Characteristics of intermittent and persistent allergic rhinitis: DREAMS study group

Abstract

SummaryBackground In the Allergic Rhinitis and its Impact on Asthma (ARIA) classification, intermittent and persistent rhinitis were proposed to replace seasonal and perennial allergic rhinitis (AR). Aim To better understand the ARIA classification of rhinitis. Methods A cross-sectional study was carried out in 591 patients consulting ENT or allergy specialists for AR and 502 control subjects. The diagnosis of AR was based on a score for allergic rhinitis (SFAR) X7. Patients were classified according to the four ARIA classes (mild intermittent, mild persistent, moderate/severe intermittent and moderate/severe persistent). Allergen sensitization (skin prick tests (SPTs) or specific IgE) and co-morbidities were examined according to the ARIA classes. Results Ten percent of patients had mild intermittent rhinitis, 14% mild persistent rhinitis, 17% moderate/severe intermittent rhinitis and 59% moderate/severe persistent rhinitis. Most patients with intermittent rhinitis had a pollen sensitivity, but 5% had a single house dust mite (HDM) sensitization. Over 50% of patients with persistent rhinitis were allergic to pollens or HDM. Asthma was present in 24% of rhinitis patients and in only 2% of the control population (Po0.0001). Patients with moderate/severe persistent rhinitis had the highest asthma prevalence (33%). Discussion Intermittent and persistent rhinitis are not synonymous of seasonal and perennial rhinitis. Most patients consulting specialists have severe rhinitis. Asthma prevalence increases with duration and severity of rhinitis supporting the ARIA major recommendation that patients with persistent rhinitis should be evaluated for asthma.

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“…• the majority of patients are sensitized to many different allergens and therefore exposed throughout the year (33,62,(67)(68)(69). In many patients, perennial symptoms are often present and patients experience seasonal exacerbations when exposed to pollens or molds.…”

Real‐life effectiveness of MP‐AzeFlu in Irish patients with persistent allergic rhinitis, assessed by visual analogue scale and endoscopy

“…PER is a distinct category of AR that merits special attention in the clinic, as patients with PER are at higher risk for sequelae including asthma 2, 28. Topical treatments are recommended for PER,2 in part to avoid the long‐term safety concerns associated with systemic medications.…”

Towards evidence‐based medicine in specific grass pollen immunotherapy

“…However, the SLIT natural allergen tablet modality (n = 7) studies or dose levels within a study) showed the lowest betweenstudy variability [tau 2 and I 2 (95% confidence intervals) for Hedges' g: 0.016 (58.5% (4.3-82%))], followed by SCIT with natural allergens (n = 7) with 0.039 [44.6% (0-76.7%)] and SLIT drops (n = 10) with 0.045 [51.9% (1.1-76.6%)]. The test was not applicable to SLIT with allergoid tablets and SCIT with allergoids, for which there were only one and two calculable studies, respectively.…”

“…This health problem affects as many as one in seven of the population in Western countries (2,3), with grass pollen as one of the major triggers (4).…”