Federica Gani1, Carlo Lombardi2, Giacomo Bonizzoni3, Giovanni Rolla4, Luisa Brussino4, Massimo Landi5, Michele Schiappoli6, Gianenrico Senna6, Eleonora Savi7, Erminia Ridolo8, Maria Teresa Ventura9, Paolo Gamba10, Vincenzo Patella11, Massimo Bugiani12. 1. Allergy Service, AOU San Luigi Gonzaga Hospital, Turin, Italy. 2. Departmental Unit of Allergology and Respiratory Diseases, Fondazione Poliambulanza Hospital, Brescia, Italy. 3. Allergy Service, AOU San Luigi Gonzaga Hospital, Turin, Italy, giacomo.bonizzoni@gmail.com. 4. Allergology and Immunology, Mauriziano Hospital, University of Turin, Turin, Italy. 5. Primary Care Physician, National Healthcare System, Turin, Italy. 6. Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy. 7. Allergy Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy. 8. Experimental and Clinical Medicine, University of Parma, Parma, Italy. 9. Department of Interdisciplinary Medicine, University of Bari, Bari, Italy. 10. ENT Department, Fondazione Poliambulanza Hospital, Brescia, Italy. 11. Centro aziendale provinciale per la cura delle malattie allergologiche e immunologiche gravi, ASL Salerno, Ospedale Civile, Battipaglia, Italy. 12. Consultant Physician of Professional Diseases Observatory, Procura della Repubblica, Turin, Italy.
Abstract
BACKGROUND: There are few studies regarding severe chronic upper-airway disease (SCUAD) that represents an important socioeconomic problem for the treatment of rhinitis and associated comorbidities, particularly asthma. OBJECTIVES: The aim of our study is to evaluate the prevalence of this pathology in patients with allergic rhinitis (AR) in real life, to phenotype allergic patients with SCUAD, and to identify which factors are related to the severity of the disease. METHODS: We studied 113 patients with uncontrolled AR despite optimal adherence to therapy according to the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in a multicenter Italian study, analyzing comorbidity, use of additional drugs, not scheduled visits, and the number of emergency room admissions. RESULTS: Our data suggest that polysensitization is the only statistically significant factor correlating with SCUAD. Asthma does not seem to represent a correlating factor. An important finding is the poor use (20%) of allergy immunotherapy (AIT), although patients were suffering from AR and the ARIA guidelines recommend the use of AIT in moderate/severe AR. CONCLUSIONS: The SCUAD population seems not to have a specific phenotype; there is a greater presence of SCUAD in polysensibilized patients, perhaps a sign of greater inflammation.
BACKGROUND: There are few studies regarding severe chronic upper-airway disease (SCUAD) that represents an important socioeconomic problem for the treatment of rhinitis and associated comorbidities, particularly asthma. OBJECTIVES: The aim of our study is to evaluate the prevalence of this pathology in patients with allergic rhinitis (AR) in real life, to phenotype allergicpatients with SCUAD, and to identify which factors are related to the severity of the disease. METHODS: We studied 113 patients with uncontrolled AR despite optimal adherence to therapy according to the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in a multicenter Italian study, analyzing comorbidity, use of additional drugs, not scheduled visits, and the number of emergency room admissions. RESULTS: Our data suggest that polysensitization is the only statistically significant factor correlating with SCUAD. Asthma does not seem to represent a correlating factor. An important finding is the poor use (20%) of allergy immunotherapy (AIT), although patients were suffering from AR and the ARIA guidelines recommend the use of AIT in moderate/severe AR. CONCLUSIONS: The SCUAD population seems not to have a specific phenotype; there is a greater presence of SCUAD in polysensibilized patients, perhaps a sign of greater inflammation.