consecutively in the spring of 2010 by 200 allergy specialists, were classified into four groups according to sensitisation to significant allergens in each geographical area (grass pollen, olive pollen, grass and olive pollen, house dust mites). Information was obtained on demographics, diagnostic procedures used, treatments prescribed, clinical characteristics of the rhinitis, and severity and control of asthma. RESULTS: Of the patients, 58.6% had rhinitis only and 38.7% had both rhinitis and asthma. Patients with more severe rhinitis had more severe and poorer controlled asthma. Sensitisation to different allergens was not associated with significant differences in severity and control of asthma, but patients with house dust mite allergy presented persistent rhinitis more frequently. Allergy to grass pollen was significantly associated with food allergies. Differences were observed in the frequency of prescription of immunotherapy and antileukotrienes in patients allergic to house dust mites and of topical corticosteroids in patients with pollen allergy. CONCLUSIONS: It was observed in this study that in respiratory allergy disease, there are clinical differences as well as differences in diagnostic procedure and therapeutic attitudes, depending on the clinically relevant allergen.
Allergologia et Immunopathologia 12/2012; · 1.04 Impact Factor
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ABSTRACT: Background: The safety and utility of nasal provocation tests with lysine-aspirin (L-ASA) in the diagnosis of aspirin-intolerant asthma (AIA) have previously been described in a short series of patients. Objectives: To describe the clinical features and safety of an L-ASA challenge test in patients with AIA. Methods: We evaluated 72 patients (79% women), with a mean ± SD age of 47.9 ± 14.5 years. All patients were submitted to an L-ASA nasal provocation test (29 mg in each nostril) under acoustic rhinometry (AcR) control. Symptom score (0-3), visual analogical scale and nitric oxide determinations were performed at baseline and at 15, 30, 60 and 90 min. A decrease in nasal volume of at least 25% was considered a positive test. Nasal nitric oxide (nNO) and forced expiratory volume in 1 s were measured. Results: Nasal congestion and rhinorrhea represented 51 and 32%, respectively, of total symptoms. According to AcR data, the L-ASA challenge test was positive in 20% of patients at 15 min, an additional 36% were positive at 30 min, 18% at 60 min, and the remaining 26% at 90 min. nNO nasal values decreased but did not reach statistical significance. No pulmonary or systemic reactions were observed. Conclusions: Symptoms of nasal congestion associated with the reduction in nasal volume measured by AcR are the most useful parameters for establishing the diagnosis of AIA using the L-ASA nasal challenge. The method is very well tolerated and can be safely used even in patients with severe asthma.
International Archives of Allergy and Immunology 10/2012; 160(3):307-312. · 2.40 Impact Factor
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M Pascal,
R Muñoz-Cano,
Z Reina,
A Palacín,
R Vilella,
C Picado,
M Juan,
J Sánchez-López,
M Rueda,
G Salcedo, A Valero,
J Yagüe,
J Bartra
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ABSTRACT: Multiple plant-food sensitizations with a complex pattern of clinical manifestations are a common feature of lipid transfer protein (LTP)-allergic patients. Component-resolved diagnosis permits the diagnosis of the allergen sensitization profile.
We sought to clinically characterize and describe the plant-food and pollen molecular sensitization profile in patients with LTP syndrome.
Forty-five subjects were recruited, after being diagnosed with multiple plant-food allergies sensitized to LTP, but not to any other plant-food allergen, according to the molecular allergen panel tested (Pru p 3 (LTP), Pru p 1 (Bet v 1-like), Pru p 4 (profilin) and those included in a commercial microarray of 103 allergenic components). IgE-mediated food-allergy symptoms and pollinosis were collected. Patients were skin prick tested with a plant-food and pollens panel, and specific IgE to Tri a 14 was evaluated.
