PATIENTS who have been diagnosed with both allergic rhinitis and comorbid asthma were found to have a poorer health-related quality of life and less symptom control than patients with allergic rhinitis alone.
A study carried out by the Desbrest Institute of Epidemiology and Public Health, Montpellier, France, has highlighted the necessity of developing comprehensive approaches which will allow clinicians to manage patients with allergic rhinitis and comorbid conditions. The study included 643 adults (mean age: 44.1 years; 61.1% female) living in Italy, France, and Austria, with allergic rhinitis. All participants were assessed using the RHINASTHMA questionnaire, as well as the Control of Allergic Rhinitis/Asthma Test (CARAT). Seventy-eight percent had been diagnosed with comorbid asthma; 54% with moderate to severe intermittent allergic rhinitis; and 34% with moderate to severe persistent allergic rhinitis.
Overall median results for RHINASTHMA were 76 out of 100 (interquartile range: 53–91), where a higher score indicates a lower health-related quality of life; and for CARAT 18 out of 30 (interquartile range: 14–22), where the higher the score, the better the disease control. Participants with both allergic rhinitis and asthma had a significantly higher total RHINASTHMA score (84.0 versus 48.5), as well as lower CARAT scores overall (16.5 versus 23.0), when compared to patients who had allergic rhinitis alone. Similar results were recorded over subdomain scores on both tests.
Although extensive research has been carried out on allergic rhinitis as a comorbid condition for those with asthma, little has been written on asthma as a comorbidity for allergic rhinitis. Subhabrata Moitra, Alberta Respiratory Centre, University of Alberta, Canada, commented: “There were no previous reports comparing the control and health-related quality of life in allergic rhinitis patients with and without comorbid asthma. We wanted to investigate asthma-rhinitis comorbidity and rhinitis control according to presence or absence of asthma at the population level, as previous results are mostly from patients.”
Due to the lack of granularity evident in the collected data from this study, Moitra expressed that researchers were unable to probe the relationship between conditions further. However, research in this area continues. In order to reduce global disease burden for allergic rhinitis with another comorbid condition, an EU-funded study, Urbanome, has recently been launched; this will study “asthma-rhinitis comorbidity and their control,” added Moitra, studying patients in 10 cities across nine countries in Europe.