Rhinoconjunctivitis Quality Of Life Questionnaire Research Articles

Determination of the minimally important difference in a nasal symptom score in house dust mite allergy

House dust mite (HDM) allergens are responsible for the most prevalent persistent respiratory allergies. Clinical trials in this field often use a four-component nasal symptom score (T4NSS) as a measure of efficacy. The present observational, prospective, multinational, multicenter study determined the minimal important difference (MID) for a T4NSS in children, adolescents, and adults with physician-diagnosed HDM-induced allergic rhinoconjunctivitis (AR). Patients rated the T4NSS daily, a 15-point global rating of change scale (GRCS)and the Rhinoconjunctivitis Quality of Life Questionnaire weekly. The MID was determined primarily by using a regression method with a GRCS threshold of 2. A total of 546 patients (210 adults, 133 adolescents, and 203 children) were included; 92.6% of the patients had moderate-to-severe AR, and 30.1% had concomitant mild asthma. During the first week, the mean±standard deviation T4NSS was 5.68±2.76 in adults, 5.34±2.66 in adolescents, and 5.07±2.48 in children. In a GRCS regression analysis, the MID [95% confidence interval] for the T4NSS was -0.90 [-1.06;-0.75] overall (n=509), -0.94 [-1.19;-0.69] in children (n=187), -0.74 [-1.07;-0.41] in adolescents (n=125), and -1.04 [-1.29;-0.79] in adults (n=197). The MID did not differ greatly from one disease severity tertile to another. Confirmatory distribution-based analyses yielded overall MID values of -0.87 for the first week of the study and -0.93 for the week 2-week 1 difference. The MID for improvement in the T4NSS is at least -0.90 units in children, adolescents, and adults suffering from HDM-induced AR This value could be rounded up to -1 unit for convenience.

Efficacy and safety of electric heating moxibustion for perennial allergic rhinitis: protocol for a randomized controlled trial

BackgroundAllergic rhinitis (AR) is an IgE-mediated disease that adversely affects quality of life. Many studies report that moxibustion is an effective treatment for perennial allergic rhinitis (PAR). However, it is difficult to perform moxibustion on the face because of possible burning of the skin and the noxious effects of smoke. Electric heating moxibustion does not have these limitations. The purpose of this clinical trial is to assess the possibility of treating PAR with electric heating moxibustion and to assess the feasibility of conducting a clinical test on a larger scale.MethodsThis is a randomized, open-label, assessor-blind, parallel-design pilot clinical study. We will recruit 40 eligible participants and randomly allocate them into an electric heating moxibustion group or an acupuncture group at a 1:1 ratio. Patients in both groups will receive eight treatments over 4 weeks, and the final follow-up will be 4 weeks after the last treatment. Eleven acupuncture points will be used for patients in both groups (EX-HN3 and bilateral EX-HN-8, LI20, LI4, GB20, and ST36). The primary outcome measure is change in the Total Nasal Symptom Score, and the secondary outcome measures are changes in the Rhinoconjunctivitis Quality of Life Questionnaire, nasal endoscopy index for pattern identification, pattern identification questionnaire for AR, total IgE, eosinophil count, and adverse effects.DiscussionThis clinical trial will examine the effect of electric heating moxibustion on PAR.Trial registrationClinicalTrials.gov, NCT03342105. Registered on 14 November 2017.

Comparison of Quality of Life and Nasal Symptoms in Chronic Rhinitis Patients Between Before and After Treatment

Background: Chronic rhinitis is a common disease which impacts the quality of life. The symptom of diseases could be controlled after treatment. However, the difference in the quality of life and symptoms after 3 months of treatment is not documented.
 Objective: To compare the quality of life in chronic rhinitis patients before and at 3 months after treatment.
 Methods: Prospective study in new cases of chronic rhinitis patients at adult allergy clinic, Ramathibodi Hospital, from August 2017 to March 2018. Assessment of quality of life and nasal symptoms was performed by using the short form 36 health survey questionnaire (SF36) and the rhinoconjunctivitis quality of life questionnaires (RCQ36). Descriptive statistic, t test, and Wilcoxon signed rank test were applied in the data analysis.
 Results: Of 127 patients, 65.4% were female. Chronic rhinitis was classified as allergic rhinitis, non-allergic rhinitis, and unspecified rhinitis in 72.4%, 18.9%, and 8.7%, respectively. The result of the study showed that there was statistically significant improvement in the quality of life (SF36 and RCQ36 ) and the decrease of nasal and other symptoms score after 3 months of period treatment in chronic rhinitis patients (P < .05).
 Conclusions: The improvement in the quality of life (SF36 and RCQ36) and the decrease in nasal and other symptoms were documented after 3 months of treatment in chronic rhinitis patients.