A heterogeneous group of plant-foods was involved in local and systemic symptoms: oral allergy syndrome (75.6%), urticaria (66.7%), gastrointestinal disorders (55.6%) and anaphylaxis (75.6%), 32.4% of which were cofactor dependent (Non-Steroidal Anti-inflammatory Drugs, exercise). All tested subjects were positive to peach and Pru p 3, Tri a 14 and to some of the LTPs included in the microarray. Pollinosis was diagnosed in 75.6% of subjects, with a broad spectrum of pollen and pollen-allergen sensitization. Plane tree and mugwort were the statistically significant pollens associated with Pru p 3.
Several plant-foods, taxonomically unrelated, independent of peach involvement, are implicated in LTP syndrome. Local symptoms should be evaluated as a risk marker for anaphylaxis because they are frequently associated with cofactor-dependent anaphylaxis. The association of these symptoms with pollinosis, especially plane tree pollinosis, could be part of this syndrome in our area.
Clinical & Experimental Allergy 10/2012; 42(10):1529-39. · 5.03 Impact Factor
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ABSTRACT: A modified allergic rhinitis and its impact on asthma (ARIA) (m-ARIA) criterion to classify the severity of allergic rhinitis (AR) has recently been validated in both treated and untreated adult patients; however, such information in children is lacking. The aim of this study was to validate this m-ARIA severity criterion, which allows for discrimination between moderate and severe AR, in a large pediatric patient sample population.
The m-ARIA classification categorizes AR severity into mild (no affected items), moderate (1-3 affected items), and severe (all four affected items). We applied this modified criterion to untreated AR pediatric patients aged 6-12 years, through an observational, cross-sectional, and multicenter study. AR symptoms were assessed using the Total Four Symptom Score (T4SS), and the severity was evaluated by both ARIA severity items and visual analogue scale (VAS).
Allergic rhinitis pediatric patients (N = 1269) from 271 centers were included. Among them, 59.5% had intermittent and 40.5% persistent disease; 89.9% had moderate/severe AR using the original ARIA (o-ARIA) classification and 59.5% had moderate, while 30.5% had severe AR using the m-ARIA criterion. Using the m-ARIA, significantly higher T4SS and VAS scores were obtained when comparing severe with moderate AR.
The m-ARIA severity classification is a useful clinical tool to discriminate moderate from severe AR among untreated pediatric patients.
Allergy 09/2012; 67(11):1437-42. · 6.27 Impact Factor
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ABSTRACT: Recently, we demonstrated that acoustic rhinometry (AR) measurements correlated with nasal cavity volumes in patients with nasal polyposis (NP). The aim of the present study was to evaluate whether AR and nasal nitric oxide (nNO) are useful methods in monitoring and follow-up of medical treatment of NP.
Patients with severe nasal polyps were randomized into two groups after a 4-week steroid washout period (w0): a treatment group received oral prednisone for 2 weeks (w2) and intranasal budesonide for 12 weeks (w12) while the control group received no steroid treatment. Nasal volume (Vol 0-6), minimum cross-sectional area (mCSA), nNO, peak nasal inspiratory flow (PNIF), nasal obstruction, and smell loss were evaluated.
At w2, the treatment group showed a significant increase of vol 0-6 compared to w0 and the control group. The mCSA area also increased compared to w0 and the control group. At w12, the improvement in vol 0-6 and mCSA was maintained after intranasal steroids compared to w0. At w2, the treatment group showed a paradoxical increase of nNO compared to w0 and the control group. At w12, this increase was maintained by intranasal steroids.
Both oral and intranasal steroid treatments improve nasal patency and paradoxically increase nNO, by opening the ostiomeatal complex. This suggests that AR and nNO are useful methods in the monitoring and follow-up of patients with NP.
