Visual analogue scale in patients treated for allergic rhinitis: an observational prospective study in primary care

Demoly, Pascal; Bousquet, P.; Mesbah, K.; Bousquet, Jean; Devillier, Philippe

doi:10.1111/cea.12121

Cited by 156 publications

(155 citation statements)

References 35 publications

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“…Hence the observed difference between single and chronic dosing in VAS score of 15mm is less than the minimal important difference (MID) of 23mm [26], while the corresponding difference in overall TNS4 score of 1.5 exceeds the MID of 0.55 [25], and for PNIF the difference of 21 L/min exceeds the MID of 5 L/min [25].…”

Section: Discussionmentioning

confidence: 87%

Effects of the inverse alpha‐agonist doxazosin in allergic rhinitis

Manoharan

Morrison

Lipworth

2016

Clin Experimental Allergy

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Summary Background We examined the paradoxical hypothesis that the alpha‐receptor inverse agonist doxazosin might produce beneficial effects in allergic rhinitis. Objectives To evaluate single and chronic dosing effects of doxazosin on nasal airflow and symptoms in allergic rhinitis. Methods Fifteen patients randomized to receive 3–5 weeks of oral doxazosin 4 mg daily or placebo in crossover fashion. Measurements were taken at baseline and after first and last doses. Results There was a fall in peak nasal inspiratory flow (PNIF) between baseline vs. first dose of doxazosin: mean difference −19 L/min (95% CI −35 to −2) P = 0.03, with recovery between first and last doses: 21 L/min (95% CI 7–34) P = 0.006. Nasal visual analogue scale (VAS) and blockage scores were worse between baseline vs. first dose of doxazosin: mean difference VAS −10 mm (95% CI −18 to −2) P = 0.02, blockage −0.7 (95% CI −1.3 to −0.1) P = 0.02, with recovery between first and last doses: VAS 15 mm (95% CI 4–25) P = 0.009, blockage 1.1 (95% CI 0.5–1.6) P = 0.001. The oxymetazoline dose–response for PNIF was blunted after single vs chronic dosing with doxazosin: mean difference −17 L/min (95% CI −30 to −4) P = 0.01. Heart rate and diastolic blood pressure showed the same pattern. There was a significant difference between doxazosin and placebo for nasal blockage score and heart rate after single but not chronic dosing. Conclusions There was a disconnect between single and chronic dosing effects of doxazosin for nasal symptoms, oxymetazoline response and cardiovascular outcomes, in turn suggesting alpha‐1 receptor up‐regulation.

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Section: Discussionmentioning

confidence: 87%

Effects of the inverse alpha‐agonist doxazosin in allergic rhinitis

Manoharan

Morrison

Lipworth

2016

Clin Experimental Allergy

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“…Prior studies12, 13 have suggested a >23 mm difference for clinically meaningful changes in VAS scores. In the present study, this threshold was observed after 3 days of treatment in more than half of the patients, as the VAS score decreased by a median of 13 mm.…”

Section: Discussionmentioning

confidence: 97%

“…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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“…It has been argued in many studies that VAS is a simple and objective method for determining the AR seriousness in school-age children (27)(28)(29). In this study, we used the Simplified Visual Analog Scale (VAS), which scores the severity of nasal obstruction from 0 to 6.…”

Section: Discussionmentioning

confidence: 99%

Adenoid Vegetation in Children with Allergic Rhinitis

Bozkurt¹,

Dizdar²,

Korkut³

et al. 2016

Turk Arch Otorhinolaryngol

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Objective: Pediatric patients with nasal obstruction due to adenoid vegetation (AV) can also encounter allergic rhinitis (AR) as a comorbidity. The aim of the study was to estimate the incidence of mite sensitization and its effect on adenoid size in children who underwent adenoidectomy.Methods: This prospective randomized study conducted between August and September 2014 included 84 children. Skin Prick Test (SPT) for inhalant allergens was preoperatively applied to all children who underwent adenoidectomy for nasal obstruction. Children were divided into two study groups: AV only (Group I) (n=52) and AV with Dermatophagoides Pteronyssinus and/or D. farinae allergy (Group II) (n=32). Postoperative specimen volumes, visual analogue scale (VAS) scores, and adenoid volumes measured using flexible fiberoptic nasopharyngolaryngoscopy were compared between the two groups.Results: Postoperative specimen volume measures were higher in Group II compared with those in Group I (p<0.05). Furthermore, in preoperative endoscopic examination, adenoid volume measures were higher in Group II compared with those in Group I (p<0.05). Pre and postoperative VAS scores in SPT+ group were higher in the Group II (p<0.05) than those in Group I. Conclusion:We observed that children with AR tend to have an early onset of symptoms of adenoid hypertrophy. We believe that focusing on the management of role of allergy regarding these early symptoms will reduce the need for surgery in a large number of cases. We suggest that SPT must be performed in all children with AV and adenoid examination should not be neglected in children with AR. Keywords: Adenoid vegetation, allergic rhinitis, adenoid volume

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Visual analogue scale in patients treated for allergic rhinitis: an observational prospective study in primary care

Abstract: The VAS can detect with high sensitivity the variations of symptoms and QoL in patients with AR.

Cited by 156 publications

References 35 publications

Effects of the inverse alpha‐agonist doxazosin in allergic rhinitis

Effects of the inverse alpha‐agonist doxazosin in allergic rhinitis

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

Adenoid Vegetation in Children with Allergic Rhinitis

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