Self-administered acupressure for allergic rhinitis: study protocol for a randomized, single-blind, non-specific controlled, parallel trial

BackgroundAllergic rhinitis (AR) is an IgE-mediated inflammatory disease. Current conventional therapies for AR are unsatisfactory. Acupuncture has been recommended as an optional treatment for AR patients who are interested in non-pharmacotherapy in the new clinical practice guidelines for AR. Acupressure is a sub-type of acupuncture which is non-invasive with a low risk and can be self-administered. However, the current limited evidence is compromised by the high risk of bias and heterogeneity of methodology. Therefore, rigorously designed randomized controlled trials (RCTs) are needed. This proposed RCT aims to evaluate the efficacy and safety of self-administered acupressure for the management of AR.Methods/designWe have designed a randomized, single-blind, non-specific controlled, two-arm, parallel clinical trial involving a 2-week run-in period, a 4-week intervention period and an 8-week follow-up period. The eligible participants will be randomized into either a specific or a non-specific acupressure group. They will be required to perform self-administered acupressure on either five specific acupressure points or five non-specific acupressure points, 1 min for each point, twice a day for 4 weeks. Participants will be asked to complete self-administered questionnaires for outcome measures including a 7-point scale of symptom severity, the Rhinoconjunctivitis Quality of Life Questionnaire with Standardized Activities (RQLQs), relief medication scores, adverse events and participants’ opinion of this study at the different assessment points throughout the trial period. Data will be analyzed by the chi-square or t test using Statistical Package for Social Science (SPSS) software.DiscussionThe findings from this study should provide scientific evidence for the efficacy and safety of self-administered acupressure for the management of AR. This study may assist the development of a non-cost, non-invasive self-management method for AR sufferers.Trial registrationAustralian and New Zealand Clinical Trials Registry (ANZCTR), ID: ACTRN12617001106325 Registered on 28 July 2017.

Impact of acupuncture for allergic rhinitis on the activity of the hypothalamus-pituitary-adrenal axis: study protocol for a randomized controlled trial

BackgroundPatients with moderate and severe persistent allergic rhinitis (AR) have long-term physical and mental stress, leading to dysfunction of the hypothalamus-pituitary-adrenal (HPA) axis, which results in recurrence of AR. Previous research has proved acupuncture can regulate the function of the neuron-endocrine-immune system and contribute to improving the quality of life of patients with AR. This research aims to investigate the mechanism of acupuncture on the HPA axis in patients with moderate or severe persistent AR.Methods/designThis randomized controlled trial aims to study the impact of acupuncture on the HPA axis of patients with moderate and severe AR. This research also aims to compare the curative effects of different treatments in three groups of patients: those receiving western medicine, western medicine and conventional acupuncture, or western medicine and mind-regulating acupuncture. We will study the therapeutic effect of acupuncture and the correlation between the changes of therapeutic indexes and experimental indexes after the treatments. Therapeutic indexes include the Visual Analog Scale (VAS) of nasal symptoms and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) for AR patients; experimental indexes include corticotropin releasing hormone (CRH), adreno-corticotropic hormone (ACTH), cortisol (CORT), interleukin 4 (IL-4), and interferon-γ (IFN-γ).DiscussionThe results of this trial will provide evidence for the influence of chronic, long-term, repeated stimulation in patients with moderate and severe persistent AR and the impact of acupuncture on the HPA axis of these patients.Trial registrationAcupuncture-Moxibustion Clinical Trial Registry, AMCTR-IOR-16000009. Registered on 22 August 2016.

Long-term effects of allergen sublingual immunotherapy.

