Frati Franco, Dell'Albani Ilaria, Passalacqua Giovanni, Bonini Sergio, Rossi Oliviero, Senna Gianenrico, Incorvaia Cristoforo
Department of Medical and Scientific, Stallergenes, Milan, Italy.
Allergy and Respiratory Diseases, University Department of Internal Medicine, Genoa, Italy.
Med Sci Monit. 2014 Nov 4;20:2151-6. doi: 10.12659/MSM.891206.
Allergic rhinitis (AR) has high prevalence and substantial socio-economic burden.
MATERIAL/METHODS: The study included 35 Italian Centers recruiting an overall number of 3383 adult patients with rhinitis (48% males, 52% females, mean age 29.1, range 18-45 years). For each patient, the attending physician had to fill in a standardized questionnaire, covering, in particular, some issues such as the ARIA classification of allergic rhinitis (AR), the results of skin prick test (SPT), the kind of treatment, the response to treatment, and the satisfaction with treatment.
Out of the 3383 patients with rhinitis, 2788 (82.4%) had AR: 311 (11.5%) had a mild intermittent, 229 (8.8%) a mild persistent, 636 (23.5%) a moderate-severe intermittent, and 1518 (56.1%) a moderate-severe persistent form. The most frequently used drugs were oral antihistamines (77.1%) and topical corticosteroids (60.8%). The response to treatment was judged as excellent in 12.2%, good in 41.3%, fair in 31.2%, poor in 14.5%, and very bad in 0.8% of subjects. The rate of treatment dissatisfaction was significantly higher in patients with moderate-to-severe AR than in patients with mild AR (p<0.0001). Indication to allergen immunotherapy (AIT) was significantly more frequent (p<0.01) in patients with severe AR than with mild AR.
These findings confirm the appropriateness of ARIA guidelines in classifying the AR patients and the association of severe symptoms with unsuccessful drug treatment. The optimal targeting of patients to be treated with AIT needs to be reassessed.
变应性鼻炎(AR)患病率高,社会经济负担沉重。
材料/方法:该研究纳入了35个意大利中心,共招募了3383例成年鼻炎患者(男性占48%,女性占52%,平均年龄29.1岁,范围为18 - 45岁)。对于每位患者,主治医生必须填写一份标准化问卷,特别涵盖一些问题,如变应性鼻炎(AR)的ARIA分类、皮肤点刺试验(SPT)结果、治疗类型、治疗反应以及对治疗的满意度。
在3383例鼻炎患者中,2788例(82.4%)患有AR:311例(11.5%)为轻度间歇性,229例(8.8%)为轻度持续性,636例(23.5%)为中重度间歇性,1518例(56.1%)为中重度持续性。最常用的药物是口服抗组胺药(77.1%)和局部用糖皮质激素(60.8%)。12.2%的受试者治疗反应被判定为优秀,41.3%为良好,31.2%为中等,14.5%为差,0.8%为非常差。中重度AR患者的治疗不满意率显著高于轻度AR患者(p<0.0001)。重度AR患者接受变应原免疫治疗(AIT)的指征明显比轻度AR患者更频繁(p<0.01)。
这些发现证实了ARIA指南在AR患者分类中的适用性以及严重症状与药物治疗效果不佳之间的关联。需要重新评估AIT治疗患者的最佳靶向选择。