Quality Of Life In Allergic Rhinitis Research Articles

A real-world study of quality of life following treatment with xylometazoline hydrochloride in individuals with common cold.

The common cold is a frequent, acute, and mild upper respiratory human disease. Nasal congestion has been considered the most bothersome symptom in the common cold, impacting quality of life (QoL). Topical decongestants containing steroids benefit QoL in allergic rhinitis, but no published research has assessed the impact of topical decongestants on QoL in the common cold. To evaluate the effects of xylometazoline hydrochloride 0.1% (Otrivin, GSK Consumer Healthcare SARL, Switzerland) for up to 7 days on QoL in participants with nasal congestion associated with the common cold. This was a decentralized, longitudinal, open-label study. The study enrolled 136 participants (⩾18 years) with early symptoms of the common cold, of which 102 were included in the modified intention-to-treat (mITT) population. Within 24 h of study product receipt, participants confirmed a 'plugged nose' and ⩾1 other common cold symptom. Primary endpoints were Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21) total score, total and individual symptom scores, and total QoL score. Secondary endpoints were additional QoL scores. Exploratory and post hoc analyses included median days to resolution for each QoL factor and analyses of five QoL categories. Consistent improvements in symptoms and QoL were seen in the mITT population. From day 1, improvements were seen in the 'plugged nose' symptom (p = 0.0023), WURSS-21 total QoL score, and all individual QoL scores (p < 0.0001 for all). After the last dose needed, significant improvements were seen in sleep quality (73%), vitality (76%), physical activity (71%), social activity (80%), and sensation (81%). No serious or unexpected adverse events were reported. This study is the first to demonstrate in a real-life setting that treating nasal congestion in adults with xylometazoline hydrochloride 0.1% during the common cold positively impacts QoL factors relevant to daily living [Otrivin: Quality of Life (QoL) Impact in a Real-World Setting; https://clinicaltrials.gov/study/NCT05556148].

Improving the Quality of Life in the Management of Allergic Rhinitis: New Perspective on Cetirizine.

Allergic rhinitis (AR) is associated with disturbed sleep and subsequent functioning, and an impaired quality of life (QoL). The symptoms of AR exhibit prominent circadian variations, with symptoms being more common at the night-time or early morning. Addressing these allergy-related sleep issues, impaired QoL, and circadian variation in symptoms is important from the patient perspective and should be considered in the management of AR. To review the efficacy of cetirizine, a second-generation antihistamine and selective H1-receptor antagonist, in relation to improvement in the QoL of the patients, addressing the sleep disturbances and circadian variations in the symptoms of AR in clinical practice, and establishing its role as a contemporary antihistamine for the management of AR compared to newer antihistamines. Systematic literature review of the databases such as PubMed/MEDLINE, Google Scholar, and the Cochrane Central Register of Controlled Trials from 1990 to 2020. The symptoms of AR exhibited a circadian variation, with symptoms being worse during the night and early morning. The patients with AR encountered several sleep-related symptoms, including poor sleep quality, daytime somnolence, fatigue, and impaired productivity and QoL. Impaired QoL in AR was related to the disease severity. Administration of cetirizine at bedtime provides effective control of sleep impairment and symptoms of AR, besides improving the QoL. The efficacy of cetirizine has been demonstrated to be superior or comparable to the newer second-generation antihistamines. Cetirizine exhibits a tolerability profile comparable to the newer antihistamines. With long years of clinical experience and a good tolerability profile, cetirizine represents a valuable therapeutic option for the management of AR, even 30 years after its introduction. Cetirizine is included in the National List of Essential Medicines of India for the management of allergic disorders in view of its established efficacy and safety profile as well as being a cost-effective option.