Rhinology 06/2012; 50(2):171-7. · 1.32 Impact Factor
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Antonio Valero,
Rosa Muñoz-Cano,
Joaquín Sastre,
Ana M Navarro,
Enrique Martí-Guadaño,
Ignacio Dávila,
Alfonso del Cuvillo,
Carlos Colás,
Ignacio Antépara,
Iñaki Izquierdo,
Joaquim Mullol
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ABSTRACT: Allergic rhinitis (AR) is a common disease with major socieconomic burden and a significant impact on quality of life.
The objective of the study was to assess the impact of AR severity, using the modified ARIA (m-ARIA) severity criterion in order to discriminate among moderate and severe AR, in symptoms and quality of life assessed with the questionnaire ESPRINT-15.
The specific quality of life questionnaire (ESPRINT-15) was applied in over thousand untreated RA patients. Severity was evaluated by the m-ARIA classification, which categorizes AR as mild, moderate, and severe. Nasal symptoms were evaluated by using categorized (none, low, middle, and high) Total Four Symptom Score (T4SS).
Using the m-ARIA severity classification, significant differences in quality of life, both global score and specific domains, and categorized T4SS were found among the AR severity groups.
Modified ARIA severity classification in mild, moderate, and severe allergic rhinitis clearly discriminates the impact of AR in all domains of quality of life and categorized symptom`s score.
Rhinology 03/2012; 50(1):33-6. · 1.32 Impact Factor
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D Benito Pescador,
M Isidoro-García,
V García-Solaesa,
M Pascual de Pedro,
C Sanz,
L Hernández-Hernández,
J Sánchez-López,
S F Lorente,
C Picado, A Valero,
I Dávila
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ABSTRACT: Nasal polyposis (NP) is a chronic inflammatory disease of the upper airways with a variable clinical course and unknown pathogenesis that often coexists with other conditions. Considering the possibility of genetic predisposition, we decided to analyze whether polymorphisms in LTC4S, CYSLTR1, PTGDR, and NOS2A were associated with NP.
The study population comprised 486 Caucasian individuals. Polyposis and aspirin intolerance were diagnosed following the recommendations of the European Position Paper on Rhinosinusitis and Nasal Polyps. Genotypes were determined using polymerase chain reaction amplification and direct sequencing.
The -444A > C LTC4S polymorphism was significantly associated with NP and atopy (P = .033) and with NP and atopic asthma, (P =.012). In addition, a significant association was found when the (CCTTT) repetition of the NOS2A gene was present more than 14 times in patients with NP and asthma (P = .034), in patients with polyposis and intolerance to nonsteroidal anti-inflammatory drugs (P = .009), and in patients with the aspirin triad (P = .005). The PTGDR diplotype CCCT/CCCC (-613CC, -549CC, -441CC and -197TC) was more frequent in patients with NP (P = .043), NP with asthma (P = .013), and the aspirin triad (P = .041).
NP was associated with specific polymorphisms only when it occurred with related phenotypes. Our results suggest that this genetic background plays a more relevant role in the development of the associated clinical features of nasal polyposis than in simple polyposis.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2012; 22(5):331-40. · 2.27 Impact Factor
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ABSTRACT: Links between the upper and lower airways have been demonstrated in recent years. However, few studies have evaluated inflammation using noninvasive methods.
A nasal allergen challenge was performed with pollen outside the pollen season in 30 patients with allergic rhinitis due to pollen but no asthma. Clinical and inflammatory nasal and bronchial responses to nasal allergen challenge were evaluated using the nasal symptoms score (NSS), visual analog scale (VAS), nasal geometry (volume between 2 and 5 cm [Vol2-5]) by acoustic rhinometry, lung function by spirometry, nasal nitric oxide (nNO), and exhaled nitric oxide (eNO). Values were recorded at baseline, 15 minutes, and 2 and 24 hours after challenge. Nasal lavage and exhaled breath condensate (EBC) samples were collected at 2 and 24 hours to assess 8-isoprostane, cys-leukotrienes, eosinophil cationic protein (ECP), tryptase, granulocyte-macrophage colony-stimulating factor, and interleukin (IL) 5.
