MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis

Abstract

The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assessment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control. Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). A CDSS is currently being developed to optimize AR control. An algorithm developed by consensus is presented in this article. This algorithm should be confirmed by appropriate trials.

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

“…Although some differences in data reporting and baseline characteristics were noted, the results of this study are consistent with the findings of the same NIS conducted in Sweden 20. Sleep impairment has been well established as a debilitating symptom associated with AR21, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26; therefore, the improvement in sleep quality with MP‐AzeFlu observed in these real‐world studies has the potential to greatly improve AR patients’ quality of life.…”

“…However, allergy symptoms and treatment relief can be difficult to assess accurately due to daily fluctuation in allergen exposure. As a result, a recent guideline from MACVIA‐ARIA (Contre les Maladies Chroniques pour un Vieillissement Actif–AR and its Impact on Asthma) endorses a simple visual analogue scale (VAS) to assess AR control and guide treatment decisions 2, 3. The VAS is a rapid and reproducible method to measure an individual's disease severity 4…”

“…MACVIA‐ARIA recommends that treated PER patients with VAS scores of 50–100 mm escalate their treatment to intranasal corticosteroids or intranasal corticosteroids plus azelastine hydrochloride 3. MP‐AzeFlu (Dymista®) delivers an intranasal corticosteroid (fluticasone propionate) and an intranasal antihistamine (azelastine hydrochloride) in a novel formulation provided in a single device 5.…”

“…MP‐AzeFlu (Dymista®) delivers an intranasal corticosteroid (fluticasone propionate) and an intranasal antihistamine (azelastine hydrochloride) in a novel formulation provided in a single device 5. MP‐AzeFlu is indicated for the relief of symptoms of moderate‐to‐severe seasonal and perennial AR (SAR and PAR) if monotherapy with either intranasal antihistamine or glucocorticoid is not considered sufficient 3, 5…”

Resumen ejecutivo de ARIA 2016: vías integradas de atención para la medicina predictiva a lo largo del ciclo de vida en Argentina

“…MACVIA-ARIA ha desarrollado un algoritmo basado en una EVA simple llamada ARIA CDSS (Sistema de Soporte de Decisión Clínica ARIA), que utiliza una puntuación para guiar las decisiones respecto al tratamiento. 27 …”