IntroductionAllergen-specific immunotherapy (AIT) is a crucial therapy for allergic rhinitis. However, the long-term effectiveness of AIT remains to be explored.AimTo evaluate clinical and immunological long-term effects of sublingual allergen immunotherapy (SLIT) for common inhalant allergens in elderly patients with allergic rhinitis.Material and methodsThis trial was a prospective follow-up observation of patients with allergic rhinitis who completed SLIT for grass pollen or house dust mites (HDM). After 3 years of SLIT, 115 patients were compared to a placebo group during an additional 5 years of observation. The combined symptom medication score (SMS), quality of life and concentration of IgG4 for Phleum pratense or Dermatophagoides pteronyssinus were monitored during the study.ResultsFive years after SLIT was discontinued, a significant clinical effect based on SMS was still observed compared with the baseline, just after SLIT and 5 years later as follows: 7.53 ±2.09 vs. 2.45 ±0.72 vs. 3.09 ±1.07 (p < 0.05) for HDM and 8.19 ±2.41 vs. 3.05 ±1.62 vs. 4.47 ±2.31 (p < 0.05) for grass pollen. Quality of life based on the Rhinoconjunctivitis Quality of Life Questionnaire was significantly improved in patients who received SLIT and remained at a good level after 5 years of observation. During the 5 years of observation after SLIT, there were no significant changes between specific IgG4 levels and the analysed allergens compared to results just after SLIT.ConclusionsThe positive effect obtained after SLIT for grass pollen or house dust mites was sustained for a long period after AIT.

Evaluation of Sub cutaneousRush Immunotherapy Effectiveness in Perennial Allergic Rhinitis after a Year from Treatment.

Allergen immunotherapy is an effective treatment for allergic rhinitis. Conventional immunotherapy takes at least 5 to 6 months to reach the maintenance dosage; nonetheless, rush immunotherapy accelerates to reach the maintenance dose several months earlier. However, the safety and efficacy of this treatment has not been widely investigated. The objective of the present study was to determine the efficacy of subcutaneous rush immunotherapy in the patients with perennial allergic rhinitis after a year from treatment. This study was carried out on a total of 15 patients with allergic rhinitis who received rush immunotherapy and were evaluated for the quality of life and clinical symptoms improvement with Sino-Nasal Outcome TestQuestionnaire (SNOT-22) and Mini Rhino conjunctivitis Quality of Life Questionnaire (RQLQ) before and after a year from treatment. Moreover, specific weed mix Immunoglobulin E(IgE)was measured before and after a year from treatment. Statistical analysis was performed using SPSS software (version 16) (P<0.05). The comparison of specific IgE indicated a significant reduction between before and after a year from treatment (P=0.005for pigweed)(P=0.022 for salsola). There was a significant decrease in clinical symptoms according to SNOT-22 Questionnaire [(mean score: 46.00, before the treatment) and (mean score: 14.06, after the treatment)]. The quality of life for most of the patients was moderate (46.7%) before the treatment and good (80%) after the treatment, which was considered statistically significant (P>0.001). Rush immunotherapy is an effective treatment in the patients with allergic rhinitis. It seems to be an alternative treatment in cases that need more rapid treatment. However, it is recommended to carry out other studies on the control group.

Association between sensitized to food allergens and childhood allergic respiratory diseases in Taiwan.

Sensitization to allergen has long been known to be relate to childhood allergic diseases. Polysensitised children have more severe atopic diseases, whereas allergic rhinitis or asthma children with cosensitized to food and inhalant allergens were under-researched. To realize the association between sensitization to food allergens and pediatric allergic rhinitis and asthma in Taiwan. We included 138 participants with sensitized to allergen as assessed by serum-specific IgE. 87 of 138 participants had allergic rhinitis and 51 participants had asthma. All participants underwent a physical examination and measurement of serum total and specific IgE values. Besides, nasal peak expiratory flow rate (nPEFR) that was performed by the participants with allergic rhinitis and were requested to complete the Pediatric Rhinoconjunctivitis Quality of Life Questionnaires (PRQLQ). Lung function test and asthma control test (ACT)/child asthma control test (C-ACT) were performed by the participants with asthma. 39 of 87 allergic rhinitis participants with sensitized to food and inhalant allergens (AR food group), 48 of 87 allergic rhinitis participants with sensitized to inhalant allergen alone (AR inhalant group). The AR food group had significantly lower nPEFR values and higher total IgE values (p<0.05) compared with the AR inhalant group. The AR food group had higher PRQLQ scores than the AR inhalant group. 24 of 51 asthma participants with sensitized to food and inhalant allergens (Asthma food group), 27 of 51 asthma participants with sensitized to inhalant allergen alone (Asthma inhalant group). The Asthma food group had significantly higher total IgE values (p<0.05) compared with the Asthma inhalant group. The Asthma food group had lower lung function test values and asthma control test (ACT) scores than the other group. Children with cosensitized to food and inhalant allergens have more severe clinical symptoms and abnormal laboratory findings. Sensitization to food allergen was more related to pediatric allergic rhinitis than asthma. We may need larger, longer and extended studies to confirm these findings.

