Abstract
Asthma and rhinitis are often co-morbid conditions. As rhinitis often precedes asthma it is possible that effective treatment of allergic rhinitis may reduce asthma progression.The aim of our study is to investigate history of allergic rhinitis as a risk factor for asthma and the potential effect of allergen immunotherapy in attenuating the incidence of asthma.Hospital-referred non-asthmatic adults, aged 18–40 years between 1990 and 1991, were retrospectively followed up until January and April 2000. At the end of follow up, available subjects were clinically examined for asthma diagnosis and history of allergen specific immunotherapy, second-hand smoking and the presence of pets in the household. A total of 436 non-asthmatic adults (332 subjects with allergic rhinitis and 104 with no allergic rhinitis nor history of atopy) were available for final analyses.The highest OR (odds ratio) associated with a diagnosis of asthma at the end of follow-up was for the diagnosis of allergic rhinitis at baseline (OR, 7.8; 95%CI, 3.1–20.0 in the model containing the covariates of rhinitis diagnosis, sex, second-hand smoke exposure, presence of pets at home, family history of allergic disorders, sensitization to Parietaria judaica; grass pollen; house dust mites; Olea europea: orchard; perennial rye; and cat allergens). Female sex, sensitization to Parietaria judaica and the presence of pets in the home were also significantly predictive of new onset asthma in the same model. Treatment with allergen immunotherapy was significantly and inversely related to the development of new onset asthma (OR, 0.53; 95%CI, 0.32–0.86).In the present study we found that allergic rhinitis is an important independent risk factor for asthma. Moreover, treatment with allergen immunotherapy lowers the risk of the development of new asthma cases in adults with allergic rhinitis.
Highlights
Asthma is one of the most common chronic conditions in developed countries, with a prevalence that has been increasing globally since the 1970s [1,2,3]
In this retrospective cohort study we found that allergic rhinitis is strongly predictive of the development of asthma even after adjustment for other risk factors for asthma
We have shown for the first time that treatment with allergen immunotherapy decreases the incidence of asthma in adults with allergic rhinitis
Summary
Asthma is one of the most common chronic conditions in developed countries, with a prevalence that has been increasing globally since the 1970s [1,2,3]. Several studies have suggested that AR usually precedes asthma and that rhinitis may be an important risk factor for the development of asthma. A number of epidemiological surveys in adults suggest that allergic rhinitis may be a prelude to airway symptoms related to asthma [14,15,16,17,18]. These five studies mostly rely on postal questionnaires for the diagnosis of allergic rhinitis and asthma.
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