Sleep impairment and daytime sleepiness in patients with allergic rhinitis: the role of congestion and inflammation

Thompson, A.R.; Sardana, Niti; Craig, Timothy J.

doi:10.1016/j.anai.2013.05.020

Cited by 64 publications

(42 citation statements)

References 71 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Kaulsay

Nguyễn

Kuhl

2018

Immunity Inflam & Disease

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IntroductionMost allergic rhinitis (AR) patients have moderate‐to‐severe, persistent disease. Meda Pharma's AzeFlu (MP‐AzeFlu) combines intranasal azelastine hydrochloride (AZE) and fluticasone propionate (FP) in a novel formulation in a single device to treat AR. This prospective, noninterventional study sought to assess the effectiveness of MP‐AzeFlu (one spray/nostril twice daily; 548 µg AZE/200 µg FP daily dose) in relieving AR symptom severity.MethodsA visual analogue scale (VAS) was used prior to MP‐AzeFlu treatment on days 0, 1, 3, 7, 14, 21, 28, 35, and 42 by 53 persistent AR (PER) patients seen in routine clinical practice in Ireland. An endoscopy was performed on days 0 and 28, and symptoms of edema, discharge, and redness were scored on a three‐point scale (for both nostrils).ResultsPatients using MP‐AzeFlu experienced rapid VAS score reduction from 73.4 mm (standard deviation [SD], 20.3) at Day 0 to 31.5 mm (SD, 25.0) at day 28 (P < 0.0001) to 28.1 mm (SD, 24.1) at day 42 (P < 0.0001), a 45.3‐mm reduction. On average, patients achieved a clinically relevant VAS score cutoff of 50 mm before Day 7. Total endoscopy score decreased from 7.5 mm (SD, 3.1) at baseline to 3.5 mm (SD, 2.5) at Day 28. The incidence of severe edema on endoscopy decreased from 53.1% at baseline to 3.8% at Day 28. A similar reduction in the incidence of thick/mucousy discharge (from 28.3% to 4.8%) and severe redness (from 34.9% to 0%) was also observed.ConclusionsMP‐AzeFlu provided effective, rapid control of PER as assessed by VAS in a real‐world clinical setting in Ireland. Symptom improvement was observed at Day 1, sustained for 42 days, and associated with improved mucosal appearance after 28 days. These results confirm the safety of MP‐AzeFlu and exceed the efficacy demonstrated in phase 3 clinical studies for controlling AR in PER patients.

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Section: Discussionmentioning

confidence: 99%

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

Kaulsay

Nguyễn

Kuhl

2018

Immunity Inflam & Disease

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“…[2,[16][17][18] The reasons for poor sleep quality are not clearly defined, but nasal congestion and elevated inflammatory cytokines have been reported to be the likely causes of sleep impairment. [2,16] Colás et al [35] reported that among 2,275 patients with AR, 52.8% had sleep disturbances and sleep quality was affected by severity of the disease. In the present study, sleep quality assessed by PSQI was similar in AR and control groups, and in contrast with our hypothesis, our results showed that presence of RLS did not seem to have any negative effect on sleep quality in AR.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18] There is a strong relationship between poor sleep quality and AR with impaired nasal function. [2,[16][17][18] Also, the addition of RLS to AR may cause poor sleep quality or RLS and AR may have a potentiating effect on sleep.…”

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confidence: 99%

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Restless legs syndrome in children with allergic rhinitis: A comparative study on frequency, severity and sleep quality

Filiz¹

2018

Turk J Phys Med Rehab

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Objectives: This study aims to investigate the frequency and severity of restless legs syndrome (RLS) and its relationship with sleep quality in children with allergic rhinitis (AR) with the hypothesis that comorbid RLS may be an additional causative factor of sleep disturbances in pediatric AR. Patients and methods:A total of 143 children with AR (aged 8-18 years) and 144 healthy control subjects (aged 8-18 years) were included. The diagnosis of AR was established on history, clinical examination and skin prick test according to the Allergic Rhinitis and its Impact on Asthma guidelines. Presence of RLS was determined using the International RLS study group (IRLSSG) criteria. The severity of RLS was assessed using the IRLSSG rating scale. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI).Results: Thirteen patients (9.1%) in AR group, and six children (4.2%) in control group had RLS (p=0.159). The frequency of RLS in AR group was higher than two folds when compared to the control group; however, the difference was not statistically significant. Restless legs syndrome severity score was significantly higher in AR group than control group (15.00 [11][12][13][14][15][16][17][18][19][20] and 11.00 [10][11][12][13][14][15][16] respectively, p=0.046). Total PSQI scores were similar between groups. Also, no significant differences were observed in total PSQI scores of AR patients with or without RLS. Conclusion:Restless legs syndrome was not more common but was more severe in children with AR. There was no evidence that RLS has an obvious effect on sleep quality in children with AR.

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“…According to the results of a recent study, approximately one‐half of people with AR in Denmark are undiagnosed, and so the disease is often untreated . AR that is uncontrolled or untreated has a considerable clinical and economic impact; patients experience significant negative impairment of their quality of life, with limitations reported in all areas of daily living from sleep disturbance to cognitive dysfunction and performance limitations reported both at work and at school . Patient expectations of AR treatments are high, but satisfaction is low .…”

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confidence: 99%

MP‐AzeFlu provides rapid and effective allergic rhinitis control: results of a non‐interventional study in Denmark

Haahr

Jacobsen

Christensen³

2019

Int Forum Allergy Rhinol

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Background: Allergic rhinitis (AR) control is a priority in the European Union (EU), and Allergic Rhinitis and its Impact on Asthma (ARIA) has endorsed a visual analogue scale (VAS) as the new language of AR control. This study evaluated the effectiveness of MP-AzeFlu (Dymista R , antihistamine [azelastine], and intranasal corticosteroid [fluticasone propionate]) using a VAS in real-life clinical practice in Denmark. Methods:The multicenter, prospective, non-interventional study included 170 patients (ࣙ12 years) with ARIA-defined moderate-to-severe AR prescribed MP-AzeFlu. Patients assessed symptom severity using a VAS (0 to 100 mm) on days 0, 1, 3, and 7 and a er ß14 days of MP-AzeFlu use. On day 3, patients assessed their disease as well controlled, partly controlled, or uncontrolled. Proportions of patients achieving VAS score cutoffs (well-controlled, partly controlled) were also calculated.Results: MP-AzeFlu reduced mean ± standard deviation VAS score from 67.1 ± 19.3 mm at baseline to 28.4 ± 23.7 mm on the last day, a reduction of 38.8 ± 27.3 mm. At day 3, 85.6% of patients considered their symptoms to be partly or well controlled. Effectiveness was consistent across disease severity, phenotype (seasonal, perennial, or combined AR), and patient age. Respectively, 28.2%, 44.2%, 61.6%, and 71.4% of patients achieved ࣘ38 mm well-controlled VAS score cutoff on days 1, 3, and 7, and the last day.Conclusion: MP-AzeFlu provided effective, rapid, and sustained symptom control in a real-life se ing among patients from Denmark. These results align with EU and ARIA objectives and support the effectiveness of MP-AzeFlu for the treatment of AR in real life. C 2019 ARS-AAOA, LLC.

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Sleep impairment and daytime sleepiness in patients with allergic rhinitis: the role of congestion and inflammation

Cited by 64 publications

References 71 publications

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

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

Restless legs syndrome in children with allergic rhinitis: A comparative study on frequency, severity and sleep quality

MP‐AzeFlu provides rapid and effective allergic rhinitis control: results of a non‐interventional study in Denmark

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