An External CAM Therapy (Tian Jiu) versus Placebo in Treatment of Allergic Rhinitis: A Pilot Single-Blinded, Three-Arm, Randomized Controlled Study.

Allergic rhinitis (AR) is one of the common allergic diseases in clinical practice and significantly impairs the quality of life (QoL) of patients. The conventional treatments are not satisfactory because of various reasons. Tian Jiu (TJ) therapy is a characteristic external intervention of complementary and alternative medicine (CAM) and has been widely utilized in the management of AR. However, the evidences resulted from current studies were generally poor due to high risk of bias. Therefore, we conducted this rigorous designed, single-blinded, three-arm, randomized controlled study to evaluate the efficacy and safety of TJ therapy on AR. Totally 138 AR patients were enrolled. The TJ group and placebo group received 4-week treatment with either TJ or placebo patches for 2 hours each time applied to Dazhui (GV 14), bilateral Feishu (UB 13), and bilateral Shenshu (UB 23) one session per week and then underwent a 4-week follow-up. The waitlist group received no treatment during the corresponding treatment period, but would be given compensatory TJ treatment in the next 4 weeks. The primary outcome was the change of the Total Nasal Symptom Score (TNSS) after treatment. The secondary outcomes included the changes of Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and rescue medication score (RMS). After treatment, the total TNSS in TJ group was significantly reduced compared with baseline, but showed no statistical meaning compared with placebo. Among the four domains of TNSS, the change of nasal obstruction exhibited statistical difference compared with placebo group. The total RQLQ score in TJ group was significantly reduced compared with both placebo and waitlist groups. The needs of rescue medications were no distinct difference between two groups. In summary, this study showed potential effectiveness of TJ therapy in improving nasal obstruction symptoms and QoL of AR patients.

Efficacy of a Novel Intranasal Formulation of Azelastine Hydrochloride and Fluticasone Propionate, Delivered in a Single Spray, for the Treatment of Seasonal Allergic Rhinitis: Results from Russia

Background: The novel intranasal formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP) in a single spray (MP-AzeFlu) was compared with a first-line intranasal antihistamine spray (AZE) in Russian seasonal allergic rhinitis (SAR) patients. Methods: Moderate-to-severe SAR/rhinoconjunctivitis patients (n = 149; aged 18–65 years) were randomized to receive MP-AzeFlu (137/50 μg AZE/FP per spray) or AZE (137 μg/spray), both as 1 spray/nostril twice daily, in a multicenter, open-label, 14-day, parallel-group trial. The primary outcome was change from baseline in morning and evening reflective total nasal symptom score (rTNSS). Secondary end points included: change from baseline in reflective total ocular symptom score (rTOSS), reflective total of 7 symptom scores (rT7SS), 28-item Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) overall score, and EuroQol-5D (EQ-5D) questionnaire score. Results: When compared with AZE-treated patients, those treated with MP-AzeFlu experienced significantly greater reductions in rTNSS (difference: –2.47; 95% confidence interval [CI] –3.65 to –1.30; p < 0.001), rTOSS (difference: –1.62; 95% CI –2.32 to –0.92; p < 0.001), and rT7SS (difference: –4.34; 95% CI –5.98 to –2.70; p < 0.001). Superior relief observed on day 2 with MP-AzeFlu versus AZE was sustained throughout the study. MP-AzeFlu-treated patients experienced a greater improvement in QoL than AZE-treated patients as measured by overall RQLQ score (mean ± SD 2.91 ± 1.08 vs. 2.05 ± 1.15) and EQ-5D score (mean ± SD 87.4 ± 10.3 vs. 83.0 ± 12.8). MP-AzeFlu was well tolerated. Conclusions: MP-AzeFlu was superior to AZE in reducing moderate-to-severe SAR symptoms, providing earlier and more complete symptom relief.

