Allergic Rhinitis: keys for the clinician

Allergic rhinitis (AR) and asthma are the most common inflammatory diseases of the airways. According to the review of the literature, there is a prevalence of AR of 10-40% worldwide. AR is defined as a type I allergic disease caused by immunoglobulin E mediated inflammation. The symptoms include nasal congestion, watery rhinorrhea and sneezing. In most cases it is accompanied by ocular symptoms like ocular redness, tearing and itchy eyes. AR can have an influence on the quality of life in patients, for example: sleep disturbances, fatigue, irritability, depression, also affect the attention, learning and memory deficits. The classification of AR is seasonal AR, perennial AR, other classification is by duration of symptoms, like intermittent, persistent, also a severity classification, based on disturbances in quality life, proposed by the Allergic Rhinitis and Its Impact on Asthma (ARIA). The first steps in the diagnosis are the clinical history and physical examination of the patient. Also, the diagnosis can include laboratory tests like skin prick test and the determination of immunoglobulin E levels in serum. In the first line of the treatment there is the no pharmacologic changes in the patient’s life, emphasizing the avoidance of contact between the patient and the allergen, and the pharmacological treatment are the second-generation antihistamines, inhaled glucocorticoids and immunotherapy, also alternative treatments can be used like acupuncture, ginger extract and probiotic therapy. Allergic rhinitis represents a limitation in the daily activity of those affected, it affects their quality of life, interferes with their ability to sleep, as well as their life at work and school.

Download Full-text

Recent Trends in Management of Allergic Rhinitis

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1286 ◽

2016 ◽

Vol 9 (3) ◽

pp. 130-136 ◽

Cited By ~ 1

Author(s):

Rajalaxmi Panigrahi ◽

Sudhir K Acharya

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Adverse Effects ◽

Immunoglobulin E ◽

Nasal Congestion ◽

Symptomatic Relief ◽

Dust Mite ◽

Recent Trends ◽

Ige Mediated

ABSTRACT Allergic rhinitis is an inflammatory, immunoglobulin E (IgE)- mediated disease, characterized by nasal congestion, rhinorrhea, and sneezing with or without nasal itching. It can significantly interfere with patient's quality of life. The goals of treatment are to provide the patient with symptomatic relief and improve the quality of life with minimal adverse effects. Prevention has been a large focus in the treatment of allergic rhinitis, but few interventions have proven effective. Although dust mite allergies are more common. How to cite this article Panigrahi R, Acharya SK. Recent Trends in Management of Allergic Rhinitis. Clin Rhinol An Int J 2016;9(3):130-136.

Download Full-text

Perubahan kualitas hidup, eosinofil mukosa hidung, dan interleukin-5 serum pasien rinitis alergi pasca terapi

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v45i2.116 ◽

2015 ◽

Vol 45 (2) ◽

pp. 121

Author(s):

