Categorization of patients with allergic rhinitis: a comparative profile of “sneezers and runners” and “blockers”

Abstract

The recent Allergic Rhinitis and Its Impact on Asthma (ARIA) workshop report classified patients into "sneezers and runners" and "blockers" and described a new disease severity categorization. To sketch the profile of these 2 groups and to evaluate the relevance of categorization. Patients were categorized as "sneezers and runners" (group 1) or "blockers" (group 2). The patients responded to a questionnaire that sought information on symptoms and associated factors. They were then categorized into seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR) groups and "intermittent" and "persistent" disease groups and compared. A total of 114 patients (72 in group 1 and 42 in group 2) participated in the study. The significant features in group 1 were age at onset younger than 20 years (90%); birth date between June and September (61%); family history of atopy (88%); itching of skin (26%), eye (43%), ears (43%), and throat and palate (67%); and aggravation with dust (93%). History of breathlessness (90%), mouth breathing (81%), loss of smell (36%), and prior nasal surgery (31%) were significant in group 2. Significantly more patients in group 1 had SAR (54%) and moderate-severe intermittent disease (60%), whereas group 2 had PAR (81%) and mild persistent (69%) disease (P = .03). Patients classified as having SAR had intermittent disease (40, 83%) (P = .005), and those with PAR had persistent disease (51, 76%) (P < .001). Sixteen patients (24%) classified as having PAR were in the intermittent category, whereas 7 (17%) classified as having SAR were in the persistent category. This study demonstrated that the 2 groups had distinct clinical profiles and that it is important to categorize patients, according to the ARIA report, into intermittent and persistent allergic rhinitis groups.