Chinese herbal medicine bi min fang for allergic rhinitis: protocol for a double-blind, double-dummy, randomized controlled trial

BackgroundPeople with allergic rhinitis (AR) often seek help from Chinese medicine due to dissatisfaction with conventional treatments. Lung-spleen qi deficiency syndrome (LSQDS) is the most common type of AR, and the Chinese herbal medicine formula bi min fang (BMF) is commonly prescribed for AR patients with LSQDS. However, direct evidence supporting its efficacy and safety is not available, and its potential mechanism of action remains unclear.Methods/designThis paper presents a double-blind, double-dummy, randomized controlled trial. After a 2-week run-in period, 80 AR patients with LSQDS will be recruited and randomly allocated to the BMF group or the control group in a 1:1 ratio. The patients in the BMF group will receive BMF and the placebo for levocetirizine hydrochloride orally, while the control group participants will receive levocetirizine hydrochloride and the placebo for BMF orally. All participants will receive 4 weeks of treatment and 12 weeks of follow-up.The primary outcome is a change in the Total Nasal Symptom Score (TNSS). Secondary outcomes include changes in scores for the standard version of the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ(S)), and visual analog scale (VAS); changes in serum levels of the cytokines interleukin-4, interferon-γ, transforming growth factor β-1, and interleukin-17; and changes in the gut microbiota composition in the stool. The TNSS, RQLQ(S), and VAS will be recorded at the beginning of, middle of and after the treatment period and at the end of each month in the 3-month follow-up period. Blood and stool samples will be collected at baseline and the end of the treatment. The aforementioned four cytokines will be detected in the serum using enzyme-linked immunosorbent assays, and the stool gut microbiota will be detected using 16S ribosomal ribonucleic acid sequencing. Any side effects of the treatment will be recorded.DiscussionThe results of this trial will provide consolidated evidence of the effect of BMF on AR and the potential mechanism by which BMF acts. This study will be the first to explore the mechanism of action of Chinese herbal medicine on the gut microbiota in AR.Trial registrationChinese Clinical Trial Registry, ChiCTR-IPR-17010970. Registered on 23 March 2017.

Minimal clinically important difference for the rhinoconjunctivitis quality of life questionnaire in allergic rhinitis in Thai population.

BackgroundClinical measurement of the severity of allergic rhinitis (AR) can be assessed by symptoms score and patient quality of life (QoL). The magnitude of change in both symptoms and patient QoL should be considered in the management of AR.ObjectiveThe aim of this study was to determine the minimal clinically important difference (MCID) in AR in Thai population.MethodsThis prospective study recruited AR patients that attended our clinic during September 2011 to February 2012. The Rhinoconjunctivitis Quality of Life (Rcq-36) questionnaire was used to evaluate patient QoL. The Global Rating of Change Scale (GRCS) was used to assess improvement or deterioration in condition. The MCID was determined using an anchor-based method based on the GRCS, which was compared to the MCID determined by a distribution-based method based on the standard deviation (SD).ResultsThree hundred seventy-two patients with chronic rhinitis were recruited. Eighty-four of those had positive skin prick test and be diagnosed as AR. Of those, 79 completed the study and were included in the final analysis. A change of 2 points on the GRCS yielded an MCID for overall QoL of 0.21 ± 0.57. When applying the distribution-based method, an SD of 1.5 SD yielded an MCID for QoL of 0.27. For the rhinitis symptoms domain, the MCID was 0.42 ± 0.72.ConclusionsThe MCID for overall QoL and rhinitis symptoms in Thai AR patients was found to be 0.21 ± 0.57 and 0.42 ± 0.72, respectively. MCID can be applied for determining the clinical significance of treatment efficacy in AR.

The correlation between children's serum 25-hydroxyvitamin D and allergic rhinitis in Jiangxi Province