Arinda Putri Pitarini ◽

Nina Irawati ◽

Niken Lestari Poerbonegoro ◽

Dewi Wulandari ◽

Saptawati Badarsono

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Eosinophil Count ◽

Immunoglobulin E ◽

Nasal Congestion ◽

Inflammatory Cells ◽

Clinical Practices ◽

Interleukin 5 ◽

Comprehensive Management

Latar belakang: Rinitis alergi adalah suatu penyakit inflamasi pada hidung yang dimediasi oleh imunoglobulin-E, yang terjadi setelah mukosa hidung terpajan alergen. Sel dan mediator inflamasi yang berperan penting adalah eosinofil, histamin, dan sitokin produk Th2. Penyakit ini ditandai dengan gejala rinorea, bersin berulang, hidung tersumbat dan/atau hidung gatal. Selain dari gejala yang mengganggu, rinitis alergi berdampak buruk terhadap kualitas hidup penderita. Tatalaksana komprehensif, meliputi penghindaran alergen, farmakoterapi, imunoterapi dan edukasi, ditujukan untuk menghilangkan gejala dan memperbaiki kualitas hidup pasien. Tujuan: Mengetahui perubahan kualitas hidup, jumlah eosinofil mukosa hidung, dan kadar IL-5 serum pada pasien rinitis alergi setelah mendapat terapi farmaka sesuai panduan. Metode: Penelitian ini merupakan studi pre-eksperimental analitik dengan pengambilan data sebelum dan sesudah pemberian farmakoterapi. Hasil: Sebanyak 31 dari 33 subjek mengalami perubahan kualitas hidup yang bermakna (MID>0,7). Seluruh pasien, 33 subjek memperlihatkan perubahan yang responsif dari jumlah eosinofil mukosa hidung. Sebanyak 30 subjek dinyatakan responsif dan terdapat penurunan kadar IL-5. Tidak ada hubungan yang bermakna antara perubahan kualitas hidup dan kadar IL-5. Kesimpulan: Perubahan kualitas hidup, jumlah eosinofil mukosa hidung, dan kadar IL-5 serum dapat digunakan sebagai penanda objektif keberhasilan terapi rinitis alergi yang dapat dipakai dalam praktik klinis sehari-hari maupun kepentingan riset. Kata kunci: rinitis alergi, kualitas hidup, eosinofil, interleukin-5ABSTRACT Background: Allergic rhinitis defined as an inflammatory disease of the nose mediated by immunoglobulin-E, induced after nasal mucosa exposure to allergen. Important inflammatory cells and mediators are eosinophils, histamine, and Th2-related cytokines. Symptoms include rhinorrhea, repeated sneezing, nasal congestion and/or nasal itching. Aside from its bothersome symptoms, allergic rhinitis decreases patient’s quality of life (QOL). Comprehensive management consist of allergen avoidance, medication, immunotherapy, and education, aimed to diminish symptoms and improve the patient’s quality of life. Purpose: To evaluate changes in quality of life, nasal mucosal eosinophil count, and level of interleukin-5 in allergic rhinitis after medicamentous treatment. Methods: This was an analytic pre-experimental study with data taken before and after medicamentous treatment. Results: Thirty-one of 33 subjects showed significant changes of QOL (MID>0,7). All samples, 33 subjects, experienced responsive changes in nasal mucosal eosinophil count. Thirty subjects were responsive, which showed decrease of IL-5 level. There was no significant relation between changes of QOL and changes of IL-5 level. Conclusion: Changes in quality of life, nasal mucosal eosinophil count, and IL-5 level are objective markers of treatment efficacy in Allergic Rhinitis, which can be used in clinical practices and researches. Keywords: allergic rhinitis, quality of life, eosinophil, interleukin-5, intranasal steroid, antihistamine

Download Full-text

Pharmacoeconomic features of the use of drugs used in the treatment of allergic rhinitis

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2021-23-2-9-16 ◽

2021 ◽

pp. 9-16

Author(s):

Afanasyeva T.G. ◽

Lavrova N.N. ◽

Tumentseva V.R.

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Nasal Mucosa ◽

Generic Drugs ◽

Cost Minimization ◽

Nasal Congestion ◽

World Health ◽

Cost Minimization Analysis ◽

Wide Range

Rhinitis is an inflammation of the nasal mucosa; today, according to the World Health Organization, the prevalence of the disease is 40% of the world's population. Allergic rhinitis is the most common type of chronic rhinitis, affecting 10–20% of the world's population, and the severity of the disease is associated with a significant deterioration in the quality of life, sleep and performance. Allergic rhinitis is an inflammatory disease of the nasal mucosa caused by exposure to an allergen, causing IgE-mediated inflammation. Clinically, the disease is characterized by the following main symptoms: rhinorrhea, sneezing, itching and nasal congestion. Despite the general symptoms of allergic rhinitis, its impact on the quality of life of patients and the significant cost of treatment, including pharmacotherapy, many patients do not adhere to drug treatment regimens due to their insufficient effectiveness in eliminating the emerging symptoms. Pharmacoeconomic research identifies, measures and compares the costs and effects of drug use. This framework includes research methods related to cost minimization, cost-effectiveness, decision analysis, cost of illness, and patient quality of life. This article will consider one of the four main methods for assessing pharmacoeconomics - cost minimization analysis. A cost-minimization analysis is a pharmacoeconomic assessment by comparing the costs of two or more drug alternatives regardless of outcome. Since the pharmaceutical market is represented by a wide range of original, reference and generic drugs for the treatment of allergic rhinitis, an important aspect of our research is the selection of effective and economically acceptable therapy for outpatients.

