Rhinitis Often Accompanies Hard-to-Control Asthma

News Author: David Douglas
CME Author: Charles Vega, MD

May 2, 2008;

May 2, 2008 — Patients who have a poor response to asthma treatment are likely to also have moderate-to-severe rhinitis, Brazilian researchers report in the May issue of Allergy.

As senior investigator Dr. Alvaro A. Cruz told Reuters Health, "this article reports on strong evidence for an association between moderate-to-severe rhinitis and uncontrolled asthma."

Dr. Cruz, of Universidade Federal de Bahia, and colleagues also note that asthma and rhinitis share many similarities and the prevalence of rhinitis among asthmatics is high.

To further investigate the relationship between the conditions, the researchers prospectively studied 557 patients with severe asthma. In all, 31% had moderate to severe rhinitis, 54% had mild rhinitis and 15% had no rhinitis.

Compared to the other subjects, patients with moderate-to-severe rhinitis were more than 3 times as likely (odds ratio, 3.83) to visit the emergency room during a year of follow-up.

By the end of follow-up, they were also almost 3 times as likely (odds ratio, 2.94) to show a less than 10% improvement in airway obstruction and were more than 12 times as likely to have uncontrolled asthma.

The team found a positive correlation between the severity of rhinitis and severity of asthma, and a negative correlation with quality-of-life scores.

"Taking into consideration that the patients were receiving the best treatment options for asthma and rhinitis," Dr. Cruz said in conclusion, "the most likely explanation for the observed inter-relationship is that both rhinitis and asthma were manifestations of the same disease affecting the entire airway, for which the degree of severity of the upper and lower airway processes is correlated."

Allergy. 2008;63:564-569.

Reuters Health Information 2008. © 2008 Reuters Ltd.