Uncontrolled allergic rhinitis during treatment and its impact on quality of life: A cluster randomized trial
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- "We wszystkich pozostałych sytuacjach zalecane jest rozpoczęcie terapii od donosowego GKS, a w przypadku braku poprawy celowe jest zastosowanie kompleksowej terapii ANN wykorzystującej GKS donosowy i lek przeciwhistaminowy w tabletkach. Aż 71% pacjentów skarży się na niewystarczającą monoterapię ANN i uważa, że wymaga stosowania 2 lub więcej leków w leczeniu nieżytu nosa. Takie dane mogą wskazywać na fakt konieczności rewizji istniejących zaleceń terapeutycznych i rozpoczynania leczenia ciężkich nieżytów nosa od razu dwoma lekami. "
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ABSTRACT: Allergic rhinitis is one of the most common upper respiratory tract diseases. It has deep influence on the quality of life of our patients. So far, the evidences have shown its impact on sleep, autonomic regulation, inflammation of the lower airways and perinasal sinuses and oxidative stress. Moreover, accumulating data have shown that it decreases productivity and school results in children and might deeply influence the sexual behavior. In this review, we focused on practical aspects and consequences of allergic rhinitis. So far, the best influence on quality of life in allergic rhinitis is related to nasal glucocorticosteroids treatment.
Available from: Valentina Fanelli
- "The evaluation included a number of parameters, including total symptom scores for rhinitis, a visual analog scale, the Rhinoconjunctivitis Quality of Life Questionnaire, and the Allergy-specific Work Productivity and Impairment Questionnaire. A cluster-randomized trial model was used to mimic real life, with no exclusion of patients at randomization, so as to include the broad range of patients regularly seen by physicians.27 "
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ABSTRACT: An important subpopulation in allergic rhinitis is represented by patients with severe form of disease that is not responsive to drug treatment. It has been reported that grass pollen subcutaneous immunotherapy is effective in drug-resistant patients. In a real-life study, we evaluated the efficacy of 5-grass pollen tablets in patients with grass pollen-induced allergic rhinitis not responsive to drug therapy.
We carried out this multicenter observational study in adults and adolescents with grass-induced allergic rhinitis not responsive to drug therapy who were treated for a year with 5-grass pollen tablets. Clinical data collected before and after sublingual immunotherapy (SLIT) included Allergic Rhinitis and its Impact on Asthma (ARIA) classification of allergic rhinitis, response to therapy, and patient satisfaction.
Forty-seven patients entered the study. By ARIA classification, three patients had moderate to severe intermittent allergic rhinitis, ten had mild persistent allergic rhinitis, and 34 had moderate to severe persistent allergic rhinitis. There were no cases of mild intermittent allergic rhinitis before SLIT. After SLIT, 33 patients had mild intermittent allergic rhinitis, none had moderate to severe intermittent allergic rhinitis, seven had mild persistent allergic rhinitis, and seven had moderate to severe persistent allergic rhinitis. The mean medication score decreased from 4.2±1.3 before to 2.4±2.0 after SLIT (P<0.01), representing a reduction of 42%. The response to treatment before SLIT was judged as poor by 70% of patients and very poor by 30%. Patient satisfaction was significantly increased after SLIT (P<0.01).
In real life, most patients with grass pollen-induced allergic rhinitis not responsive to drug treatment can achieve control of the condition with one season of treatment using 5-grass pollen tablets.
Available from: Zoltán Rónai
- "They found that 59% had intermittent rhinitis, 41% persistent rhinitis, 25% mild rhinitis, and 75% moderate-persistent rhinitis. Bousquet et al. reported that 46% of 3,052 subjects had intermittent rhinitis, 54% persistent rhinitis, 19% mild rhinitis, and 81% moderate-severe disease
. Consistent with findings from previous surveys, it can be concluded that the prevalence of moderate to severe AR is higher among women than among men
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ABSTRACT: The casual and severity distribution of allergic rhinitis (AR) in Hungary is unknown.
The aim of this survey was to evaluate symptom perception, disease severity, concomitant asthma frequency and the impact of AR on everyday life activities in a cross-sectional, multicenter study in Hungary under the supervision of Hungarian Respiratory Society.
Data were recorded by 933 AR patients (65.93% women) and their treating specialists. The perceptions of patients regarding the symptoms (nasal, ocular and others) of AR and its severity, together with its impact on everyday life were assessed. Physicians recorded data regarding the diagnosis and severity of AR, and comorbidities.
52.5% of patients suffered from seasonal AR, 35.1% from perennial AR. A large proportion of patients had moderate to severe disease (MS-AR) (57.34%), persistent disease (98.0%) and concomitant asthma (53.32% in the mild, 57.52% in the MS-AR group). MS-AR was more frequent among women. Despite the treatment used, in MS-AR the proportions of patients reporting moderate to severe rhinorrhoea, nasal obstruction, ocular itching/redness, watering, itchy throat and sneezing were as high as 52.0%, 54.0%, 33.8%, 26.5%, 44.0% and 31.2%, respectively. Overall, there was a poor agreement between disease severity reported by patients and specialists. The adherence to oral antihistamines and intranasal corticosteroids was found to be between 50 and 65%; mostly depending on the dosage form.
AR remains a significant health problem in Hungary because of the burden of symptoms, high rate of concomitant asthma and the significant proportion of MS-AR affecting general well being.
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