How representative are clinical study patients with allergic rhinitis in primary care?

Costa, David J.; Amouyal, Michel; Lambert, Pierre-Paul; Ryan, Dermot; Schünemann, Holger J.; Daurès, Jean Pierre; Bousquet, Jean; Bousquet, Philippe

doi:10.1016/j.jaci.2010.10.058

Cited by 54 publications

(47 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, allergy was tested in 49% of patients. This percentage is highly consistent with other studies carried out in France in general practices [14,28]. Since this study examined outcomes in primary care settings, the lack of diagnostic testing for allergy in almost half of the patients reflects real clinical practice.…”

Section: Discussionsupporting

confidence: 88%

See 1 more Smart Citation

Impact of Allergic Rhinitis Symptoms on Quality of Life in Primary Care

Bousquet

Demoly

Devillier

et al. 2012

Int Arch Allergy Immunol

Self Cite

166

142

View full text Add to dashboard Cite

Background: Allergic rhinitis (AR) impairs quality of life (QoL), sleep and work. The Allergic Rhinitis and its Impact on Asthma (ARIA) classification is widely used, but the impact of the different symptoms on QoL is not clear. Objective: To describe characteristics of patients consulting in primary care for AR and to study the impact of AR symptoms and the ARIA classes on QoL. Methods: A multicenter prospective observational cross-sectional study assessed the visual analogue scale (VAS) in the management of AR in 990 patients consulting general practitioners for AR. Patients were classified according to the four classes of ARIA. VAS, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and total symptom score (TSS) for nasal and non-nasal symptoms were evaluated. VAS and TSS measures were compared with RQLQ. Results: Mild intermittent rhinitis was diagnosed in 20% of patients, mild persistent rhinitis in 17%, moderate/severe intermittent rhinitis in 15% and moderate/severe persistent rhinitis in 48%. The presence of treatments did not affect VAS levels. Both severity and duration of rhinitis had an impact on QoL and VAS levels. Ocular symptoms (OR: 2.78, 95% CI: 1.965–3.939) including eyelid edema (OR: 2.07, 95% CI: 1.274–3.360) and asthenia (OR: 2.73, 95% CI: 1.922–3.877) had more impact on RQLQ than nasal obstruction (OR: 1.61, 95% CI: 1.078–2.405) and nasal pruritus (OR 1.45, 95% CI: 1.028–2.042). Sneezing and rhinorrhea did not impact RQLQ. Conclusions: This study confirmed that ocular symptoms and, to a lesser degree, nasal obstruction and pruritus have a significant impact on QoL.

show abstract

Section: Discussionsupporting

confidence: 88%

“…Allergic and non-allergic rhinitis [26] may therefore be observed [27,28]. It was found that patient clinical characteristics are similar in those with or without a diagnosis of allergy [5].…”

Section: Introductionmentioning

confidence: 99%

Impact of Allergic Rhinitis Symptoms on Quality of Life in Primary Care

Bousquet

Demoly

Devillier

et al. 2012

Int Arch Allergy Immunol

Self Cite

166

142

View full text Add to dashboard Cite

show abstract

“…The generalizability of these data is an inherent limitation of all randomized trials [30] since inclusion and exclusion criteria has to be in agreement with FDA and EMA guidelines. However, the results of FP are representative for the entire class of INS, since FP and fluticasone furoate [31] and FP and mometasone furoate [32] have shown comparable efficacy in direct comparison studies.…”

Section: Discussionmentioning

confidence: 99%

Clinically Relevant Effect of a New Intranasal Therapy (MP29-02) in Allergic Rhinitis Assessed by Responder Analysis

Meltzer

Ratner

Bachert

et al. 2013

Int Arch Allergy Immunol

Self Cite

102

135

View full text Add to dashboard Cite

Background: It is unclear what constitutes a clinically meaningful response for allergic rhinitis (AR) outcomes. The objectives of these post hoc analyses were (1) to define a clinically meaningful response using novel efficacy analyses (including a responder analysis), and (2) to compare the efficacy of MP29-02 [a novel intranasal formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP)] with commercially available FP, AZE and placebo in seasonal AR (SAR) patients, using these novel analyses. Methods: 610 moderate-to-severe SAR patients (≥12 years old) were randomized into a double-blind, placebo-controlled, 14-day, parallel-group trial. Change from baseline in the reflective total nasal symptom score (rTNSS) over 14 days was the primary outcome. Post hoc endpoints included the sum of nasal and ocular symptoms (rT7SS), efficacy by disease severity and by predominant nasal symptom, and a set of responder analyses. Results: MP29-02 most effectively reduced rT7SS (relative greater improvement: 52% to FP; 56% to AZE) and both nasal and ocular symptoms irrespective of severity. More MP29-02 patients achieved a ≥30, ≥50, ≥60, ≥75 and ≥90% rTNSS reduction, which occurred days faster than with either active comparator; MP29-02 alone was superior to placebo at the ≥60% (or higher) threshold. One in 2 MP29-02 patients achieved a ≥50% rTNSS reduction and 1 in 6 achieved complete/near-to-complete response. Only MP29-02 was consistently superior to placebo for all patients, whatever their predominant symptom. Conclusions: MP29-02 provided faster and more complete symptom control than first-line therapies. It was consistently superior irrespective of severity, response criteria or patient-type, and may be considered the drug of choice for moderate-to-severe AR. These measures define a new standard for assessing relevance in AR.

show abstract

“…In addition, convenient study design decisions may undermine generalisability. For example, trial participants are often unrepresentative of the target population [8][9][10][11][12][13], which can limit the use of trial data to inform clinical practice [14].…”

Section: Introductionmentioning

confidence: 99%