Download Full-text

Treatment with desloratadine improves quality of life and symptom scores, including nasal congestion, in patients with seasonal allergic rhinitis*1

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2003.12.053 ◽

2004 ◽

Vol 113 (2) ◽

pp. S27 ◽

Cited By ~ 2

Author(s):

A PRADALIER

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Seasonal Allergic Rhinitis ◽

Nasal Congestion ◽

Symptom Scores

Download Full-text

The Relationship Between Perception of Disease and Quality of Life in Patients with Acne Vulgaris from 2013 to 2014

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v1i2.28 ◽

2017 ◽

Vol 1 (2) ◽

Author(s):

Mohamad Ebrahimzadeh Ardakani ◽

Farideh Dehghani ◽

Narges Ghanei ◽

Fatemeh Hoseini Kasnavie ◽

Fariba Sepehri ◽

...

Keyword(s):

Quality Of Life ◽

Acne Vulgaris ◽

Illness Perception ◽

Life Quality ◽

Duration Of Symptoms ◽

Life Score ◽

Severe Acne ◽

Quality Life ◽

Perception Of Disease

Background: Acne vulgaris is a common skin disease that can affect people in any ages. The development of acne have adverse effects on life quality. Psychological disorders increased in these patients and their psycho social activities have been affected. Since few studies have been done regarding illness perception in people with acne in Iran, this study aimed to investigate the association of perception of acne disease and quality of life in central of IranMethods: we analyzed 200 patients Acne Vulgaris referred to Khatam-Al Anbia in 2013-14 by questionnaire of perception of disease (Brief IPQ) and quality of life (DLQL. the data was analyzed using t-test and Chi-square by SPSS-16Results: Mean age of patients was 24.3 years and 158 people (79%) were women and 42 people (21 %) were men. Mean quality life score in women was 8.79±5.3 and in men was 8.69±5.18. Most patients had moderate acne and duration of their disease was between 1 to 5 years. 136 people were 18 to 25 years old and 64 persons were higher than 25 years. The mean perception scores in men and women were 51.83 and 53.26 respectively In this study, there was a relation between sex (P=0.03), Acne severity and duration with quality of life score.Conclusion: Women and patients with severe acne and longer duration of symptoms had higher quality life score that had more disorder in life.. There was relation between perception and sex and duration of symptoms.

Download Full-text

Subcutaneous Immunotherapy Improves the Symptomatology of Allergic Rhinitis

International Archives of Otorhinolaryngology ◽

10.1055/s-0035-1564437 ◽

2015 ◽

Vol 20 (01) ◽

pp. 006-012 ◽

Cited By ~ 3

Author(s):

Edmir Lourenço ◽

Eduardo Caldeira ◽

César Carvalho ◽

Marcelo Cunha ◽

Marcus Carvalho ◽

...

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Nasal Congestion ◽

Average Score ◽

Subcutaneous Immunotherapy ◽

Therapeutic Tool ◽

Pathological Conditions ◽

In The Beginning ◽

Subcutaneous Specific Immunotherapy

Introduction The relevance of allergic rhinitis is unquestionable. This condition affects people's quality of life and its incidence has increased over the last years. Objective Thus, this study aims to analyze the effectiveness of subcutaneous injectable immunotherapy in cases of nasal itching, sneeze, rhinorrhea and nasal congestion in allergic rhinitis patients. Methods In the present study, the same researcher analyzed the records of 281 patients. Furthermore, the researchers identified allergens through puncture cutaneous tests using standardized extracts containing acari, fungi, pet hair, flower pollen, and feathers. Then, the patients underwent treatment with subcutaneous specific immunotherapy, using four vaccine vials for desensitization, associated with environmental hygiene. The authors analyzed conditions of nasal itching, sneeze, rhinorrhea, and nasal congestion throughout the treatment, and assigned them with a score ranging from zero (0), meaning absence of these symptoms to three (3), for severe cases. The symptoms were statistically compared in the beginning, during, and after treatment. Results In this study, authors analyzed the cases distribution according to age and the evolution of symptomatology according to the scores, comparing all phases of treatment. The average score for the entire population studied was 2.08 before treatment and 0.44 at the end. These results represent an overall improvement of ∼79% in symptomatology of allergic rhinitis in the studied population. Conclusion The subcutaneous immunotherapy as treatment of allergic rhinitis led to a reduction in all symptoms studied, improving the quality of life of patients, proving itself as an important therapeutic tool for these pathological conditions.