Objective:We attempt to investigate the correlation between serum 25-hydroxyvitamin D［25(OH)D］ level and allergic rhinitis(AR) of children in Jiangxi Province,for providing new clues for the pathogenesis of AR in children.Method:Seventy-six AR children and 68 healthy controls from various counties and cities of Jiangxi Province were enrolled. All subjects recepted questionnaire survey, allergen skin prick test,serum specific IgE test,serum 25(OH)D test and routine blood test. AR children completed the visual analogue scale(VAS) scores and rhinoconjunctivitis quality of life questionnaire(RQLQ) scores.Result:The mean body mass index(BMI) of AR children in Jiangxi Province was significantly lower than that of healthy peers (P<0.000 1),but there was no correlation between BMI and serum 25(OH)D level.Serum 25(OH)D level of AR children was signtificantly lower,compared to the conrtols (P=0.0008),while the area under the receiver operating characteristic curve(AUC)of subjects was 0.6614, That is,serum 25(OH)D was not an efficient auxiliary diagnosis in AR children.Serum 25(OH)D level of AR children was not correlated with the severity, gender,peripheral blood eosinophils and asthma.Conclusion:AR can affect the growth and development of children.Children's serum 25(OH)D deficiency was correlated to AR, but its efficiency for auxiliary diagnosis in AR is not high.So it cannot be used as an auxiliary indicator for clinical diagnosis of AR.Serum 25(OH)D may not be directly involved in the pathogenesis of children's AR.

Effects of Serum Vitamin D and Efficacy of Subcutaneous Immunotherapy in Adult Patients With Allergic Rhinitis.

Immunotherapy is the standard of treatment for long-life relief of symptoms of allergic rhinitis. Vitamin D may affect the outcomes of treatment. This study evaluated the clinical efficacy of subcutaneous allergen immunotherapy in adult patients with allergic rhinitis based on the serum level of vitamin D. Patients with persistent allergic rhinitis and positivity for skin prick test were evaluated by Sino-nasal Outcome Test (SNOT-22) and Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ) before subcutaneous allergen immunotherapy and during the maintenance phase to assess the relation of the serum level of vitamin D and the clinical efficacy of immunotherapy. After immunotherapy, the greatest reduction in SNOT-22 scores were reported in patients with vitamin D sufficiency (39.0 ± 9.2), followed by vitamin D suboptimal provision (35.1 ± 12.1), insufficiency (25.0 ± 7.5), and deficiency (18.3 ± 6.0) (P < 0.001). The MiniRQLQ reduction in patients with vitamin D sufficiency, suboptimal provision, insufficiency, or deficiency was 30.7 ± 8.7, 27.1 ± 8.7, 20.0 ± 8.6, or 17.4 ± 7.1, respectively (P < 0.001). Both of SNOT-22 and MiniRQLQ scores decreased significantly following immunotherapy in patients with different levels of vitamin D. However, these effects were more pronounced when the level of vitamin D was sufficient.

The Effect of Allergic Rhinitis on Quality of Life in Patients Suffering from the Disease: A Case Control Study

Background: Apart from nasal symptoms allergic rhinitis was associated with ocular or other symptoms affecting social and somatic activities or sleep. In the literature, only a few prospective studies regarding allergic rhinitis and holistic consideration of quality of life were reported. Methods: The aim of this case control study was to investigate prospectively the effect of allergic rhinitis on quality of life. 103 patients (50 males and 53 females) with mean age 30.8 ± 13.4 years, range 18 - 55 years, diagnosed with the disease with skin prick testing, were evaluated regarding quality of life by using the General Health Questionnaire-28, the Athens Insomnia Scale (AIS) and the mini Rhinocon-junctivitis Quality of Life Questionnaire. 50 participants without history or al-lergic symptoms during the last 12 months formed the control group. Inde-pendent sample t-tests were conducted to assess significant differences between patients with allergic rhinitis and controls regarding all the examined parameters concerning quality of life. Data was analyzed using Windows statistical package of SPSS version 18.0 (SPSS Inc., Chicago, IL, USA). Statistical significance was set a priori at 0.05. Results: Dust mite, mixed grass and pollens were the most common allergens found in patients with allergic rhinitis. It was also observed that the examined patients showed statistically worse results concerning not only physical and social activities but also quality of sleep and nasal or other symptoms as compared to healthy controls (p 0.05). Conclusion: Allergic rhinitis negatively affected the quality of life especially the parameters that were related to psychosocial activities and sleep, which might have an impact on daily living.

