History Of Perennial Allergic Rhinitis Research Articles

A predictive model to estimate fever after receipt of the second dose of Pfizer-BioNTech coronavirus disease 2019 vaccine: An observational cohort study.

Background and AimsFever after coronavirus disease 2019 (COVID‐19) vaccination is generally a mild and benign event, but can cause excessive anxiety in younger adults. This study aimed to find key factors that include allergic diseases or physique that determine fever after vaccination.MethodsWe conducted an observational cohort study in our hospital to assess post‐COVID‐19 vaccination fever from April to June 2021. A total of 153 medical personnel aged 22–86 years of age were involved in the study to receive two doses, intramuscularly 21 days apart, of the Pfizer‐BioNTech COVID‐19 vaccine (30 μg per dose). Vaccination records were taken more than 72 h after vaccination. Clinical and laboratory variables (age, sex, allergy history, weight, height, serum hemoglobin concentration, and these derivatives) were examined by multivariable logistic regression analysis using the peak axillary temperature in the 4‐day period after the second vaccination as a dependent variable.ResultsNo serious safety problems were detected. The incidence of a postsecond vaccination fever of 37.3°C or above was 29.4%. Logistic regression analysis found age, history of perennial allergic rhinitis, body surface area, body weight, percent overweight, and serum hemoglobin concentration as independent predictors of postvaccination fever. The characteristics of this individual were incorporated into the numerical model of human thermoregulation. The evaluation of this model had a sensitivity of 66.1% and a specificity of 90.7% in the detection of postvaccination fever. The multiple coefficient of determination (R 2) was 0.410.ConclusionThe COVID‐19 vaccine induced higher rates of fever during the 4‐day period after the second vaccination. Younger age, part of the allergy history, small and light body, and concentrated blood were associated with postvaccination fever.

Effect of the Use of Intranasal Spray of Essential Oils in Patients With Perennial Allergic Rhinitis: A Prospective Study

To evaluate the effectiveness of a hypertonic essential oil (EO)-based nasal spray on perennial allergic rhinitis symptoms.A total of 43 patients from academic hospitals in France and Belgium were recruited. Participants were >18 years of age, diagnosed with allergic rhinitis, and had a >1-year history of perennial allergic rhinitis and positive skin test for at least 1 perennial allergen.This was a multicentric, prospective open-label, nonrandomized study. All patients used Puressential Respiratory-Decongestant Nasal Spray, which is a combination of hypertonic seawater and organic rosemary floral water with 4 EOs (ravintsara, geranium, eucalyptus radiata, and niaouli). Subjects were asked to use 2 sprays in each nostril morning and evening for 4 weeks. Participants continued to take their usual allergy medications but were not allowed to add any new medications. Rhinitis control was assessed by using a self-completed questionnaire, the Allergic Rhinitis Control Test. Daily questions pertaining to discomfort and side effects were also completed. Nasal Inspiratory Peak Flow, which is a direct measure of nasal obstruction, was measured at baseline and at 4 weeks.Statistically significant improvement was documented in both the Allergic Rhinitis Control Test (ARCT) and Nasal Inspiratory Peak Flow. According to ARCT scores, 70% of subjects reported controlled rhinitis symptoms at the end of the study, compared with 14% at the start of the study. No moderate or severe adverse events were reported.The use of Puressential Respiratory-Decongestant Nasal Spray, when used as an add-on to baseline rhinitis management for 4 weeks, was associated with an improvement in subjective nasal symptom scores and improvement in objective measurement of nasal obstruction.EOs have been previously demonstrated to have antiinflammatory effects. With this study, the researcher yields promising results for a natural way to significantly improve symptoms of perennial allergic rhinitis. Although the data are impressive, the study is limited by the fact that there was no placebo group. In addition, although a significant response in a brief time period is encouraging, 4 weeks is not long enough to demonstrate long-term tolerance of intranasal EOs. It remains to be determined if side effects, such as irritation of the nasal mucosa, will occur with long-term use.