Download Full-text

Impact of allergic rhinitis on quality of life and main risk factor: a study in Jazan region

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212335 ◽

2021 ◽

Author(s):

Radeif Shamakhi ◽

Musleh Mubarki

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Sleep Disturbances ◽

Negative Impact ◽

Cross Sectional Study ◽

Inflammatory Disorder ◽

Upper Respiratory Tract ◽

Cross Sectional ◽

Present Cross Sectional Study

Background: Allergic rhinitis is a common inflammatory disorder that affects the upper respiratory tract. It affects about one-third of the world’s population. The prevalence of rhinitis varies greatly in various countries and also in various parts of the same country. With this disease, the quality of life which includes sleep disturbances, fatigue, diminished memory, depression is decreased because of the direct impact on the life of the patient.Methods: The present cross-sectional study was conducted on patients over the age of 18 years old who suffered from symptoms of allergic rhinitis between 1 March 2021 to 30 March 2021 in Jizan regionPatients were answered for questionnaires that sent for them online through social media.Results: A total of 37 participants enrolled. According to the ARIA guidelines, patients were divided into four groups: a moderate to severe intermittent group that comprised the majority of the patients 38%, a mild intermittent group 19%, a moderate to severe permanent group 27%, and a mild permanent group 15%. Among the total of 37 patients, the quality of life was mildly affected in 35% and severely influenced in 65% patients.Conclusions: In the patients studied in Saudi Arabia's southern area, allergic rhinitis can have a negative impact on sleep quality, mood, and daily activities.

Download Full-text

Montelukast Effectively Treats the Nighttime Impact of Seasonal Allergic Rhinitis

American Journal of Rhinology ◽

10.1177/194589240501900611 ◽

2005 ◽

Vol 19 (6) ◽

pp. 591-598 ◽

Cited By ~ 13

Author(s):

Eli O. Meltzer ◽

George Philip ◽

Steven F. Weinstein ◽

Craig F. LaForce ◽

Marie-Pierre Malice ◽

...

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Seasonal Allergic Rhinitis ◽

Nasal Congestion ◽

Positive Control ◽

Global Evaluation ◽

Life Questionnaire ◽

Double Blind ◽

Significant Burden

Background Nighttime problems constitute a significant burden on the quality of life of patients with seasonal allergic rhinitis (SAR). The aim of this study was to evaluate the effectiveness of montelukast on nighttime AR symptoms. Methods In seven multicenter, double-blind, parallel-group trials, nighttime problems were assessed as the nighttime symptoms score (NSS), an average of three individual symptom scores: difficulty going to sleep, nighttime awakening, and nasal congestion on awakening (each rated 0 = none to 3 = severe). Patients (aged 15–82 years) were randomized to receive montelukast, 10 mg (n = 1751), placebo (n = 1557), or the positive control loratadine, 10 mg (n = 1616). Results In a combined analysis, changes from baseline (mean ± SE) in NSS were -0.28 ± 0.01, -0.16 ± 0.01, and —0.24 ± 0.01 for the montelukast, placebo, and loratadine groups, respectively. Difference versus placebo in least-squares mean change from baseline were —0.11 (95% confidence interval, -0.14, -0.08; p ≤ 0.001) for montelukast and -0.09 (-0.12, -0.06; p ≤ 0.001) for loratadine. Strong baseline correlations (R > 0.70; p < 0.001) of NSS and two of its individual symptoms with the sleep domain of the validated Rhinoconjunctivitis Quality of Life Questionnaire support the validity and importance of measuring nighttime morbidity in SAR. Furthermore, a clinically important benefit of montelukast on the nighttime impact of SAR was shown using an analysis anchored on the Patient's Global Evaluation. Conclusion These data underscore the importance of nighttime problems in patients with SAR and the need to treat nighttime symptoms. In these studies, montelukast significantly improved the NSS, a clinically relevant and valid measure in patients with SAR.

Download Full-text