CLINICAL EFFICACY OF 69 PATIENTS WITH JAPANESE CEDAR POLLINOSIS TREATED BY SUBLINGUAL IMMUNOTHERAPY WITH CEDARCURE® IN THE FIRST FOLLOW-UP YEAR

Cedarcure® for sublingual immunotherapy of cedar pollinosis was purchased in 2018. We studied clinical efficacy of Cedarcure® in the first year. We compared 69 patients treated with Cedarcure® (age, 18.0±13.5 years; male-to-female ratio, 40;29) and a control group of 97 patients treated with Cedartolen® (age, 29.8±16.2 years; male-to-female ratio, 44;53) during the peak season of large amount of pollen dispersal (10933 grains/cm2/season) in 2019. The clinical efficacy was evaluated by assessing symptom scores by Japanese rhino-conjunctivitis quality of life questionnaire and visual analog scale (VAS). All the assessments except nasal congestion were slightly better in Cedarcure® group, but they were not significant. There was no difference of concomitant medication in both groups. Because insurance coverage of Cedartolen® is for patients over 12 years old in Japan, the efficacy in Cedarcure® group enhanced better in all assessments if comparing the patients of over 12 years old. Percentage of adverse events was even in both over and under 12 years old. Cedarcure® was treated in safe, and reduced symptoms as well as Cedartolen®.

Efficacy of allergen-blocker mechanical barrier gel on symptoms and quality of life in patients with allergic rhinitis.

Allergic rhinitis (AR) is a very common, chronic and global health problem. In the last two decades, the efficiency of barrier-enforcing measures in AR has been investigated. In this study, we aimed to evaluate the effect of allergen-blocker mechanical barrier gel (MBG) (AlerjiSTOP®) treatment on symptoms and quality of life score (QoLS) in patients with seasonal and perennial allergic rhinitis. A single-center, prospective study was conducted between January 2017 and May 2018. Patients diagnosed with allergic rhinitis with a visual analogue scale (VAS) of 5 or higher (moderate/severe) were enrolled in the study. Patients were evaluated in terms of VAS, nasal symptom score (NSS), ocular symptom score (OSS), total symptom score (TSS) and QoLS at baseline, 1 week and 1 month of MBG treatment. A total of 83 patients with AR were enrolled in the study. Clinical and laboratory examinations showed that 50 (60.2%) patients were mono-sensitized. Allergen-blocker mechanical barrier gel treatment was performed as monotherapy in 22 (26.5%) patients. Median VAS, NSS, OSS and TSS decreased from 7 to 4, 8 to 3, 4 to 0 and 12 to 4, respectively (p < 0.0001). Correlation analysis revealed positive correlations between lower pediatric rhinoconjunctivitis quality of life questionnaire scores for patients under 12years of age and decrease in VAS, NSS and TSS (r = 0.380, p = 0.008; r = 0.544, p < 0.0001; r = 0.543, p < 0.0001). Positive correlations were detected between lower rhinoconjunctivitis quality of life questionnaire (self-administered) scores for patients ≥ 12years of age and decrease in VAS, NSS, OSS and TSS (r = 0.703, p < 0.0001; r = 0.465, p = 0.005; r = 0.526, p = 0.001; r = 0.624, p < 0.0001). In conclusion, we found significant decrease in all symptom scores and improvement in QoLS of patients treated with MBG as monotherapy and combination therapy.

Observation on pollinosis with vegetable food allergy

Objective: To investigate the incidence of plant food allergy in patients with pollinosis and the effect of food allergens on the clinical symptoms of pollinosis patients. Method: A total of 40 patients with pollinosis and food allergy attended to the allergy Department of Duolun People's Hospital of Inner Mongolia were accepted skin prick test of inhaled allergens while the rhino conjunctivitis quality of life questionnaire(RQLQ) were also completed. The patients were divided into A and B groups randomly. Patients in group A were required for avoiding allergic plant foods intake but not them in group B. The two groups of patients with RQLQ, VAS and clinical symptom scores were statistically analyzed by P<0.05, the difference was statistically significant. Result: Forty cases were allergic to Artemisia. The most common allergic plant foods was peach, which accounted for 47.5%. Twenty-four patients were allergic to multiple foods simultaneously. Seventeen cases of pollinosis were preceded by food allergy, and 23 cases of food allergy were preceded by pollinosis. The mean values of RQLQ, VAS and symptom scores in group A were 81.44±14.31, 6.02±1.39, 10.60±3.68, respectively. The mean values of group B patients after 1 years were 100.73±21.66, 8.30±1.00, 13.45±3.51, the difference was statistically significant (P<0.01). The patients in group A complained that the symptoms were better than before. The mean values of RQLQ, VAS and symptom scores before intervention were 105.2±26.69, 7.00±1.71, 14.83±3.66, with significant difference (P<0.01). There was no significant improvement in the symptoms of Group B patients (P>0.05). Conclusion: Patients with pollinosis are often associated with food allergies. Reducing the intake of allergic plant foods should help alleviate symptoms.