NSS and VAS increased significantly at 15 minutes and 2 and 24 hours after challenge. Vol2-5 decreased significantly at 15 minutes and 2 hours, while nNO decreased at 15 minutes. All inflammatory mediators except ECP increased significantly at 2 hours in nasal lavage samples, while ECP, 8-isoprostane, and cys-leukotrienes increased at 24 hours (P < .01). In EBC, 8-isoprostane and cys-leukotrienes increased at 2 and 24 hours (P < .01). No significant changes were found at any time in lung function or eNO.
Nasal allergen challenge induces clinical and inflammatory responses in the nose and bronchi that can be assessed using noninvasive methods such as nasal lavage, EBC, and nNO.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2012; 22(5):351-6. · 2.27 Impact Factor
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Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2012; 22(4):299-300. · 2.27 Impact Factor
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ABSTRACT: Second-generation oral antihistamines (AH) and intranasal corticosteroids (ICS) are the most widely used drugs for allergic rhinitis (AR).
To obtain information on the preferences for and applications of these drugs under conditions of routine clinical practice.
We performed a multicenter multidisciplinary observational study. Participating physicians completed a questionnaire with information on preferences for and application of drugs for AR, patient characteristics, and physician/patient satisfaction with the treatment provided (visual analog scale).
A total of 1008 physicians participated in the study (primary care physicians, 53%; ear, nose, and throat specialists, 28%; allergologists, 19%). Treatment preferences in AR were AH combined with ICS (7.68), AH (7.25), and ICS (6.94). AH and ICS were used continuously by 58% and 71% of patients, respectively. Physicians reported having a good knowledge of the Allergic Rhinitis and its Impact on Asthma guidelines (93%), and 90% claimed to follow the guidelines. A total of 4040 patients were recruited (52% females, mean [SD] age 34 [14] years). The findings for AR were as follows: mean (SD) duration, 9 (8) years; persistent AR, 52%; mild AR, 72%; moderate AR, 7%; and severe AR, 1%. Patients considered the disorder to be well controlled/almost controlled (79%). As for treatment, 77% followed the regimen recommended by the physician. Oral treatment (41%) and intranasal treatment (22%) were preferred, while 35% showed no preference for any given administration route. The treatments prescribed were AH combined with ICS (66%), AH (20%), ICS (11%), other antihistamines (4%), and other drugs (6%). Combination treatment was the preferred therapy, regardless of the type of rhinitis.
Physicians prefer and more often use combination treatment with oral AH and ICS, regardless of the frequency and intensity of AR.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2011; 21(5):363-9. · 2.27 Impact Factor
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ABSTRACT: According to current guidelines, new second-generation oral Hi-antihistamines, as well as intranasal corticosteroids (ICSs), are recommended for the treatment of allergic rhinitis (AR) in adults and children.
To assess changes in AR severity, in addition to nasal symptoms and health-related quality of life (HRQoL), after 4 weeks of treatment with rupatadine in a cohort of AR patients.
A subanalysis of a longitudinal, observational, prospective, multicenter Spanish study was carried out in spring-summer 2007. Enrolled patients had a clinical diagnosis of AR of at least 2 years' evolution, a total nasal symptom score (TNSS) of at least 5, and had not received antihistamines in the previous week or ICSs in the previous 2 weeks. HRQoL (ESPRINT-15 questionnaire), disease severity (using both the original and modified Allergic Rhinitis and its Impact on Asthma [ARIA] classifications), and nasal symptoms (TNSS) were measured at baseline and after 4 weeks of rupatadine treatment.
Data from a cohort of 360 patients treated with rupatadine were analyzed (57.2% women, 42.5% with intermittent AR, 36.4% with asthma, and 61.7% with conjunctivitis). After 4 weeks of treatment, the patients showed a significantly lower mean (SD) TNSS (8.2 [1.9] vs 3.1 [2.1], P < .001), a significant improvement in HRQoL (3.0 [1.2] vs 1.0 [0.9], P < .001) and significantly reduced AR severity (P < .0001).
