RCAT reflects symptom control and quality of life in allergic rhinoconjunctivitis patients

Liedtke, Jan-Patrick; Mandl, A.; Köther, J.; Chwieralski, J.; Shah‐Hosseini, Kija; Raskopf, E.; Pieper‐Fürst, Ursula; Allekotte, Silke; Mösges, R.

doi:10.1111/all.13362

Cited by 10 publications

(10 citation statements)

References 37 publications

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“…In addition, cross‐reactivity of birch pollen allergens extends to plant food allergens, resulting in the pollen food syndrome (PFS) . Subsequently, the negative impact on health‐related quality of life in patients allergic to birch pollen is substantial . The purpose of this manuscript was to narratively review topics of interest such as taxonomy, cross‐reactivity, prevalence, PFS, and quality of life with regard to birch pollen allergy from a European perspective.…”

Section: Introductionmentioning

confidence: 99%

“…One published study that evaluated HRQoL in patients specifically allergic to birch pollen simply reported that there was no difference in HRQoL between monosensitized and polysensitized (defined as sensitization to at least 2 allergens among Bet v 1, Bet v 2, and Bet v 4) patients . Using the Rhinitis Control Assessment Test, another study found that 45.7% of patients with birch pollen allergy who were receiving treatment in accordance with Allergic Rhinitis and its Impact on Asthma recommendations had insufficiently controlled symptoms . More research is needed to determine the impact of birch allergy specifically on HRQoL, as well as the socioeconomic burden of disease.…”

Section: Introductionmentioning

confidence: 99%

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Birch pollen allergy in Europe

Biedermann

Winther

Till

et al. 2019

Allergy

237

186

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Birch and other related trees of the families Betulaceae and Fagaceae (alder, hazel, oak, hornbeam, chestnut, and beech) constitute the birch homologous group. This grouping is primarily based on the extensive IgE cross-reactivity of allergen homologs to the major birch allergen Bet v 1. Birch pollen is the most dominant tree pollen in Northern and Central Europe and is a major cause of allergic rhinitis and, possibly, asthma symptoms. Over the last few decades, levels of birch pollen have risen and the period of exposure has increased due to climate changes. Subsequently, the prevalence of birch pollen sensitization has also increased. The cross-reactivity and sequential pollen seasons within the birch homologous group create a prolonged symptomatic allergy period beyond birch pollen alone. Furthermore, many plant food allergens contain homologs to Bet v 1, meaning that the majority of patients with birch pollen allergy suffer from secondary pollen food syndrome (PFS). As a result, the negative impact on health-related quality of life (HRQoL) in patients allergic to birch pollen is significant. The purpose of this manuscript was to narratively review topics of interest such as taxonomy, cross-reactivity, prevalence, clinical relevance, PFS, and HRQoL with regard to birch pollen allergy from a European perspective.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Birch pollen allergy in Europe

Biedermann

Winther

Till

et al. 2019

Allergy

237

186

View full text Add to dashboard Cite

show abstract

“…Even with the most effective intranasal formulation, combined azelastine and fluticasone furoate, patients with moderate-to-severe allergic rhinitis showed a relatively low responder rate of 12.4% [ 56 ] or 16.7% [ 57 ] after 14 days of treatment. In general, only 30.3% of grass pollen-allergic patients and 54.3% of those suffering from birch pollen allergy attain symptom control with guideline-concordant pharmacotherapy [ 58 ]. All studies investigating a monotherapy with ectoine invariably attested positive effects of ectoine monotherapy in alleviating symptoms of allergic rhinitis.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of the Bacteria Derived Extremolyte Ectoine for the Treatment of Allergic Rhinitis

