Association of asthma control with allergic rhinitis severity in adult patients

The efficacy of aqueous suspensions of budesonide nasal spray and fluticasone propionate nasal spray, in the treatment of seasonal allergic rhinitis, was compared in a large, placebo-controlled, two-center study. A 1-week baseline period was followed by a 4- to 6-week treatment period during which 635 adult patients, aged 18–72 years, were randomized to receive either placebo, budesonide 128 μg, or 256 μg once daily, or fluticasone propionate, 200 μg once daily. Nasal and eye symptoms, overall treatment efficacy and safety assessments were made during the study period. Combined, as well as individual, nasal symptoms were significantly improved in all three active treatment groups compared with placebo therapy. Treatment with 256 μg/day of budesonide was found to be significantly more effective in reducing the sneezing score compared with 200 μg/day of fluticasone propionate. Analysis of symptom scores on days when the pollen count was greater than 10 grains/m3 revealed 256 μg/day of budesonide therapy to be significantly more effective in reducing combined symptom scores as well as the individual scores for sneezing and runny nose, compared with 200 μg/day fluticasone propionate. The higher dose of budesonide (256 μg/day) was also more effective than the lower dose (128 μg/day) in reducing sneezing scores and statistical significance was almost reached for the reduction in combined symptom and runny nose scores. Substantial or total control of symptoms was achieved by 31.4%, 85.3%, 88.4%, and 81.9% of patients receiving placebo, 128 μg/day of budesonide, 256 μg/day of budesonide, and 200 μg/day of fluticasone propionate, respectively. The incidence of adverse events was low in all treatment groups. In conclusion, both budesonide and fluticasone propionate treatments were effective and well-tolerated in the treatment of seasonal allergic rhinitis. However, 256 μg/day of budesonide tended to be more effective than 200 μg/day of fluticasone propionate and 128 μg/day of budesonide, especially when patients were exposed to a higher pollen load.

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Medication Adherence in a Community Population with Uncontrolled Asthma

Pharmacy ◽

10.3390/pharmacy8040183 ◽

2020 ◽

Vol 8 (4) ◽

pp. 183

Author(s):

Sarah Serhal ◽

Bandana Saini ◽

Sinthia Bosnic-Anticevich ◽

Ines Krass ◽

Frances Wilson ◽

...

Keyword(s):

At Risk ◽

Allergic Rhinitis ◽

Medication Adherence ◽

Asthma Control ◽

Hospital Admissions ◽

Medication Management ◽

Uncontrolled Asthma ◽

Medication History ◽

Factors Affecting ◽

Oral Corticosteroids

It is well documented that the use of medications in asthma and allergic rhinitis is often suboptimal, and consequently, patients remain symptomatic. This study aimed to determine the extent and type of medication-related issues contributing to poor asthma control by profiling medication management in those most at risk—a population with clinically uncontrolled asthma. Participants (n = 363) were recruited from Australian community pharmacies, and a dispensed medication history report for the previous 12 months was collected to examine medication adherence and factors affecting adherence. Information was also collected regarding participant asthma control and asthma/allergic rhinitis (if applicable) management. The participants’ mean asthma control score was 2.49 (± 0.89 SD, IQR = 1.20) (score ≥ 1.5 indicative of poorly controlled asthma), and 72% were either non-adherent or yet to initiate preventer therapy. Almost half had been prescribed high doses of inhaled corticosteroid and 24% reported use of oral corticosteroids. Only 22% of participants with concomitant allergic rhinitis were using first line treatment. A logistic regression model highlighted that participant health care concession status and hospital admissions were associated with better adherence. Suboptimal medication management is evident in this at-risk population.

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