In addition to an improvement in nasal symptoms and HRQoL, rupatadine reduced AR severity after 4 weeks of treatment.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2011; 21(3):229-35. · 2.27 Impact Factor
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ABSTRACT: Chronic urticaria has an important impact upon patient quality of life, and no treatment has yet been developed capable of effectively controlling the disease. The most recent guidelines recommend the use of non-sedating antihistamines at high doses as second-step therapy before resorting to other treatments. The present review examines the studies published to date on the use of H1 antihistamines at doses higher than those indicated as therapeutic doses in chronic urticaria. Most of the studies report no significant differences among the studied doses-only a tendency towards increased response on elevating the dose. There are no clinically well designed, randomized double-blind trials comparing efficacy between therapeutic doses and doses higher than those indicated in the corresponding Summary of Product Characteristics. Likewise, there are insufficient data to conduct a meta-analysis and thus classify the degree of evidence of the few available studies, which moreover present contradictory results. At present, the prescription of high-dose H1 antihistamines is based only on experts opinion. However, considering the high safety profile of these drugs, it would be a good option to evaluate their efficacy at high doses, before moving on to other therapeutic steps.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2011; 21 Suppl 3:34-9. · 2.27 Impact Factor
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ABSTRACT: Antihistamines have been classifed as first or second generation drugs, according to their pharmacokinetic properties, chemical structure and adverse effects. The adverse effects of antihistamines upon the central nervous system (CNS) depend upon their capacity to cross the blood-brain barrier (BBB) and bind to the central H1 receptors (RH1). This in turn depends on the lipophilicity of the drug molecule, its molecular weight (MW), and affinity for P-glycoprotein (P-gp) (CNS xenobiotic substances extractor protein). First generation antihistamines show scant affinity for P-gp, unlike the second generation molecules which are regarded as P-gp substrates. Histamine in the brain is implicated in many functions (waking-sleep cycle, attention, memory and learning, and the regulation of appetite), with numerous and complex interactions with different types of receptors in different brain areas. Bilastine is a new H1 antihistamine that proves to be effective in treating allergic rhinoconjunctivitis (seasonal and perennial) and urticaria. The imaging studies made, as well as the objective psychomotor tests and subjective assessment of drowsiness, indicate the absence of bilastine action upon the CNS. This fact, and the lack of interaction with benzodiazepines and alcohol, define bilastine as a clinically promising drug with a good safety profile as regards adverse effects upon the CNS.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2011; 21 Suppl 3:9-15. · 2.27 Impact Factor
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M T Dordal,
M Lluch-Bernal,
M C Sánchez,
C Rondón,
A Navarro,
J Montoro,
V Matheu,
M D Ibáñez,
B Fernández-Parra,
I Dávila,
J Conde,
E Antón,
C Colás, A Valero
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ABSTRACT: Specific nasal provocation testing (NPT) consists of eliciting a response from the nasal mucosa by controlled exposure to allergens. It is indicated in the diagnostic confirmation of allergic rhinitis and when discrepancies arise or difficulties exist in the assessment of a patient's medical history and the results of skin and/or serological tests. The technique is also applied to evaluate sensitivity to the allergen, the efficacy and safety profile of treatment, and in research on the pathophysiological mechanisms of nasal response to allergens. NPT also provides information on the etiology of occupational respiratory diseases of allergic origin. Although there have been many studies and publications on the use and standardization of bronchial provocation tests with allergen, few analyze specific NPT. In this review, the Rhinoconjunctivitis Committee of the Spanish Society of Allergy and Clinical Immunology discuss the methodology, monitoring, and assessment of allergen-specific NPT in order to provide a practical and up-to-date review of the technique.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2011; 21(1):1-12; quiz follow 12. · 2.27 Impact Factor
