Predictors of Quality of Life Improvement in Allergic Rhinitis Patients After Sublingual Immunotherapy

Katotomichelakis, Michael; Riga, Maria; Tripsianis, Gregory; Balatsouras, Dimitrios G.; Kourousis, Christos; Danielides, Gerasimos; Giotakis, Evangelos; Danielides, Vassilios

doi:10.1177/0003489414565001

Cited by 12 publications

(17 citation statements)

References 29 publications

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“…Whether the improvements that were found in this study reflect a global improvement in disease symptoms or are they a result of specific aspects is uncertain. While several factors may predict QoL outcomes in patients with AR following therapy, it has been reported that improvements in olfactory function and reduction in asthma symptoms may be of particular importance,24,25 both of which were seen in our cohort across the study period (Table 2). These were matched by the reduction in medication use by patients both with and without asthma (Figure 3).…”

Section: Discussionmentioning

confidence: 77%

Evaluation of a sublingual immunotherapy solution in olive-induced respiratory allergy in Jordan: a retrospective observational study

Al-Asad

Al-Nazer

Al-Faqih

et al. 2017

JAA

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BackgroundOlive pollen is an important cause of respiratory allergy in the Middle East. In this study, the clinical characteristics of adults and children with confirmed allergic rhinitis (AR; with or without asthma) in Jordan were described, and the use of sublingual immunotherapy (SLIT) in a real-life clinical setting was assessed.MethodsThis retrospective observational study evaluated the clinical features of olive-induced allergy and the use of an SLIT solution of standardized extracts toward Ole e 1 given in a pre- and coseasonal scheme with a daily dose of 300 index of reactivity for two consecutive seasons. Inclusion criteria were as follows: ≥5 years of age, AR, proven olive sensitization, and at least 2 years follow-up after SLIT initiation. The following data were recorded at SLIT initiation: clinical characteristics, rhinitis and asthma symptom scores, and concomitant symptomatic medications. During follow-up and at the end of each season, the following data were recorded: symptom progression/scores, any changes to symptomatic medications, and treatment compliance. The secondary objective was to determine any effect on quality of life, use of concomitant AR medications, and treatment compliance.ResultsEighty-six patients with seasonal AR were included in this analysis (52.3% with coexisting asthma). Between the initiation of treatment and the end of second pollen season, symptoms of AR and asthma were decreased by 79.5% and 41.7%, respectively, with an improvement in quality of life score in 71.5% of the patients (P<0.0001 for all). Physicians reported that after 2 years of SLIT, there was an improvement in the symptoms of both AR (95.2%) and asthma (93.3%), with 98.8% of the patients showing good treatment compliance. A reduction in symptomatic medications was also found. SLIT was well tolerated with no systemic reactions being reported.ConclusionIn children and adults with olive-associated respiratory allergy in Jordan, the use of a pre- and coseasonal SLIT with a 300 index of reactivity daily dose is effective in reducing the clinical burden of AR and asthma with no tolerability issues.

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Section: Discussionmentioning

confidence: 77%

Evaluation of a sublingual immunotherapy solution in olive-induced respiratory allergy in Jordan: a retrospective observational study

Al-Asad

Al-Nazer

Al-Faqih

et al. 2017

JAA

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“…Our analysis does not permit comparison of the HRQL of AR patients with that of the general population; however, a Spanish cross-sectional study that investigated the overall HRQL of patients with AR using SF-12 reported that HRQL was 25 % lower than in the general population [ 79 ]. Poor HRQL in patients with AR is also supported by evidence that successful treatment of AR symptoms with AIT [ 21 – 23 ] or symptomatic treatment [ 24 – 31 ] improves patient’s HRQL scores. A comparison of published EQ-5D utility baseline scores indicated that perennial allergy and/or AA (13 patients with AR and 12 with AR+AA), on a typical day with allergy symptoms, had a score of 0.60 [ 23 ], indicating comparable HRQL to diabetes (0.83) [ 80 ], cardiovascular disorders (0.73), musculoskeletal disorders (0.63), and psychosomatic disorders (0.57), when measured with the same EQ-5D instrument [ 81 ].…”