A review: quality of life of patients with allergic rhinitis receiving various treatment

The high prevalence of allergic rhinitis in a population, the link between this disease and asthma, and a significantly higher economic burden of the disease, causing a negative impact on the patients quality of life, have resulted in increased attention to the problem of allergic rhinitis at the global level. Nowadays optimal allergic rhinitis treatment and management include disease control, consisting of assessing the level of disease control and selecting a treatment scheme based on this assessment. Current studies are focused on the development of questionnaires and testing systems for assessing the level of disease control, especially given the absence of a standardized control assessment procedure tool. Studies also address the possibility of using the indicators of quality of life to measure the level of disease control. The present review deals with the issue of understanding of using this parameter to measure the effectiveness of pharmacotherapy of different groups of patients with allergic rhinitis. The review includes randomized clinical trials covering the period 20102019 including the following keywords: Rhinitis Quality of Life, Allergic Rhinitis Quality of Life, Allergic Rhinitis Questionnaire, RQLQ. In total, 4.407 publications were identified and analyzed, only 60 publications were selected for comparative analysis after a second review. According to the results, in general, it can be concluded that the indicator of the quality of life allows us to identify the advantages of pharmacotherapeutic regimens in the long term (for example, allergen-specific immunotherapy, alternative therapy). Moreover, it demonstrates a correlation with objectivistic indicators in randomized clinical trials of standard treatment. It is still necessary, however, to address the question of whether it would be possible to use the assessment of the quality of life as a part of allergic rhinitis treatment in everyday clinical practice to select a group of drugs, their dosages, and correct regimes in dynamics. Using the indicator of the quality of life for managing patients with allergic rhinitis in Russia requires tremendous work in terms of cross-cultural adaptation of questionnaires and large-scale population-based pharmacoepidemiological studies.

The 22-Item Sinonasal Outcome Test as a Tool for the Assessment of Quality of Life and Symptom Control in Allergic Rhinitis.

Background The 22-item Sinonasal Outcome Test (SNOT-22) is a validated patient-reported outcome measure for chronic rhinosinusitis and in many circumstances is used in rhinology/otolaryngology clinics to assess sinonasal symptoms in general when a formal diagnosis is not established, although with little support for such usage. Objective To assess the utility of the SNOT-22 as a reflection of quality of life (QOL) and symptom control for patients with allergic rhinitis (AR). Methods Retrospective review of 353 patients with persistent AR. Each patient completed a SNOT-22, 5-item EuroQol general health-related QOL (EQ-5D) questionnaire (from which the visual analog scale [VAS] was used), and Rhinitis Control Assessment Test (RCAT). In addition, 95 patients also completed these questionnaires 1 to 12 months later. Results The SNOT-22 was negatively correlated with the EuroQol 5-dimensional visual analog scale (EQ-5D VAS; r = −.45, 95% confidence interval [CI]: −0.53 to −0.36, P &lt; .001) and RCAT ( r = −.62, 95% CI: −0.68 to −0.55, P &lt; .001), with excellent internal consistency. The SNOT-22 demonstrated responsiveness, with mean change of −5.8 (95% CI: −8.9 to −2.6, P &lt; .001) from pre- to posttreatment. The change in SNOT-22 over the treatment period was correlated with change in EQ-5D VAS ( r = −.28, 95% CI: −0.46 to −0.07, P = .008) and RCAT ( r = −.56, 95% CI: −0.69 to −0.41, P &lt; .001). The minimal clinically important difference was calculated to be between 6 and 11. Conclusion The SNOT-22 has utility to assess QOL and symptom control in AR, and it is both reliable and responsive in its application to patients with AR. The SNOT-22 may therefore be a convenient and versatile tool in the clinical assessment of patients with AR.

Validation of the Children's Sleep Habits Questionnaire in a sample of Greek children with allergic rhinitis

BackgroundObstructive respiratory disorders, such as allergic rhinitis and asthma may impair sleep quality. The aim of this study is to validate the Children's Sleep Habits Questionnaire (CSHQ) for Greek children from 6 to 14 years of age. No validated tool has been developed so far to assess sleep disturbances in Greek school-aged children. MethodsWe examined the reliability and validity of the CSHQ in a sample of children with allergic rhinitis (AR) and a non-clinical population of parents of these children as a proxy measure of children's AR quality of life (QoL) as evaluated by the Pediatric Allergic Rhinitis Quality of Life (PedARQoL) questionnaire. ResultsThe CSHQ questionnaire Child's Form (CF) had a moderate internal consistency with a Cronbach's alpha 0.671 and Guttman split-half coefficient of 0.563 when correlated with the PedARQoL (CF). There was also a moderate intraclass correlation of ICC=0.505 between the responses to both questionnaires in the two visits. The CSHQ Parent's Form (PF) had a very good internal consistency with a Cronbach's alpha of 0.928 and Guttman split-half coefficient of 0.798. There was a high intraclass correlation of 0.643 between the responses in the two visits. ConclusionsThe Greek version of the CSHQ CF, but particularly the PF has proved to be a very reliable clinical instrument, which can be used in clinical trials for assessing sleep quality in school-aged children with sleep disturbances because of obstructive airway disorders, such as AR.