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ABSTRACT: Interest in understanding the underlying mechanisms of the placebo effect has considerably grown during the last few decades. Studies made in this sense have led to a change in the conception of this peculiar phenomenon, and nowadays the placebo effect is viewed as a psychobiological event resulting from the interaction between individual patient factors and factors relating to the physician and the therapeutic environment. Investigation of the placebo effect in disease conditions such as pain or Parkinson's disease has improved our understanding of its underlying psychological and neurobiological mechanisms. Clinical studies directly designed to investigate the placebo effect have shown placebo to have a more beneficial effect upon diseases evaluated by means of physical or subjective parameters than by means of biochemical parameters. A strong placebo effect has been observed in allergic diseases, where the evaluating parameters tend to be physical or subjective. Biomedical research and the development of new drugs implies an important investment of human and economical resources for conducting clinical trials designed to evaluate the efficacy and safety of new medications. Knowledge of the mechanisms of the placebo effect and how the latter can influence the results of the different efficacy variables in these research studies appears essential in order to optimize the available resources in application to the development of new drugs.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2011; 21 Suppl 3:40-5. · 2.27 Impact Factor
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ABSTRACT: Ocular symptoms often accompany allergic rhinitis and can be as or even more bothersome for the patient than the actual nasal symptoms. Ocular manifestations of allergic rhinoconjunctivitis may result from both direct allergen-mediated mast cell stimulation on the surface of the eye and naso-ocular reflexes--histamine being one of the mediators of symptoms onset. An H1 antihistamine would be the first line treatment for allergic conjunctivitis. Since allergic conjunctivitis is always (or almost always) accompanied by nasal symptoms, a second-generation H1 antihistamine administered via oral route is the drug of choice for jointly managing both the nasal and the ocular symptoms--minimizing the impact of the effects inherent to first-generation H, antihistamine, including particularly drowsiness. Bilastine is a new H1 antihistamine with an excellent safety profile, developed for the treatment of allergic rhinoconjunctivitis and urticaria, with potency similar to that of cetirizine and desloratadine, and superior to that of fexofenadine. This new drug has been shown to be effective in controlling the ocular symptoms of allergic rhinoconjunctivitis.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2011; 21 Suppl 3:24-33. · 2.27 Impact Factor
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ABSTRACT: The evaluation of quality of life (QoL) and its modification through therapeutic interventions has become a prioritary concern in recent years and a requirement on the part of regulatory agencies for the authorization of new drugs. In clinical studies of allergic disorders, particularly allergic rhinitis and urticaria, different types of generic questionnaires have been used - especially disease specific instruments such as the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) or skin disease specific tools such as the Dermatology Life Quality Index (DLQI). Throughout its clinical development, bilastine has been shown to be more effective than placebo and at least as effective as cetirizine, levocetirizine, fexofenadine or desloratadine in controlling the symptoms of seasonal allergic rhinitis and chronic urticaria. QoL has been studied as a secondary objective in three allergic rhinitis clinical trials, using the RQLQ, in a total of 2335 patients. Likewise, in chronic urticaria, QoL has been evaluated using the DLQI in a total of 525 patients, versus levocetirizine and placebo. The improvement in the QoL parameters in these studies (RQLQ or DLQI domains) at all times proved proportional to the symptoms improvement. In general, the data obtained relating to changes in QoL are concordant with the mean global visual analog scale (VAS in mm) values and their changes, from the beginning until the end of the treatment period, for all of the trials, for bilastine and all its comparators.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2011; 21 Suppl 3:16-23. · 2.27 Impact Factor
