Abstract
BackgroundNasal irrigations (NI) are increasingly used as an over-the-counter adjunctive treatment for allergic rhinitis (AR), but clinical studies on their effectiveness are limited.MethodsAn open-label, controlled, non-randomized, real-life study was conducted to evaluate the effectiveness of NI with a new hypertonic solution as add-on treatment for AR. Children and adolescents with AR were prescribed symptomatic treatment. The active group also received an additional sea-water NI solution supplemented with algae extracts. The primary endpoint was symptom control, assessed by the control of allergic rhinitis and asthma test (CARAT) questionnaires. Moreover, the MASK/Allergy Diary was used to track symptoms and daily medication use that were combined in a novel total symptom/medication score (TSMS).ResultsWe assessed 76 patients. Overall, there was a significant improvement of CARAT results (median Z-score change of 1.1 in the active/NI group vs. 0.4 in the control group; p = 0.035). Among patients > 12 years old (n = 51), there was a significant improvement in CARAT10 results among participants receiving NI (21.0 to 25.5; p < 0.001), but not in the regular treatment group (21.5 to 24.0; p = 0.100). For children < 12 years old (n = 25), the ΝΙ group had significantly improved symptom control (CARATKids results: 5.0 to 2.0; p = 0.002), in contrast to the control group (4.0 to 2.5; p = 0.057). MASK data on allergic symptoms were comparable between groups. However, the NI group had lower TSMS, more days with < 20% symptoms and fewer days using symptomatic treatment (26.9% vs. 43.5%; p = 0.005).ConclusionAddition of NI with a sea-water solution to regular treatment improved AR symptom control. CARAT questionnaires and MASK application can be useful outcome tools in real-life studies.
Highlights
Allergic rhinitis (AR) is a very common manifestation of respiratory allergy, with a prevalence of up to 20–25% in Western societies
This study aimed to evaluate the effectiveness of Nasal irrigations (NI) as an add-on treatment for allergic rhinitis (AR), using a new NI product based on sea-water supplemented with (1) extracts from the sea weeds Undaria pinnatifida and Spirulina platensis, and (2) dexpanthenol
Exclusion criteria consisted of adenoidal hyperplasia, septal deformity, polyps, infectious rhinitis, vasomotor rhinitis, rhinitis medicamentosa, i.e. signs and symptoms indicative of non-allergic rhinitis
Summary
Allergic rhinitis (AR) is a very common manifestation of respiratory allergy, with a prevalence of up to 20–25% in Western societies. Among add-on treatments, nasal irrigation (NI) with saline solutions appears to be useful [7,8,9,10,11], as it does not need medical prescription and is considered safe for long-term use [7]. Normal saline is primarily used, studies have shown increased effectiveness with hypertonic solutions [8, 9]. Meta-analyses suggest that NI can be used as add-on to medical treatment [11]. Nasal irrigations (NI) are increasingly used as an over-the-counter adjunctive treatment for allergic rhinitis (AR), but clinical studies on their effectiveness are limited
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