Correlations of nasal responses to leukotriene D4 and histamine nasal provocation with quality of life in allergic rhinitis.

BackgroundThe symptoms of allergic rhinitis (AR) greatly affect the quality of life (QoL) in the patients with AR. The correlations of nasal response to leukotriene D4 (LTD4) and histamine nasal provocation with health related QoL in AR are not clear.ObjectiveTo evaluate the correlations of nasal response to LTD4 and histamine nasal challenge with QoL in AR.MethodsPatients randomly underwent LTD4 and histamine nasal challenge tests, completed the rhinoconjunctivitis quality of life questionnaire (RQoLQ), and rating the symptom severity score (total symptom score 4, TSS4) in the previous week. The correlations between nasal challenge tests induced nasal responses and QoL in RQoLQ were analyzed.ResultsA total of 25 eligible AR patients enrolled and finished both LTD4 and histamine nasal challenge and completed the questionnaire of RQoLQ. Histamine nasal challenge induced sneezing, increased nasal resistant were correlated with most of the dimensions (general, practical, nasal, eye problems, and quality of sleep, p < 0.05), while LTD4 nasal challenge induced sneeze, increased nasal resistant only correlated with nasal and ocular problems. On the contrary, the severity of the sneeze assessed by TSS4, was not correlated with QoL, while the severity of rhinorrhea, congestion, and nasal pruritus were correlated with nasal and practical problems, and nasal congestion was also correlated with ocular problems (r = 0.60, p = 0.01).ConclusionLTD4 and histamine nasal challenge induced nasal responses were correlated with different clinical symptoms severity and QoL, which can be used as a good diagnosis and evaluation methods for the management of AR.

Comparison of Mometazon Furoate to Cetirizin for Symptom Severity Control and QOL in Allergic Rhinitis

Objectives: Evaluate and compare nasal symptom scores and quality of life (QOL) findings in allergic rhinitis patients. Methods: A total of 426 adult allergic rhinitis patients’ medical records were evaluated retrospectively. Group A consisted of 188 patients and received mometasone furoate nasal spray (100 mcg daily/nostril). Group B consisted of 238 patients receiving cetirizine (10 mg oral/daily) for 30 days. Nasal symptoms (watery discharge from the nose, nasal congestion, sneezing and nasal pruritus) and QOL (Short Form-36) were recorded before and after treatment. Results: When compared before and after treatment, each group’s total nasal symptom scores reduced significantly (Group A, P = .001; Group B, P = .002), and QOL scores improved significantly (Group A, P = .001, Group B, P = .001). But when compared between groups, Group A results were better than Group B (total nasal symptom scores P = .001, QOL scores P = .003). Conclusions: Although intranasal mometasone furoate is a better choice than oral cetirizine, both of these medicines can be used to control allergic rhinitis symptoms and improve patient QOL.

Allergic rhinitis quality of life in urban children with asthma

BackgroundUrban children with asthma and allergic rhinitis (AR) are at risk for experiencing worse AR-related quality of life (QOL). Although AR may be underdiagnosed and undertreated in urban minority children, research has not considered which illness-related indicators (eg, AR control) may contribute to AR QOL in this population. ObjectiveTo examine associations among AR control, asthma control, allergy symptoms, asthma symptoms, and AR QOL in a sample of 195 urban caregivers and their children with asthma (7-9 years of age) from African American, Latino, and non-Latino white backgrounds. Racial and ethnic differences in AR QOL were also examined. MethodsFamilies resided in 1 of 4 cities selected as recruitment sources because of their high concentrations of ethnic minority and non-Latino white, urban families. Caregivers and children completed a series of interview-based and clinician-based assessments across one academic year and 4-week periods to track daily asthma and nasal symptoms. ResultsBetter AR control was associated with higher AR QOL (β = −.32, P < .01) and all QOL subscales. AR control predicted AR QOL over and above asthma control (β = −.28, P < .01). Controlling for AR control, non-Latino white children reported better QOL related to practical problems than both Latino and African American children (P < .05). ConclusionFindings suggest that strategies to enhance AR control in urban children with asthma may assist in improving AR QOL. Non-Latino white children may experience less impairment of their AR QOL because of practical problems (eg, blow nose) than African American or Latino children with asthma.