Efficacy predictors of omalizumab in Chinese patients with moderate-to-severe allergic asthma: Findings from a post-hoc analysis of a randomised phase III study

BackgroundOmalizumab has demonstrated efficacy as an add-on therapy in Chinese patients with moderate-to-severe allergic asthma. This post-hoc analysis assessed the potential predictors for the efficacy of omalizumab in these patients. MethodsA post-hoc analysis was performed on a Phase III, randomised, controlled study conducted in Chinese patients with moderate-to-severe persistent allergic asthma (NCT01202903). We evaluated if levels of pre-treatment serum total immunoglobulin-E (IgE) and blood eosinophil (EOS), asthma severity, allergen profile, history of perennial allergic rhinitis (PAR), and free IgE level during omalizumab treatment were predictive of omalizumab's efficacy. ResultsThis analysis included 608 patients (omalizumab, N = 306; placebo, N = 302). Improvements in forced expiratory volume in 1 s (FEV1), standardized Asthma Quality of Life Questionnaire (AQLQ), Asthma Control Questionnaire (ACQ), and Global Evaluation of Treatment Effectiveness (GETE) scores with omalizumab treatment compared with placebo were observed in patients with baseline IgE levels ≥76 IU/mL (irrespective of the EOS count). Relatively greater improvements with omalizumab treatment was also noted in patients with both moderate or severe allergic asthma (regardless of asthma severity), and patients sensitised to >3 allergens and with a history of PAR. All patients who were treated with omalizumab achieved free IgE levels below 50 ng/mL by Week 1. Similar clinical outcomes were observed in the subset of patients who achieved free IgE levels of <25 and ≥ 25 ng/mL. ConclusionsIn Chinese patients with moderate-to-severe allergic asthma, baseline IgE and allergen profile (number/PAR history) are potential predictors of treatment response to omalizumab. Trial registrationNCT01202903 (www.clinicaltrials.gov).

A 26-week Tolerability Study of Ciclesonide Nasal Aerosol in Patients with Perennial Allergic Rhinitis

A new, hydrofluoroalkane nasal aerosol solution formulation of ciclesonide (CIC-HFA) delivered via a metered dose inhaler is currently in clinical development for treatment of allergic rhinitis. To study tolerability and quality of life following administration of CIC-HFA 74- or 148-μg doses once-daily compared with placebo in patients with perennial allergic rhinitis (PAR) over 26 weeks. Patients ≥12 years of age with a ≥2 year history of PAR were randomized in a placebo-controlled, double-blind, parallel group, multicenter study to CIC-HFA 74 μg, 148 μg, or placebo QD AM for 26 weeks. Safety was assessed by monitoring treatment-emergent adverse events (TEAEs). Quality of life was assessed by using a rhinoconjunctivitis quality of life questionnaire with standardized activities (RQLQ[S]) in patients with baseline RQLQ ≥3.00. Reflective total nasal symptom scores (rTNSS) and instantaneous total nasal symptom scores (iTNSS) over 26 weeks were also evaluated. In this study, 1111 patients were randomized. The overall incidence of TEAEs was comparable between the treatment groups. Treatment with CIC-HFA 74- or 148-μg doses showed improvements in RQLQ[S] [least squares (LS) mean change 0.40 and 0.37, respectively from baseline, p < 0.01 versus placebo for both], rTNSS (LS mean change 0.65 and 0.52, respectively from baseline; p ≤ 0.01 versus placebo for both), and iTNSS (LS mean change 0.51 and 0.42, respectively from baseline; p < 0.05 versus placebo for both) from baseline. In this study, once-daily treatment with CIC-HFA 74- or 148-μg doses over 26 weeks was well tolerated with comparable incidence of TEAEs between the treatment groups.

Nasal carbon dioxide for the symptomatic treatment of perennial allergic rhinitis

Brief nasal carbon dioxide insufflation has previously been shown to provide rapid relief of the symptoms of allergic rhinitis. To examine the safety and efficacy of nasal carbon dioxide on the symptoms of perennial allergic rhinitis. This was a randomized, double-blind, placebo-controlled, multicenter, in-clinic study that evaluated 2 flow rates (5 or 10 mL/s) and 2 administration durations (10 or 30 seconds per nostril) for nasal carbon dioxide vs placebo. Study participants rated their symptoms in clinic for 4 hours after administration and then through 24 hours outside the clinic. A total of 348 symptomatic patients with a minimum 2-year history of perennial allergic rhinitis requiring pharmacotherapy were randomized and treated. The mean change in total nasal symptom score from baseline at 30 minutes (the primary end point) showed greater improvement in the nasal carbon dioxide-treated groups compared with placebo. This change was statistically significant in the group treated with 10 mL/s for 10 seconds per nostril: -4.69 carbon dioxide vs -2.00 placebo (P = .03). The effect of a single dose lasted approximately 4 to 6 hours. The mean change from baseline at 30 minutes in total nonnasal symptom score was also statistically significant (-4.06 carbon dioxide vs -2.25 placebo, P = .029) for this group. The most common adverse events were nasal discomfort, lacrimation, and headache. The study provides further evidence that nasal carbon dioxide is a potentially efficacious treatment for the symptoms of allergic rhinitis.

