Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia, Spain.
Clin Exp Allergy. 2013 Jul;43(7):723-9. doi: 10.1111/cea.12081.
Although the treatment of allergic rhinitis (AR) is now well established, its impact on severity has not yet been evaluated.
The aim was to analyse specialist-based treatment on AR severity, nasal symptoms and quality of life.
A longitudinal observational, prospective, multi-centre study with 4 weeks of follow-up was carried out by 141 allergologists and ENT specialists in Spain. Selection criteria were adult patients with AR, clinically diagnosed at least 2 years before, with a total nasal symptom score (TNSS) ≥5, not receiving either antihistamines within the previous week or nasal corticosteroids during the 2 previous weeks. Disease severity using both original Allergic Rhinitis and its Impact on Asthma (o-ARIA) and modified (m-ARIA) classifications, nasal symptoms, and Quality of Life (ESPRINT-15), were measured at baseline and after 4 weeks of treatment.
Among the recruited AR patients (n = 707, 58% women), 39.3% were intermittent and 60.7% persistent, 40.2% had asthma and 61.4% conjunctivitis. Most patients were treated with second generation antihistamines in monotherapy (63.2%) or in combination with intranasal corticosteroids (31.5%). While using o-ARIA, 96.9% of patients had 'moderate/severe' AR, the m-ARIA discriminated between 'moderate' (55.4%) and severe (41.5%) AR, at baseline. After 4 weeks of treatment, improvement was found on disease severity (P < 0.0001), TNSS (8.2 ± 1.8 vs. 3.5 ± 2.3, P < 0.0001) and Quality of Life (ESPRINT-15 global score: 3.0 ± 1.2 vs. 1.1 ± 1.0, P < 0.0001).
Specialist-based treatment reduces AR severity, evaluated using the m-ARIA classification for the first time, in addition to the improvement of nasal symptoms and quality of life.
Specialist-based treatment improves AR severity, in addition to nasal symptoms and quality of life. However, no matter the treatment option some AR patients remain severe and need further follow-up.
尽管过敏性鼻炎（AR）的治疗方法现已确立，但尚未评估其对严重程度的影响。
旨在分析基于专科医生的 AR 严重程度、鼻部症状和生活质量的治疗效果。
这是一项在西班牙由 141 名过敏专家和耳鼻喉科专家进行的为期 4 周随访的纵向观察性、前瞻性、多中心研究。选择标准为成人 AR 患者，至少在 2 年前临床诊断，总鼻部症状评分（TNSS）≥5，在过去 1 周内未使用抗组胺药，在过去 2 周内未使用鼻用皮质类固醇。在基线和治疗 4 周后，使用原始过敏性鼻炎及其对哮喘的影响（o-ARIA）和改良（m-ARIA）分类来测量疾病严重程度、鼻部症状和生活质量（ESPRINT-15）。
在所招募的 AR 患者（n=707，58%女性）中，39.3%为间歇性，60.7%为持续性，40.2%患有哮喘，61.4%患有结膜炎。大多数患者接受第二代抗组胺药单药治疗（63.2%）或联合鼻内皮质类固醇治疗（31.5%）。使用 o-ARIA 时，96.9%的患者患有“中度/重度”AR，m-ARIA 在基线时可区分“中度”（55.4%）和重度（41.5%）AR。治疗 4 周后，疾病严重程度（P<0.0001）、TNSS（8.2±1.8 比 3.5±2.3，P<0.0001）和生活质量（ESPRINT-15 全球评分：3.0±1.2 比 1.1±1.0，P<0.0001）均有改善。
基于专科医生的治疗可降低 AR 严重程度，这是首次使用 m-ARIA 分类进行评估，同时还改善了鼻部症状和生活质量。
基于专科医生的治疗可改善 AR 严重程度，以及鼻部症状和生活质量。然而，无论选择哪种治疗方案，一些 AR 患者仍然严重，需要进一步随访。