To Compare the Safety, Efficacy and Quality of Life in Patients with Allergic Rhinitis Treated with Levocetirizine and Desloratadine

Background: Allergic Rhinitis (AR) is a very common disease that affects almost 10-30% of the world’s population. Second-generation H1 antihistaminics are the preferred drugs for treatment of patients with AR. Levocetirizine and desloratadine are commonly prescribed newer non-sedating second-generation antihistaminics. Various studies show no difference in efficacy and quality of life (QOL) between the two drugs desloratadine and levocetirizine and that the drugs are quiet safe; however, some studies show negative impact on patients’ QOL with these drugs. Studies comparing the two drugs were insufficient in India; hence, this study was designed to evaluate and compare the efficacy, safety and QOL of patients with AR, following treatment with levocetirizine or desloratadine, in the Indian scenario.Methods: This 2-month randomized, prospective study was performed in 60 patients with AR visiting the department of Otorhinolaryngology. Patients were randomized into one of the two treatment groups, and prescribed levocetirizine 5 mg once daily for two weeks or desloratadine 5 mg once daily for two weeks. The outcome measures for the severity of AR symptoms used were Total Nasal Symptom Score (TNSS); and QOL was assessed using Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) Score.Results: Data from 54 patients who completed the study shows that both levocetirizine and desloratadine significantly (p<0.05) improved the AR symptoms and QOL at the end of 2 weeks study period, analyzed using TNSS and RQLQ scores, respectively. However, statistically non-significant differences in analysis of TNSS score between levocetirizine and desloratadine showed that the two drugs may be equally effective in patients with AR, with patients on levocetirizine showing slightly better response. The adverse events were low in patients on levocetirizine and no adverse event was seen with desloratadine. At baseline visit, rhinorrhoea was the most common and severe symptom, whereas nasal itching was the least common and severe symptom.Conclusion: Study findings showed that both levocetirizine and desloratadine were equally effective in patients with AR, however, desloratadine group showed better safety profile. The drugs were safe and well tolerated.

Tap water nasal irrigation in adults with seasonal allergic rhinitis: a randomized double-blind study

Saline nasal irrigation is effective in the treatment of seasonal allergic rhinitis, and sodium chloride itself has no antiallergic effects. The mechanism of saline nasal irrigation depends mainly on washing away allergens and inflammatory mediators induced by allergic reactions. Tap water has the same washing effects as saline. In this study, it was investigated if tap water nasal irrigation was effective in the treatment of seasonal allergic rhinitis. Sixty-four patients diagnosed with seasonal allergic rhinitis were enrolled. Patients were randomized to tap water nasal irrigation group and non-tap water nasal irrigation group for treatment. Patients of both groups were treated with desloratadine. Treatment outcomes were measured using allergic rhinitis Quality of Life (QoL) survey was completed at baseline and after 3weeks of therapy. There were statistically significant differences in QoL scores between tap water nasal irrigation group and non-tap water nasal irrigation group. The tap water nasal irrigation group had better QoL scores than the non-tap water nasal irrigation group. Tap water nasal irrigation can be a valuable adjuvant therapy for patients with seasonal allergic rhinitis.

Quality of life in allergic rhinitis: relationship with clinical, immunological, and functional aspects

The relationship among nasal obstruction, T-helper type 2-dependent inflammation, nasal airflow limitation, and reversibility to the nasal decongestion test has been evidenced in allergic rhinitis (AR). Moreover, quality of life (QoL) has been widely evaluated in AR and its evaluation is considered in numerous trials. The aim of this cross-sectional study was to identify the QoL as measured by the Quality of Life Questionnaire in a population of patients with AR and to compare it with clinical, immunological, and functional parameters. One hundred and twenty-three patients with persistent AR were prospectively and consecutively evaluated. Clinical evaluation, skin prick test, nasal scraping for cytology, rhinomanometry, decongestion test, and QoL questionnaire were performed in all subjects. There was a significant relationship among QoL and functional and immunological parameters. Particularly, the multivariate analysis showed that having more than two sensitivities was a determinant of the QoL. The eosinophil count was significantly associated with QoL as well as the baseline nasal flow (mL/s) with the eye symptoms scale only. This study provides the first evidence that QoL in AR is strictly associated with allergic inflammation and eye symptoms significantly contribute to impairment of QoL. QoL, moreover, represents an important aspect to consider in managing patients with AR as it has a relationship with clinical, immunological, and functional parameters.

