The Prevalence and Impact of Allergic Rhinitis on Asthma Exacerbations in Asthmatic Adult Patients in the Riyadh Region of Saudi Arabia: A Cross-Sectional Study

Abstract

Objectives: Allergic rhinitis (AR) and asthma are highly prevalent conditions known to occur concomitantly. However, observational, cross-sectional studies in Saudi Arabia assessing the frequency and severity of rhinitis in asthmatics adults using questionnaires based on guidelines are unavailable. Therefore, this study attempted to investigate this side and evaluate the role of triggers, symptoms, and family history or history of AR on asthma control levels.Methods: From April 2nd to September 18th, 2021, this observational cross-sectional study was conducted through an online self-administrated questionnaire that was distributed electronically on social media through the SurveyMonkey website (Momentive Inc., Waterford, NY). The study targeted asthmatic adult patients residing in Riyadh city in Saudi Arabia.Results: Overall, 187 questionnaires were analyzed. In this study, the frequency of AR in asthmatic patients was 75.5% (95% CI: 74.87-75.4%). Of those, AR was intermittent mild for 15.0%, intermittent moderate to severe for 43.9%, mild persistent for 2.14%, persistent moderate to severe for 14.4%, and 24.6% of patients were without AR. A significant association was observed between asthma control level and the severity of AR (P < 0.001). Moderate to severe persistent AR was more prevalent in patients with uncontrolled asthma (40.6%) than patients with partially controlled (25%) or controlled asthma (2.7%).Conclusions: This study suggested that AR was related to more severe asthma and more difficulty in controlling asthma. The frequency significantly increased with the severity of asthma.

The Prevalence and Impact of Allergic Rhinitis on Asthma Exacerbations in Asthmatic Adult Patients in the Qassim Region of Saudi Arabia: A Cross-Sectional Study

“…Based on the study by Mahfouz et al, it is noted that patients with AR had a significantly higher risk of experiencing asthma exacerbations compared to those without AR. Over 80% of patients with AR reported experiencing at least one asthma exacerbation in the past year, compared to 72% of patients without AR [ 7 ]. The study conducted by Lababidi et al indicated that the Arabic ACT showed a good correlation with the clinical assessment of asthma control based on Global Initiative for Asthma (GINA) guidelines.…”

“…Patients were asked whether they agreed to participate before filling out the questionnaire. After obtaining permission, we used a questionnaire from a previous study which was taken completely in both languages (Arabic and English) [ 7 ]. It starts first with questions that include and exclude the participants' asthma diagnosis and comorbidity and is composed of the validated Arabic versions of the Score for Allergic Rhinitis (SFAR) questionnaire [ 12 ], Allergic Rhinitis and Its Impact on Asthma (ARIA) Guidelines [ 7 ], and the Asthma Control Test (ACT) questionnaire [ 13 ].…”

“…According to some studies, the severity of AR and asthma may be related, with the frequency and severity of AR increasing with the severity of asthma [ 5 , 6 ]. In the Riyadh region, a cross-sectional study was conducted which suggests a positive association between asthma and AR control [ 7 ]. When asthma and AR coexist, this condition may require more hospitalizations and doctor visits for asthma-related issues, incurring higher costs overall [ 8 - 10 ].…”

The Impact of Allergic Rhinitis on Asthma and Its Effect on the Quality of Life of Asthmatic Patients

“…Higher scores reflect better asthma control. ACT cutoff points for uncontrolled and partly controlled asthma were ≤19 and ≤22, respectively [ 11 , 12 ]. Respondents whose asthma was reported as controlled or completely controlled were grouped when doing the analysis.…”