Evaluation of treatment response in patients with seasonal allergic rhinitis using domiciliary nasal peak inspiratory flow

Wilson, Andrew M.; Dempsey, Owen; Sims, Erika J.; Coutie, Wendy J.; Paterson, M. C.; Lipworth, Brian J.

doi:10.1046/j.1365-2222.2000.00749.x

Cited by 66 publications

(69 citation statements)

References 12 publications

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“…27In contrast, a single centre study in seasonal allergic rhinitis showed no benefit of adding montelukast to cetirizine on objective and subjective measures over four weeks 28. In a study of patients with concomitant asthma and seasonal allergic rhinitis, treatment with montelukast 10 mg plus cetirizine 10 mg once daily was found to be equally as effective as orally inhaled budesonide Turbuhaler 400 μg once daily plus intranasal aqueous budesonide 200 μg once daily, in terms of objective and subjective markers of upper and lower airway disease 29…”

Section: Treatment Optionsmentioning

confidence: 98%

Allergic inflammation in the unified airway: start with the nose

Lipworth

White

2000

Thorax

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Section: Treatment Optionsmentioning

confidence: 98%

Allergic inflammation in the unified airway: start with the nose

Lipworth

White

2000

Thorax

View full text Add to dashboard Cite

“…46 Studies have not yielded data for urban ethnic groups of children pertinent to the United States, and it is unclear what constitutes healthy and compromised AR functioning in these groups. There is also limited information on what constitutes a clinically meaningful change in PNIF values among children (there is limited information available on adults) 34 ; therefore, more research is needed with repeated measurement of PNIF over time in correspondence with other rhinitis and asthma assessment indicators.…”

Section: Discussionmentioning

confidence: 99%

Perceptual Accuracy of Upper Airway Compromise in Children: Clinical Relevance and Future Directions for Research

Koinis-Mitchell

Esteban

Kopel

et al. 2013

Allergy�Rhinol (Providence)

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Approximately 80% of children with asthma have coexisting allergic rhinitis. The accurate recognition and assessment of asthma and rhinitis symptoms is an integral component of guideline-based treatment for both conditions. This article describes the development and preliminary evaluation of a novel paradigm for testing the accuracy of children's assessment of their upper airway (rhinitis) symptoms. This work is guided by our previous research showing the clinical efficacy of tools to evaluate children's perceptual accuracy of asthma symptoms and linking accurate asthma symptom perception to decreased asthma morbidity (Fritz G, et al., Ethnic differences in perception of lung function: A factor in pediatric asthma disparities? Am J Respir Crit Care Med 182:12–18, 2010; Klein RB, et al., The Asthma Risk Grid: Clinical interpretation of symptom perception, Allergy Asthma Proc 251–256, 2004). The pilot study tests a paradigm that allows for the examination of the correspondence of children's assessment of their upper airway functioning with actual values of upper airway flow through the use of a portable, handheld nasal peak flowmeter. Nine children with persistent asthma were evaluated over a 4-week period. The article describes the rhinitis perceptual accuracy paradigm and reviews the results of a pilot study, showing a large proportion of inaccurate rhinitis symptoms “guesses” by the sample of children with persistent asthma. Patterns of inaccuracy, rhinitis control, and asthma morbidity are also described. Directions for future work are reviewed. The development of clinical tools to evaluate children's accuracy of rhinitis symptoms are needed, given the central role of the self-assessment of symptoms in guideline-based care. Accurate perception of the severity of rhinitis symptoms may enhance rhinitis control, lessen the burden of asthma, and prevent unnecessary emergency use among this high-risk group of children.

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“…Studies have shown that PNIF is comparable to rhinomanometry [19] and has a good correlation with the sensation of nasal blockage [20,21,22]. According to the manufacturer’s recommendation, participants used a face mask sealed around the nose and mouth, closed their mouth, and inhaled forcefully through the nose.…”

Section: Methodsmentioning

confidence: 99%

Assessment of Sleep Impairment in Persistent Allergic Rhinitis Patients Using Polysomnography

Meng¹,

Xuan²,

Qiao³

et al. 2010

Int Arch Allergy Immunol

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Background: Although questionnaires have demonstrated an association between impairment of quality of sleep and symptoms in allergic rhinitis (AR) patients, to date there is no report of an objective assessment of sleep in patients with persistent allergic rhinitis (PER) as defined by ARIA guidelines. The aim of the present study was therefore to assess sleep disturbance in PER patients by polysomnography (PSG). Methods: Ninety-eight PER patients with moderate-to-severe nasal obstruction and 30 healthy volunteers were included in the study. All patients underwent PSG during nocturnal sleep to assess the presence and severity of sleep disorders. Peak nasal inspiratory flow (PNIF) was also measured to assess nasal resistance. Results: There were statistically significant, though clinically modest, differences between PER patients and healthy controls in most PSG parameters including sleep efficiency, arousal index, average SaO₂, lowest SaO₂, time spent with a saturation below 90%, and snoring time. Although the apnea-hypopnea index (AHI) was not significantly different between the 2 groups, 17 subjects (17.3%) in the PER group but none of the control subjects had an AHI >5. Patients with higher T5SS scores (12 ≤ T5SS ≤ 15) had a greater tendency to snore than did patients with lower scores (8 ≤ T5SS ≤ 11). Finally, PNIF in the PER group was significantly lower than in the control group. Weak correlations between the arousal index and PNIF, average SaO₂, and PNIF were found. Conclusion: PSG showed modest changes in PER patients versus control subjects.

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Evaluation of treatment response in patients with seasonal allergic rhinitis using domiciliary nasal peak inspiratory flow

Abstract: These results suggest that domiciliary measurements of nasal peak flow correlate significantly with symptoms of seasonal allergic rhinitis and may therefore be a potentially useful objective short-term marker of treatment response.

Cited by 66 publications

References 12 publications

Allergic inflammation in the unified airway: start with the nose

Allergic inflammation in the unified airway: start with the nose

Perceptual Accuracy of Upper Airway Compromise in Children: Clinical Relevance and Future Directions for Research

Assessment of Sleep Impairment in Persistent Allergic Rhinitis Patients Using Polysomnography

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