Acupuncture for the treatment of allergic rhinitis: A systematic review protocol.

Background:Allergic rhinitis is a major chronic inflammatory disease of the respiratory tract. A large number of epidemiological investigations have shown that the prevalence of allergic rhinitis (AR) is increasing, resulting in a large burden of disease. Desensitizing drugs such as nasal glucocorticoids and antihistamines are commonly used to treat allergic rhinitis, but this method has a long treatment period and is prone to repeated attacks, and there are certain adverse reactions. Acupuncture can be used to treat a wide variety of diseases including allergic rhinitis without the occurrence of drug damage. We aim to evaluate the efficacy and safety of acupuncture in the treatment of allergic rhinitis.Methods:Relevant databases include the English databases incorporating Web of science, PubMed, Springer, Medline, Cochrane Library, EBASE, WHO International Clinical Trials Registry Platform (ICTRP), as well as the Chinese databases like the China National Knowledge Infrastructure Database (CNKI), Chinese Scientific Journal Database (VIP), Wanfang Database, and Chinese Biomedical Literature Database will be searched normatively according to the rule of each database from the inception to September 1, 2018. Reference list of identified studies, potential gray literatures, relevant conference abstracts, and clinical trial registrations will also be searched. The literature screening, data extraction, and quality assessment will be conducted by 2 researchers independently. Data will be synthesized by either the fixed-effects or random-effects model according to a heterogeneity test. Symptom score will be assessed as the primary outcome. Rhinoconjunctivitis quality of life questionnaire (RQLQ), participants with asthma can use asthma control test (ACT), medicine usage and scoring, laboratory examination, and side effects or adverse events will be evaluated as the secondary outcome. Meta-analysis will be performed using RevMan5.3.5 software provided by the Cochrane Collaboration.Results:This study will provide high-quality synthesis based on current evidence of acupuncture treatment for allergic rhinitis in several aspects, including symptom score, drug score, quality of life score, asthma control score, side effects and laboratory examination such as nasal function test, serum total immunoglobulin (IgE), nasal secretion smear, etc.Conclusion:The results of this study will provide updated evidence for weather acupuncture is an effective and safe intervention for allergic rhinitis.Ethics and dissemination:It is not necessary for this systematic review to acquire an ethical approval. This review will be disseminated in a peer-reviewed journal or conference presentation.PROSPERO registration number:PROSPERO CRD42018109105.

UNCONTROLLED ALLERGY IS ASSOCIATED WITH SIGNIFICANT PRODUCTIVITY LOSS AMONG WORKING AMERICANS

Introduction Uncontrolled allergic rhinitis negatively impacts workplace productivity. House dust mite (HDM) is the most prevalent perennial allergy, but it can be effectively treated with allergy immunotherapy (AIT). Subcutaneous injection (SCIT) is the most common route of HDM AIT, however SCIT itself can adversely affect workplace productivity when the travel time required to receive the injections overlaps the workday. Methods This is an assessment, using an economic model, of the productivity impact of uncontrolled allergy in the US and an evaluation of the productivity impact of SCIT versus a new FDA-approved form of AIT, sublingual immunotherapy tablet (SLIT-tablet). The productivity impact is split into absenteeism and presenteeism. Results For the average employee with uncontrolled allergy the estimated annual productivity loss is $4,500, where presenteeism accounts for 81% of that total. In the pivotal North American placebo-controlled trial with HDM SLIT-tablet, statistical significant improvement was demonstrated by the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) in the activities domain (p=0.0001 vs placebo), which includes work-related actions. The HDM SLIT-tablet is home-administered and associated with considerably fewer doctor's office visits, contributing to less workplace productivity loss versus SCIT. The additional productivity loss of SCIT and SLIT-tablet due to related doctor visits are $1,147 and $80, respectively. Conclusions Uncontrolled allergic rhinitis is associated with workplace productivity loss. HDM SLIT-tablet offers an AIT treatment option that demonstrates improved RQLQ and contributes to decreased productivity loss. Furthermore, the home-administration of SLIT-tablet optimizes productivity versus SCIT because of fewer visits to the doctor.