The prevalence of non‐allergic rhinitis phenotypes in the general population: A cross‐sectional study

Abstract

Background Non‐allergic rhinitis (NAR) can be subdivided into several phenotypes: rhinorrhea of the elderly, rhinitis medicamentosa, smokers', occupational, hormonal, drug‐induced, gustatory, and idiopathic rhinitis. There are two pathophysiological endotypes of NAR: inflammatory and neurogenic. Phenotypes may serve as an indicator of an underlying endotype and, therefore, help to guide the treatment. The prevalence of each phenotype in the general population is currently unknown. Methodology/Principal Cross‐sectional questionnaire‐based study in the general population of the Netherlands. Results The prevalence of chronic rhinitis in the general population was 40% (N = 558, of those, 65% had NAR and 28% AR, in 7% allergy status is unknown). Individuals with NAR (N = 363) had significantly more complaints in October–February. Those with AR (N = 159) had significantly more complaints in April–August. The most common NAR phenotypes were idiopathic (39%) and rhinitis medicamentosa (14%), followed by occupational (8%), smokers' (6%), hormonal (4%), gustatory (4%), and rhinorrhea of the elderly (4%). The least prevalent phenotype was drug induced (1%). Nineteen percent of the NAR group could not be classified into any of the phenotypes. Conclusions This is the first study to describe the prevalences of NAR phenotypes in the general population. AR and NAR have a distinct seasonality pattern with NAR being more prevalent in autumn/winter and AR in spring/summer. Our data on the prevalence of phenotypes may help clinicians to anticipate the type of patients at their clinic and help guide a tailored treatment approach. The high prevalence of rhinitis medicamentosa is alarming, since this is a potentially preventable phenotype.

Rhinitis phenotypes and multimorbidities in the general population: the CONSTANCES cohort

“…Three studies conducted in Belgium, Sweden and Italy found very similar prevalences of NAR, between 9.6% and 12.0% [ 21 – 23 ]. Recently, a study in the Netherlands found a prevalence of NAR of 26% [ 7 ]. The actual prevalence of rhinitis may be underestimated because most studies had only considered AR.…”

“…However, most of this knowledge on rhinitis is derived from clinical practice, and there are few epidemiological studies in the general adult population that have assessed the prevalence and characteristics of phenotypes of rhinitis. Furthermore, few of them have assessed NAR [ 3 , 6 , 7 ].…”

Diamine Oxidase Activity Deficit and Idiopathic Rhinitis: A New Subgroup of Non-Allergic Rhinitis?

“…NAR comprises a large heterogeneous group of patients without systemic signs of allergic inflammation (allergen-specific IgE in the blood and/or positive SPT results) or clinical signs of infection. Of these cases, up to 50% do not have a clear etiology underlying the symptoms and are defined as idiopathic rhinitis (IR) [ 1 , 2 , 3 ].…”

Clinical characteristics of chronic rhinitis following stroke

“…Most patients complained of discomfort during meals because of rhinorrhea. These symptoms could be defined as non-allergic rhinitis, a type of chronic rhinitis (CR) that causes rhinorrhea, nasal obstruction, sneezing, and/or itchy nose without any clinical evidence of infection or allergic diseases ( 5 ). Non-allergic rhinitis is affected by the sympathetic and parasympathetic nervous system of the nasal cavity, and rhinitis symptoms are thought to develop due to autonomic dysfunction that occurs after stroke ( 6 ).…”