A multicenter real-life study on the multiple reasons for uncontrolled allergic rhinitis.
aeroallergens
allergens
allergic rhinitis
chronic disease
rhinitis
Journal
International forum of allergy & rhinology
ISSN: 2042-6984
Titre abrégé: Int Forum Allergy Rhinol
Pays: United States
ID NLM: 101550261
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
revised:
05
04
2021
received:
24
01
2021
accepted:
06
04
2021
pubmed:
15
7
2021
medline:
15
12
2021
entrez:
14
7
2021
Statut:
ppublish
Résumé
Recent data show uncontrolled disease in 35% of allergic rhinitis (AR) patients on medical treatment. The reasons for uncontrolled disease can arbitrarily be divided into disease-related, diagnosis-related, treatment-related, and patient-related factors. However, the relative importance of these factors in uncontrolled disease remains speculative. This explorative study aimed at determining the factors causing uncontrolled AR on four different continents worldwide, identifying the most common reasons for uncontrolled disease in AR. Patients with uncontrolled AR (n = 430) were asked to fill out a questionnaire and underwent a clinical examination at the outpatient clinic in five university outpatient clinics (Leuven [Belgium], Beijing [China], Kinshasa [Congo], Bangalore [India], and Philadelphia [US]). Two independent physicians evaluated the reason or multiple reasons for uncontrolled disease. The study was coordinated from the University Hospital of Leuven. In uncontrolled AR patients, 76% of patients showed two or more reasons for uncontrolled disease according to the physicians' evaluation. Disease-related factors (64%) were considered most often the reason for uncontrolled disease, followed by treatment- (56%), patient- (54%), and diagnosis-related (47%) factors. There is limited variability in observations across different centers worldwide. We here define the multiple reasons for uncontrolled AR across different continents, with disease-related factors being most frequently associated with uncontrolled disease. A better understanding of uncontrolled disease will guide us in defining strategies to improve AR care.
Sections du résumé
BACKGROUND
Recent data show uncontrolled disease in 35% of allergic rhinitis (AR) patients on medical treatment. The reasons for uncontrolled disease can arbitrarily be divided into disease-related, diagnosis-related, treatment-related, and patient-related factors. However, the relative importance of these factors in uncontrolled disease remains speculative. This explorative study aimed at determining the factors causing uncontrolled AR on four different continents worldwide, identifying the most common reasons for uncontrolled disease in AR.
METHODS
Patients with uncontrolled AR (n = 430) were asked to fill out a questionnaire and underwent a clinical examination at the outpatient clinic in five university outpatient clinics (Leuven [Belgium], Beijing [China], Kinshasa [Congo], Bangalore [India], and Philadelphia [US]). Two independent physicians evaluated the reason or multiple reasons for uncontrolled disease. The study was coordinated from the University Hospital of Leuven.
RESULTS
In uncontrolled AR patients, 76% of patients showed two or more reasons for uncontrolled disease according to the physicians' evaluation. Disease-related factors (64%) were considered most often the reason for uncontrolled disease, followed by treatment- (56%), patient- (54%), and diagnosis-related (47%) factors. There is limited variability in observations across different centers worldwide.
CONCLUSION
We here define the multiple reasons for uncontrolled AR across different continents, with disease-related factors being most frequently associated with uncontrolled disease. A better understanding of uncontrolled disease will guide us in defining strategies to improve AR care.
Substances chimiques
Allergens
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1452-1460Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2021 ARS-AAOA, LLC.
Références
Greiner AN, Hellings PW, Rotiroti G, Scadding GK. Allergic rhinitis. Lancet 2011;378(9809):2112-2122.
Bousquet J, Bachert C, Canonica GW, et al. Unmet needs in severe chronic upper airway disease (SCUAD). J Allergy Clin Immunol 2009;124(3):428-433.
Akdis CA, Bachert C, Cingi C, et al. Endotypes and phenotypes of chronic rhinosinusitis: a PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma Immunol. J Allergy Clin Immunol 2013;131(6):1479-1490.
Prokopakis EP, Vlastos IM, Ferguson BJ, et al. SCUAD and chronic rhinosinusitis. Reinforcing hypothesis driven research in difficult cases. Rhinology 2014;52(1):3-8.
Hellings PW, Fokkens WJ, Akdis C, et al. Uncontrolled allergic rhinitis and chronic rhinosinusitis: where do we stand today? Allergy 2013;68(1):1-7.
López-Chacón M, Mullol J, Pujols L. Clinical and biological markers of difficult-to-treat severe chronic rhinosinusitis. Curr Allergy Asthma Rep 2015;15(5):19.
Hellings PW, Fokkens WJ, Bachert C, et al. Positioning the principles of precision medicine in care pathways for allergic rhinitis and chronic rhinosinusitis - A EUFOREA-ARIA-EPOS-AIRWAYS ICP statement. Allergy 2017;72(9):1297-1305.
Droessaert V, Timmermans M, Dekimpe E, et al. Real-life study showing better control of allergic rhinitis by immunotherapy than regular pharmacotherapy. Rhinology 2016;54(3):214-220.
Lund V, Hopkins C, Akdis C, et al. EUFOREA Rhinology Research Forum 2017: report of the brainstorming sessions on endotype-driven treatment, patient empowerment and digital future in airways care. Rhinology online 2018;1.
Muraro A, Lemanske RF, Hellings PW, et al. Precision medicine in patients with allergic diseases: Airway diseases and atopic dermatitis-PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol 2016;137(5):1347-1358.
Hox V, Steelant B, Fokkens W, et al. Occupational upper airway disease: how work affects the nose. Allergy 2014;69(3):282-291.
Hellings PW, Prokopakis EP. Global airway disease beyond allergy. Curr Allergy Asthma Rep 2010;10(2):143-149.
Hens G, Vanaudenaerde BM, Bullens DMA, et al. Sinonasal pathology in nonallergic asthma and COPD: “united airway disease” beyond the scope of allergy. Allergy 2008;63(3):261-267.
Hellings PW, Klimek L, Cingi C, et al. Non-allergic rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy 2017;72(11):1657-1665.
Brożek JL, Bousquet J, Agache I, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol 2017;140(4):950-958.
Hellings PW, Dobbels F, Denhaerynck K et al. Explorative study on patient's perceived knowledge level, expectations, preferences and fear of side effects for treatment for allergic rhinitis. Clin Transl Allergy 2012;2(1):9.
Hellings PW, Fokkens WJ. Allergic rhinitis and its impact on otorhinolaryngology. Allergy 2006;61(6):656-664.
Prokopakis E, Vardouniotis, A, Bachert C, et al. Rhinology future debates 2018, a EUFOREA report. Rhinology 2020;58(4):384-393
Bousquet PJ, Combescure C, Neukirch F, et al. Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines. Allergy 2007;62(4):367-72.
Giovino GA, Mirza SA, Samet JM, et al. Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys. The Lancet 2012;380 (9842):668-679.
Segboer CL, Holland CT, Reinartz SM, et al. Nasal hyper-reactivity is a common feature in both allergic and nonallergic rhinitis. Allergy 2013;68(11):1427-1434.