Effect of the addition of montelukast to fluticasone propionate for the treatment of perennial allergic rhinitis

Guidelines for the treatment of patients with allergic rhinitis (AR) recommend intranasal corticosteroids as first-line therapy. In clinical trials, however, only 50% of patients obtain excellent symptom control. To evaluate the effectiveness of montelukast add-on therapy in patients with perennial AR (PAR) who have incomplete relief of symptoms after 2 weeks of treatment with intranasal fluticasone propionate. We performed a 4-week parallel, randomized, double-blind, placebo-controlled trial. One hundred two patients with a history of PAR and a positive skin test reaction to perennial allergens were recruited. They completed the Rhinitis Quality of Life Questionnaire (RQLQ) and were given intranasal fluticasone propionate, 200 microg daily. They were asked to complete symptom diary cards twice daily. After 2 weeks of treatment, patients with a mean total nasal symptom score of at least 4 during the past week (n = 54) were randomized to receive either montelukast (n = 28) or placebo (n = 26) in addition to the continued use of fluticasone propionate. At weeks 3 and 4, the RQLQ was completed again and symptom diary cards were collected. Compared with baseline, there were significant improvements in almost all domains of the RQLQ while taking fluticasone propionate (P < .001). A similar trend was observed for nasal symptom scores. After randomization to receive montelukast or placebo, there were no significant differences in RQLQ measures or nasal symptom scores between the groups during the 2 weeks of combination therapy. The addition of montelukast to an intranasal corticosteroid for the treatment of PAR with residual symptoms is no more effective than is placebo.

HPA axis safety of fluticasone furoate nasal spray once daily in children with perennial allergic rhinitis

The effects of intranasal corticosteroids (INSs) on the hypothalamic-pituitary-adrenal (HPA) axis should be assessed for any to be marketed INS. The objective of this study was to assess the effects of fluticasone furoate nasal spray (FFNS) on cortisol production (as a measure of HPA axis function) following 6 wk of treatment with FFNS 110 microg once daily (QD) compared with placebo in pediatric patients with perennial allergic rhinitis (PAR). In this double-blind, parallel-group study, patients (n = 112) aged 2-11 yr with a 1-yr history of PAR (6 months for patients aged 2-3 yr) were randomized in a 1:1 ratio to either placebo or FFNS. Serum cortisol (SC) concentrations and urinary cortisol (UC) excretion were measured over a 24-h period at the randomization (baseline) and final treatment (week 6) visits for HPA axis evaluation in a domiciled environment (overnight in the clinic). Plasma samples were collected for FFNS at several time points over the 24 h after the final dose for pharmacokinetic analyses. FFNS was non-inferior to placebo with respect to change from baseline (expressed as a ratio) in 24-h SC weighted mean. The lower limit of the two-sided 95% confidence interval (CI) for the treatment ratio was greater than the pre-specified non-inferiority margin of 0.8 (treatment ratio = 0.97, 95% CI 0.88-1.07). UC excretion over 24 h at baseline and end of treatment was similar between treatment groups; no patients had 24-h excretion levels below normal range after 6 wk of treatment. Plasma concentrations of FFNS were generally non-quantifiable (<10 pg/ml). Results of the current study indicate that FFNS 110 microg QD has no significant effect on HPA axis function in 2- to 11-yr-old pediatric patients with PAR.

The First Case of Anaphylactic Shock due to Sublingual Immunotherapy with Standardized Mites Allergens