Bilstein¹,

Werkhäuser

Rybachuk

et al. 2021

BioMed Research International

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Nonpharmacological therapies with a good tolerability and safety profile are of interest to many patients with allergic rhinitis, as a relevant proportion of them have reservations about guideline-concordant pharmacological therapies due to their local irritations and side effects. Ectoine is a bacterial-derived extremolyte with an ability to protect proteins and biological membranes against damage caused by extreme conditions of salinity, drought, irradiation, pH, and temperature. Evidence from preclinical and clinical studies attests its effectiveness in the treatment of several inflammatory diseases, including allergic rhinitis. In this review, we analyzed 14 recent clinical trials investigating ectoine nasal spray in patients with allergic rhinitis and/or conjunctivitis, including sensitive patient groups like children or pregnant women. Some studies investigated monotherapy with ectoine; others investigated combination therapy of ectoine and an antihistamine or a corticosteroid. Analysis of the study results demonstrated that patients with mild-to-moderate symptoms of allergic rhinitis can be successfully treated with ectoine-containing nasal spray. When applied as monotherapy, ectoine exerted noninferior effects compared to first-line therapies such as antihistamines and cromoglicic acid. Using ectoine as an add-on therapy to antihistamines or intranasal glucocorticosteroids accelerated symptom relief by days and improved the level of symptom relief. Importantly, concomitant treatment with ectoine was proven beneficial in a group of difficult-to-treat patients suffering from moderate-to-severe rhinitis symptoms. Taken together, the natural substance ectoine represents a viable alternative for allergic rhinitis and conjunctivitis patients who wish to avoid local reactions and side effects associated with pharmacological therapies.

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“…In our study, the percentage of patients who did not need any symptomatic medication increased by over 25% of the whole cohort in 2017 (in total 34.3%) compared to the previous season. Liedtke et al 19 . reported that patients who attained symptom control used significantly less symptomatic medication than did patients with uncontrolled symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…The German version of the validated Rhinitis Control Assessment Test (RCAT) 19 was used to determine whether patients' rhinitis symptoms were controlled in the peak of the 2017 pollen season (assessed prospectively at V4). The RCAT is based on six items: nasal congestion, sneezing, watery eyes, sleep disruption, and activity limitation caused by symptoms, as well as patients’ self-rating of symptom control.…”

Section: Methodsmentioning

confidence: 99%

Shortened up-dosing with sublingual immunotherapy drops containing tree allergens is well tolerated and elicits dose-dependent clinical effects during the first pollen season

Mösges

Breitrück

Allekotte³

et al. 2019

World Allergy Organization Journal

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Background: This study compared a rapid home-based up-dosing schedule for sublingual immunotherapy (SLIT) drops containing tree pollen allergens with two previously established schedules. Furthermore, the clinical effect of the SLIT was investigated with respect to patients' first pollen season under treatment. Methods: In this open-label, prospective, patient-preference, non-interventional study, local and systemic reactions were compared between three up-dosing groups using a SLIT formulation containing birch, alder, and hazel pollen extracts (ORALVAC ® Compact B€ aume). Clinical improvement after patients' first season under treatment was analysed using symptom scores, ARIA classification, symptom control, and the use of symptomatic medication and was compared with data from the previous, pre-treatment pollen season. As the real-life study design allowed no placebo group, the late-treated patients (co-seasonal) served as a control, and crowd-sourced symptom data from persons with hay fever were used from a free web-based online diary. Results: In 33 study centres in Germany and Austria, 164 patients were included. The treatment was well tolerated, without difference between the groups during the up-dosing phase. At the end of the assessment, 96.1% rated the tolerability of the treatment as good or very good. Local reactions were mostly mild in severity and no serious adverse events occurred. Symptom scores decreased from the 2016 pollen season to the 2017 pollen season. As for the ARIA classification, 79.0% of patients had persistent, moderate-to-severe rhinitis before treatment, but only 18.6% had the same classification after treatment. In all, 62.4% of patients achieved symptom control, and 34.3% of patients required no symptomatic medication after treatment. The rhinoconjunctivitis score was 34.4% lower for pre-seasonal treatment initiation than for the control group. Crowd-sourced symptom load indices showed that the 2016 season caused slightly more symptoms; however, it is assumed that this difference of 0.3-0.5 (score range 0-10) was of less clinical relevance.

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RCAT reflects symptom control and quality of life in allergic rhinoconjunctivitis patients

Cited by 10 publications

References 37 publications

Birch pollen allergy in Europe

Birch pollen allergy in Europe

The Effectiveness of the Bacteria Derived Extremolyte Ectoine for the Treatment of Allergic Rhinitis

Shortened up-dosing with sublingual immunotherapy drops containing tree allergens is well tolerated and elicits dose-dependent clinical effects during the first pollen season

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