Desloratadine improves quality of life and symptom severity in patients with allergic rhinitis

Desloratadine is associated with decreased signs and symptoms and improved nasal airflow in multiple clinical trials in patients with allergic rhinitis (AR). The effect of desloratadine on quality of life (QOL) in AR has not been widely reported to date. We compared the effects of desloratadine and placebo on QOL in seasonal AR using validated, disease-specific measures. This was a multicenter, double-blind, randomized, parallel-group study of desloratadine 5 mg or placebo daily for 2 weeks in patients with symptomatic seasonal AR. QOL was assessed at baseline and at day 14 using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). AR signs/symptoms and the global response to therapy were measured at baseline and at day 14; signs/symptoms were also rated AM/PM in patient diaries. Adverse events (AE) were recorded. Overall 234 patients received desloratadine and 249 received placebo. At day 14 desloratadine was associated with a significantly larger improvement from baseline in the mean total RQLQ score vs placebo (P = 0.0003). Desloratadine also led to significant improvements from baseline in all RQLQ sub-domains (P < or = 0.043). At day 14 significant decreases from baseline were noted in the desloratadine group for total nasal (P = 0.0003), total non-nasal (P = 0.001) and total symptoms scores (P = 0.0001). Morning AR symptoms were significantly decreased in the desloratadine group after 1 day of treatment. Desloratadine was well tolerated, with an AE rate similar to placebo. Significant reductions in signs and symptoms of AR with desloratadine treatment were accompanied by improved disease-specific QOL measures.

Correlation between disease-specific and generic measures of quality of life (QOL) support improvement in nocturnal rhinitis-related QOL in allergic rhinitis (AR) patients treated with triamcinolone acetonide aqueous (TAA AQ) nasal spray

Rationale Generic and disease-specific questionnaires are used to measure effects of AR treatment on QOL. Often, statistical differences are observed with the more sensitive disease-specific instrument but the generic instrument may lack sufficient depth to measure important problems associated with a particular condition. 1 1 Juniper EF. Clin Exp Allergy 1998;28(suppl):34–8. Methods An open-label study of AR patients (N=651) treated in a primary care setting assessed nighttime rhinoconjunctivitis-related QOL using the validated Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ; domains: sleep problems, symptoms during sleep, symptoms upon waking in morning, practical problems); and sleep disturbances using the validated Pittsburgh Sleep Quality Index (PSQI; domains: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medications, daytime dysfunction), at baseline and after 3 weeks of treatment with TAA AQ 220 μg QD. Changes from baseline in NRQLQ and PSQI scores were assessed by t-test methods, and Pearson's Correlation Coefficient was used to evaluate the relationship between NRQLQ and PSQI scores at baseline and study end. Results Mean patient age (± SD) was 45.7 (15.5) years, 58% were female, 85% were Caucasian, and 63% shared a bed with a partner. Significant improvements from baseline overall and in all individual domains of the NRQLQ and PSQI were observed (all comparisons P<.001). There were strong correlations between NRQLQ and PSQI instruments (all correlations >0.5; P<.001). Conclusions Correlations between outcomes of generic and disease-specific instruments strongly support improvement in nighttime QOL after 3 weeks of TAA AQ treatment in AR patients.

Allergic rhinitis and quality of life: where are we?

SummaryHealth‐Related Quality of Life (QoL) considers the impact of both illness and treatment on a patient's life as perceived by the patient himself. As well as providing information on how a disease affects a patient's life, QoL instruments could provide important information concerning the treatment outcomes. The SF‐36 enlighted a significant impairment in eight of the nine QoL domains in patients with persistent allergic rhinitis, compared to healthy subjects. In seasonal rhinitis a patient's satisfaction profile does not show consistent changes before and after the pollen season. Adherence to treatment and caregivers' and relatives' QoL assessment still deserve more attention. In conclusion there is still a long way to go towards a full knowledge of QoL in allergic rhinitis.