Section: Discussionmentioning

confidence: 96%

“…There is now considerable evidence that the symptoms of AR and AA negatively affect patients’ health-related quality of life (HRQL) [ 11 – 20 ]. This is supported by evidence that successful treatment of symptoms with allergy immunotherapy (AIT) [ 21 – 23 ] or symptomatic treatments [ 24 – 31 ] improves the HRQL of patients with AR. These improvements generally mirror those of conventional clinical outcome measures, such as symptom and medication scores, and lung function tests [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

Burden of allergic respiratory disease: a systematic review

et al. 2016

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This meta-analysis compared the health-related quality of life (HRQL) of patients with allergic rhinitis (AR) and/or allergic asthma (AA) caused by perennial house dust mite (HDM) versus AR and/or AA caused by seasonal pollen allergy. Following a systematic search, the identified studies used the disease-specific rhinitis quality of life questionnaire or generic instruments (SF-36 and SF-12). Summary estimates obtained by meta-analysis showed that HRQL in patients with perennial HDM allergy was significantly worse than that of patients with seasonal pollen allergy, when measured by both disease-specific and generic HRQL instruments, and was reflected by an impact on both physical and mental health. A systematic review of cost data on AR and AA in selected European countries demonstrated that the majority of the economic burden was indirectly caused by high levels of absenteeism and presenteeism; there was little or no evidence of increasing or decreasing cost trends. Increased awareness of the detrimental effects of AR and/or AA on patients’ HRQL and its considerable cost burden might encourage early diagnosis and treatment, in order to minimize the disease burden and ensure beneficial and cost-effective outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12948-016-0049-9) contains supplementary material, which is available to authorized users.

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“…Underestimation of symptoms is also supported by our findings, according to which, half of the patients evaluated their symptoms severity as mild, with 32% reporting some concern and only 16.5% reporting moderate-to-severe disease. Self-reported symptom-free cases make early screening and diagnosis, as well as early treatment, clinically meaningful to prevent future disease comorbidities (e.g., asthma and chronic rhinosinusitis) [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although AR has recently been divided according to the ARIA classification into intermittent versus persistent based on the duration of symptoms [ 34 ], allergen-specific treatment also needs to be incorporated with the seasonal and perennial classification to ascertain the correct allergen to be used in desensitization [ 37 ]. Therefore, according to seasonality, subjects with PAR described their symptoms as moderate-to-severe, but patients with SAR had milder symptoms.…”

Section: Discussionmentioning

confidence: 99%

Symptomatology Patterns in Children with Allergic Rhinitis

et al. 2017

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BackgroundAlthough allergic rhinitis (AR) is recognized as a growing global health disease with considerable importance for patients’ lives, especially among children and adolescents, there is a lack of population studies concerning symptomatology patterns of the disease. The present study aimed to explore symptoms prevalence among school-aged children, to detect any correlation between allergen sensitivities with symptomatology patterns, and, finally, to evaluate the association of the sensitivity grade score with symptoms severity or seasonality.Material/MethodsThis was a cross-sectional, observational study in a childhood population. The first stage included recruitment of children and parental-completed questionnaires. The second stage included skin-prick tests for the most common allergens. Severity of symptoms was self-evaluated using a scale that ranged from “0” (no symptoms), “1” (mild), and “2” (moderate-to-severe). AR was classified as seasonal (SAR) or perennial (PAR).ResultsThe most frequent symptoms were reported for nasal obstruction, sneezing, and rhinorrhea. All nasal symptoms were significantly more profound among children with HDM sensitivity. However, more symptoms, not only nasal, but also ocular and general ones, were detected among patients with grass pollen sensitivity. Patients with PAR reported more severe symptoms. SAR was associated with mild disease. Finally, the sensitivity grade score was significantly correlated with symptom severity.ConclusionsOur results suggest that allergen sensitivity may be correlated with symptomatology patterns among children who have allergic rhinitis.

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Predictors of Quality of Life Improvement in Allergic Rhinitis Patients After Sublingual Immunotherapy

Abstract: Several factors were found that may predict QoL outcomes in AR patients following SLIT.

Cited by 12 publications

References 29 publications

Evaluation of a sublingual immunotherapy solution in olive-induced respiratory allergy in Jordan: a retrospective observational study

Evaluation of a sublingual immunotherapy solution in olive-induced respiratory allergy in Jordan: a retrospective observational study

Burden of allergic respiratory disease: a systematic review

Symptomatology Patterns in Children with Allergic Rhinitis

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