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ABSTRACT: H1 antihistamines constitute one of the main references for the treatment of allergic rhinitis. Classically, these drugs have been considered effective in controlling sneezing, rhinorrhea and itching, though they have not been regarded as particularly effective in application to nasal obstruction. The most recent studies, involving second-generation H1 antihistamines (desloratadine, fexofenadine, levocetirizine, rupatadine), have shown these drugs to offer effects upon nasal obstruction significantly superior to those of placebo. The present review examines the effect of bilastine, a new, potent and highly specific H1 antihistamine without sedative effects or cardiac toxicity, upon nasal obstruction. The analysis of the data from the different clinical trials indicates that in patients with allergic rhinitis, the effect of bilastine upon nasal obstruction is superior to that of placebo and similar to that of other second-generation H1 antihistamines, manifesting within 24 hours after the start of treatment.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2011; 21 Suppl 3:2-8. · 2.27 Impact Factor
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A Valero,
M Ferrer,
E Baró,
J Sastre,
A M Navarro,
E Martí-Guadaño,
I Dávila,
A Del Cuvillo,
C Colás,
I Antépara,
J Alonso,
O Mola,
I Izquierdo,
J Mullol
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ABSTRACT: Allergic rhinitis (AR) is a common disease with major socioeconomic burden and a significant impact on quality of life. Objective: The aim of this study was to discriminate between moderate and severe AR patients whether receiving treatment or not, using a modified criterion of allergic rhinitis and its impact on asthma (ARIA) classification.
The modified ARIA severity classification (J Allergy Clin Immunol, 120, 2007, 359) categorizes AR as mild (no items affected), moderate (1-3 items affected), and severe (all four items affected). We applied these criteria to 1666 treated and 1058 untreated AR patients and compared their symptoms total four-symptom score (T4SS) and quality of life (ESPRINT-15), according to their clinical severity.
Allergic rhinitis clinical status was significantly worse (P < 0.001) in treated than in untreated patients. For both treated and untreated patients, T4SS and ESPRINT-15 Quality of life scores were significantly worse (P < 0.001) in severe than in moderate patients.
The modified ARIA severity classification is a useful clinical tool to discriminate moderate from severe AR among both treated and untreated patients.
Allergy 12/2010; 65(12):1609-13. · 6.27 Impact Factor
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ABSTRACT: Acoustic rhinometry (AR) accuracy in the diagnosis and follow-up of nasal polyps is as yet unclear. Our objective was to study its accuracy compared with computed tomography (CT) in patients with nasal polyps.
We studied 29 patients diagnosed of nasal polyposis by nasal endoscopy. In all patients sinunasal CT-scan, AR and nasal nitric oxide (NO) were assessed. Nasal volumes between 0 and 5 (V(0-5)) and 5 and 9 (V(5-9)) centimetres from nasal inlet were measured with AR and CT-scan, by using Pearson and intraclass correlation coefficient tests.
All patients (29,79% males, mean age 48.2 yr [range 34-61]) had nasal polyps (score 2-3 on Lildholdt classification, score 0-3). Measurements (right plus left sides) were: AR 8.9 +/- 0.8 cm(3) (V(0-5)) and 15.5 +/- 3.6 cm(3)(V(5-9)); CT 6.5 +/- 0.4 cm(3) (V(0-5)) and 6.3 +/- 0.8 cm(3) (V(5-9)). Pearson correlation was r = 0.67 (p < 0.01) for V(0-5) and r = 0.62 (p < 0.05) for V(5-9). Intraclass correlation coefficient test was 0.51 (V(0-5)) and 0.28 (V(5-9)) for consistency; and 0.43 (V(0-5)) and 0.23 (V(5-9)) for absolute agreement. Low levels of NO (312.3 +/- 43.8 ppb) were found and the correlation between NO levels and volumes (V(0-5) or V(0-9)) measured by AR was not statistically significant.
Compared to CT-scan, AR measurements accurately reflect the geometry of nasal cavity volumes in patients with nasal polyps, with a better assessment in the anterior part of the nasal cavity.
Rhinology 06/2010; 48(2):224-7. · 1.32 Impact Factor