IntroductionSublingual immunotherapy (SLIT) is home administration treatment without medical supervision and therefore the safety of this form of immunotherapy is especially important.Case reportA 16-year-old girl, with a history of perennial allergic rhinitis and well-controlled intermittent asthma due to house dust mites began SLIT with standardized extract of HDM (Stallergenes, France). In the 3rd year of SLIT after 3 week break in maintenance dose (10 drops, 100 IR/ml), with unknown reason the girl administered herself 60 drops (100 IR/ml) of allergen extract, equivalent of 26.9 μg of house dust mites allergen. Within 5 minutes generalized pruritus, flushing and generalized urticaria developed, and the girl became dyspneic, began wheezing and shivering followed by double short collapse. Emergency team was called. The doctor found: blood pressure 70/40 mmHg, heart rate 160/min, weak pulse, generalized urticaria, mild asthma symptoms. The girl was sleepy but conscious. Doctor gave methylprednisone i.v., aminophylline i.v., intravenous fluids and oxygen. After several minutes she was admitted to Hospital Emergency Department when she suddenly became unconscious without pulse and blood pressure. She received epinephrine i.m., oxygen, corticosteroids, intravenous fluids and was transferred to Intensive Care Unit, where she recovered during one day.ConclusionsThe case leads to reconfirm the safety of sublingual immunotherapy schedule with large dose of allergen without up-dosing phase and expands the education and monitoring field of SLIT patients. IntroductionSublingual immunotherapy (SLIT) is home administration treatment without medical supervision and therefore the safety of this form of immunotherapy is especially important. Sublingual immunotherapy (SLIT) is home administration treatment without medical supervision and therefore the safety of this form of immunotherapy is especially important. Case reportA 16-year-old girl, with a history of perennial allergic rhinitis and well-controlled intermittent asthma due to house dust mites began SLIT with standardized extract of HDM (Stallergenes, France). In the 3rd year of SLIT after 3 week break in maintenance dose (10 drops, 100 IR/ml), with unknown reason the girl administered herself 60 drops (100 IR/ml) of allergen extract, equivalent of 26.9 μg of house dust mites allergen. Within 5 minutes generalized pruritus, flushing and generalized urticaria developed, and the girl became dyspneic, began wheezing and shivering followed by double short collapse. Emergency team was called. The doctor found: blood pressure 70/40 mmHg, heart rate 160/min, weak pulse, generalized urticaria, mild asthma symptoms. The girl was sleepy but conscious. Doctor gave methylprednisone i.v., aminophylline i.v., intravenous fluids and oxygen. After several minutes she was admitted to Hospital Emergency Department when she suddenly became unconscious without pulse and blood pressure. She received epinephrine i.m., oxygen, corticosteroids, intravenous fluids and was transferred to Intensive Care Unit, where she recovered during one day. A 16-year-old girl, with a history of perennial allergic rhinitis and well-controlled intermittent asthma due to house dust mites began SLIT with standardized extract of HDM (Stallergenes, France). In the 3rd year of SLIT after 3 week break in maintenance dose (10 drops, 100 IR/ml), with unknown reason the girl administered herself 60 drops (100 IR/ml) of allergen extract, equivalent of 26.9 μg of house dust mites allergen. Within 5 minutes generalized pruritus, flushing and generalized urticaria developed, and the girl became dyspneic, began wheezing and shivering followed by double short collapse. Emergency team was called. The doctor found: blood pressure 70/40 mmHg, heart rate 160/min, weak pulse, generalized urticaria, mild asthma symptoms. The girl was sleepy but conscious. Doctor gave methylprednisone i.v., aminophylline i.v., intravenous fluids and oxygen. After several minutes she was admitted to Hospital Emergency Department when she suddenly became unconscious without pulse and blood pressure. She received epinephrine i.m., oxygen, corticosteroids, intravenous fluids and was transferred to Intensive Care Unit, where she recovered during one day. ConclusionsThe case leads to reconfirm the safety of sublingual immunotherapy schedule with large dose of allergen without up-dosing phase and expands the education and monitoring field of SLIT patients. The case leads to reconfirm the safety of sublingual immunotherapy schedule with large dose of allergen without up-dosing phase and expands the education and monitoring field of SLIT patients.

Vitamin E effects on nasal symptoms and serum specific IgE levels in patients with perennial allergic rhinitis

Studies have shown that vitamin E intake may reduce IgE production. To evaluate the effects of vitamin E supplementation on the severity of nasal symptoms and the serum levels of specific IgE in patients with perennial allergic rhinitis. Sixty-three patients (mean +/- SD age, 12 +/- 2.4 years) with a history of perennial allergic rhinitis participated in this study. None of the patients had evidence of acute infectious disease or used tobacco, corticosteroids, antihistamines, or vitamins. Patients were randomized to receive either vitamin E (400 IU/d) or placebo for 4 weeks, with loratadine-pseudoephedrine (0.2/0.5 mg/kg) during the first 2 weeks of treatment. The severity of nasal symptoms was evaluated using a validated questionnaire, which was administered weekly for 4 weeks. The serum concentrations of specific IgE to 5 common inhalant allergens and lipid peroxides were measured before treatment and at the end of the study. Before, during, and after treatment, the symptom severity scores were similar in the 2 groups; within each group, a significant decrease was observed after the first week of follow-up (P < .05), with no further changes. Serum levels of specific IgE and lipid peroxides did not show any significant changes related to vitamin E intake within and between groups. In patients with perennial allergic rhinitis, vitamin E supplementation (400 IU/d) did not have any significant effects on nasal symptom severity or on serum concentrations of specific IgE to 5 common allergens.