The Characteristics of Severe Chronic Upper-Airway Disease (SCUAD) in Patients with Allergic Rhinitis: A Real-Life Multicenter Cross-Sectional Italian Study

Abstract

Background: There are few studies regarding severe chronic upper-airway disease (SCUAD) that represents an important socioeconomic problem for the treatment of rhinitis and associated comorbidities, particularly asthma. Objectives: The aim of our study is to evaluate the prevalence of this pathology in patients with allergic rhinitis (AR) in real life, to phenotype allergic patients with SCUAD, and to identify which factors are related to the severity of the disease. Methods: We studied 113 patients with uncontrolled AR despite optimal adherence to therapy according to the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in a multicenter Italian study, analyzing comorbidity, use of additional drugs, not scheduled visits, and the number of emergency room admissions. Results: Our data suggest that polysensitization is the only statistically significant factor correlating with SCUAD. Asthma does not seem to represent a correlating factor. An important finding is the poor use (20%) of allergy immunotherapy (AIT), although patients were suffering from AR and the ARIA guidelines recommend the use of AIT in moderate/severe AR. Conclusions: The SCUAD population seems not to have a specific phenotype; there is a greater presence of SCUAD in polysensibilized patients, perhaps a sign of greater inflammation.

Control of Allergic Rhinitis and Asthma Test: A systematic review of measurement properties and COSMIN analysis

“…A total of 4467 participants were assessed, with the mean reported age ranging between 15 and 55 years old. In four studies (eight reports), all the 2622 participants were reported to have AR, 36,37,41,43,44,48–50 while asthma was reported in all the 1245 participants in six studies (seven reports) 19,22,38–40,46,47 . Five studies included only patients ( n = 508) with both AR and asthma 17,20,35,42,45 …”

Effect of Loratadine Tablets in Combination with Other Drugs on Nasal Physiological Function and T Lymphocyte Subsets in Patients with Allergic Rhinitis

“…Loratadine tablet is a tricyclic antihistamine with high efficiency and long-lasting effect, and it is a selective peripheral H1 receptor antagonist, which can relieve all kinds of symptoms caused by allergic reactions [ 24 ]. Antihistamines are available orally and intranasally.…”

Unresolved issues of management of patients with severe allergic rhinitis and nasal polyposis. The possibilities of anti-IgE therapy

“…Причинами могут являться как факторы, связанные с болезнью (тяжелое течение -SCUAD, сопутствующие заболевания), так и проблемы диагностики, а также приверженности к терапии [52]. Далеко не всем пациентам возможно провести АСИТ -такая терапия проводится не более, чем у 20% больных [21,53].…”

“…В данной группе большинство пациентов имели полисенсибилизаацию (72%), а также характерную коморбидную патологию: БА (49%), назальный полипоз (30%), синусит (51%). Полисенсибилизация коррелировала со SCUAD, предположительно в связи с большей выраженностью воспалительного процесса [53]. По данным литературы, распространенность тяжелых неконтролируемых на стандартной терапии форм АР могут достигать 20% [21].…”