Increased risk of asthma attacks and emergency visits among asthma patients with allergic rhinitis: a subgroup analysis of the improving asthma control trial

Bousquet, Jean; Gaugris, Sabine; Kocevar, Vasilisa Sazonov; Zhang, Q.; Yin, Donald; Polos, Peter; Bjermer, Leif

doi:10.1111/j.1365-2222.2005.02251.x

Cited by 181 publications

(112 citation statements)

References 24 publications

(39 reference statements)

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“…Rhinitis has been shown to be associated with the lack of asthma control. 8,37 This association was not significant with the multidimensional asthma control classification, and heterogeneous results were observed for the 1-dimensional aspects.…”

Section: Discussionmentioning

confidence: 52%

Phenotypic determinants of uncontrolled asthma

Siroux

Boudier

Bousquet

et al. 2009

Journal of Allergy and Clinical Immunology

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Section: Discussionmentioning

confidence: 52%

Phenotypic determinants of uncontrolled asthma

Siroux

Boudier

Bousquet

et al. 2009

Journal of Allergy and Clinical Immunology

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“…Several other studies confirm the link of comorbid A+AR with increased resource utilization and costs [9, 11, 12]. However, when AR is diagnosed and properly treated, not only are symptoms alleviated, but additional benefits may occur through a reduction of asthma-related complications [13,14,15,16], and potentially through an improved quality of life.…”

Section: Introductionmentioning

confidence: 92%

Treatment and Outcomes in Patients with Asthma and Allergic Rhinitis in the United Kingdom

Zhang

Thomas

Wiśniewski

et al. 2006

Int Arch Allergy Immunol

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Background: Since allergic rhinitis in asthma patients is associated with worse asthma control, the treatment of the comorbid condition may improve outcomes. Methods: A 1-year retrospective study using the UK Mediplus® database (2001–2004) included asthmatic patients aged 15–55 with allergic rhinitis. Patients starting therapy based on the Global Initiative for Asthma guidelines, defined as an increase in inhaled corticosteroids (high-dose inhaled corticosteroids, hdICS), or the addition of montelukast (ICS+MON) or long-acting β-agonists (ICS+LABA) to ICS, were studied. Univariable and multiple logistic regressions evaluated asthma-related outcomes. Results: Among 2,596 asthma and allergic rhinitis patients, 83.2% initiated ICS+LABA, 12.1% hdICS and 4.7% ICS+MON. The mean age was 34 years and 60% were female. ICS+MON patients had more moderate-severe asthma (p = 0.04). Approximately 84% of the ICS+LABA patients experienced an asthma control failure compared to 50% in the other groups (p < 0.0001). The proportions of patients requiring treatment change were 73.8, 22 and 27.3% in the ICS+LABA, hdICS and ICS+MON groups, respectively (p = 0.001). Asthma-related resource use was similar among all groups. The ICS+MON group received fewer mean prescriptions for oral corticosteroids (p = 0.024) than the other groups (p = 0.026). Conclusions: In asthma and allergic rhinitis, treatment with ICS+MON or hdICS was associated with lower rates of asthma control failure and fewer treatment changes than the ICS+LABA group. MON users also required fewer oral corticosteroids.

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“…First, regarding asthma severity, self-reported concomitant allergic rhinitis results in more frequent emergency room visits and asthma attacks in patients with chronic asthma [8]. Another retrospective study showed that asthmatics with concomitant allergic rhinitis visited general practitioners more frequently, had more asthma-related hospitalizations, and had higher asthma-related medication costs than those without [9].…”

Section: Discussionmentioning

confidence: 99%

“…Allergic rhinitis often precedes the development of asthma [4,5,6,7], suggesting that it may be a risk factor for asthma. The presence of concomitant allergic rhinitis in asthmatics results in more frequent asthma attacks, emergency room visits [8], and asthma-related hospitalizations [9], as well as higher asthma-related medication costs [9,10]. Nonasthmatics with allergic rhinitis have elevated numbers of eosinophils in the bronchial mucosa [11,12,13].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Clinical Relevance of Allergic Rhinitis in Patients with Classic Asthma and Cough Variant Asthma

et al. 2013

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Background: A clinically relevant relationship between classic asthma and allergic rhinitis has been reported. However, the possible link between cough variant asthma (CVA) and allergic rhinitis remains unknown. Objectives: To clarify the prevalence and clinical relevance of perennial allergic rhinitis or seasonal allergic rhinitis in CVA patients compared to classic asthma patients. Methods: We retrospectively studied adult patients with classic asthma (n = 190) and those with CVA (n = 83). The prevalence of perennial allergic rhinitis or seasonal allergic rhinitis and associations of concomitant perennial or seasonal allergic rhinitis with asthma severity, forced expiratory volume in 1 s (% predicted), fractional exhaled nitric oxide (FeNO) levels, and eosinophil proportions in sputum and blood were analyzed in the two groups. Results: The prevalence of perennial allergic rhinitis and/or seasonal allergic rhinitis was significantly higher in classic asthma patients than in CVA patients (all p < 0.05). Concomitant perennial allergic rhinitis was associated with higher FeNO levels and eosinophil proportions in sputum and blood in classic asthma patients (p = 0.035, p = 0.036, and p = 0.008, respectively) and with higher asthma severity, FeNO levels, and sputum eosinophil proportions in CVA patients (p = 0.031, p = 0.007, and p = 0.010, respectively). Concomitant seasonal allergic rhinitis was only associated with higher sputum eosinophil proportions in CVA patients with active rhinitis symptoms during the sensitized pollen season (p = 0.025). Conclusions: Perennial allergic rhinitis may be relevant for CVA patients as well as classic asthma patients by consistently augmenting eosinophilic lower airway inflammation.

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Increased risk of asthma attacks and emergency visits among asthma patients with allergic rhinitis: a subgroup analysis of the improving asthma control trial

Abstract: Presence of self-reported concomitant AR in patients with asthma resulted in a higher rate of asthma attacks and more emergency room visits compared with asthma patients without concomitant AR.

Cited by 181 publications

References 24 publications

Phenotypic determinants of uncontrolled asthma

Phenotypic determinants of uncontrolled asthma

Treatment and Outcomes in Patients with Asthma and Allergic Rhinitis in the United Kingdom

Prevalence and Clinical Relevance of Allergic Rhinitis in Patients with Classic Asthma and Cough Variant Asthma

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