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Abnormal Pulmonary Function Test in Children with Allergic Rhinitis due to House Dust Mites
S262 Abstracts
1015
Prevalence of Allergic Rhinitis among Medical School Students in Edirne (Turkey) and the Impact of Symptoms on Quality of Life M. Yazicioglu1, S. Yildirim1, H. Celik1, B. Kaptan1, B. Teloren1, H. Aylanc1, M. Ture2; 1Department of Pediatrics, Trakya University, Edirne, Turkey, 2Department of Biostatistics, Trakya University, Edirne, Turkey. RATIONALE: To investigate the self-reported prevalence of symptoms, diagnosis, treatment of allergic rhinitis (AR) and its impact on quality of life among medical school students in Trakya University (Edirne, Turkey). METHODS: A questionnaire based on ISAAC core questions on rhinitis, with additional questions on medicine used and treatment adherence was distributed to medical students. Health-related quality of life was assessed using the Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ). RESUTS: Of 915 questionnaires distributed, 599 were utilized. The prevalence of symptoms in the past year and the lifetime was 23.9% and 25.5%, respectively. Prior physician diagnoses existed for 44 of 599 (7.35%) students. Mini-RQLQ scores for activity limitations, practical problems, nose symptoms, eye symptoms, non-nose/eye symptoms were 1.5 6 1.3, 2.7 6 1.4, 2.4 6 1.6, 1.7 6 1.6, and 2.1 6 1.6, respectively. The most commonly used drugs were antihistamines (30.1%), decongestants (25.2%), and nasal steroids (23.1%). Forty-two percent of the cases were compliant to prescribed treatment. Patients reporting high scores for nose symptom in mini-RQLQ were more compliant to regular treatment (p 5 0.016). CONCLUSIONS: In medical students with AR, the most effected parameter in mini-RQLQ was practical problems. The adherence to regular medical treatment was low. Patients suffering more severe nose symptoms showed better compliance with therapy.
1016
TUESDAY
Co-morbidity and Health-Related Quality of Life in NonAllergic Rhinitis C. Rondon1, I. Don˜a1, M. Torres1, P. Campo1, J. Romero1, P. Chaves2, J. Cornejo2, M. Blanca1; 1Carlos Haya Hospital, Ma´laga, Spain, 2Carlos Haya Hospital-Fundacion IMABIS, Ma´laga, Spain. RATIONALE: Allergic rhinitis (AR) is frequently associated to other comorbidities, and has a great impact on the quality of life of patients; however, few data are available in non-allergic rhinitis (NAR). The purpose of this study was to determinate the persistence of symptoms, co-morbidities and health-related quality of life (HRQOL) in non-allergic rhinitis (NAR) and compare to AR patients. METHODS: A cross-sectional study was conducted among rhinitis patients in our allergy service. SPT, serum specific-IgE, and clinical, sociodemographic, co-morbidity and HRQOL questionnaires were performed. RESULTS: A total of 110 NAR patients and 282 AR patients were randomly selected. Patients with NAR showed a predominance of women (NAR: 74,5%, AR: 55,5%, p < 0.05), non-smokers, no family history of atopy, and lived in the city or on the coast. According to ARIA classification the majority of NAR patients reported persistent symptoms and moderate-severe rhinitis. Co-morbidities data showed that an important number of NAR patients associated conjunctivitis (45.5%) and sinusitis (30.5%) and bronchial asthma (18.8%) but less frequently than AR patients (57.8%, 39.6%, p < 0.05). NAR patients showed a higher impair of HRQOL (99.1%) compared with AR patients (89’7%, p < 0.05), affecting general symptoms, emotional, job and sleep domains. AR were affected practical daily problems, leisure and home working domains more frequently than NAR. CONCLUSIONS: The most subjects with NAR showed moderate-severe rhinitis with persistent symptoms, associated to conjunctivitis and impairment of HRQOL more frequently than AR patients. More studies with a greater number of subjects are needed to cofirm these findings.
J ALLERGY CLIN IMMUNOL FEBRUARY 2009
1017
Abnormal Pulmonary Function Test in Children with Allergic Rhinitis due to House Dust Mites Y. Rha1, S. Choi2; 1Kyung Hee Medical Center, Seoul, Republic of Korea, 2 Kyung Hee East West Neo-Medical Center, Seoul, Republic of Korea. RATIONALE: Many epidemiological studies have shown that asthma and rhinitis co-exist frequently and rhinitis patients may have abnormal airway function as demonstrated by an obstruction in the large or small airways. The purpose of this study was to investigate the presence of spirometric impairment in children with perennial allergic rhinitis due to HDM, without underlying asthma. METHODS: A cross-sectional study was performed. Seventy-five children with moderate/severe persistent allergic rhinitis due to HDM without asthma were assessed. The control group consisted of 20 matched healthy subjects. The forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), PEF, and forced expiratory flow at 25% to 75% of FVC (FEF25-75) were determined by spirometry. RESULTS: Expiratory airflow parameters including FVC, FEV1, PEFR were similar in both groups, however FEF25-75 were significantly lower in children with perennial allergic rhinitis due to HDM (p < 0.05). CONCLUSIONS: This study provides evidence that there is a reduction of FEF25-75 which could be a marker for early inflammatory involvement of the small airways in children with perennial allergic rhinitis due to HDM, without underlying asthma. Clinical and functional follow-up of these patients should assess the long-term consequences of this parameter and their clinical importance.
1018
Evaluating Pulmonary Function with Ciclesonide 80 mG Twice Daily or 160 mG Once Daily in the Morning in Patients with Mild-to-moderate Asthma Not Using an Inhaled Corticosteroid E. Kerwin1, W. Andrews2, A. Pedinoff3; 1Clinical Research Institute of Southern Oregon, Medford, OR, 2Sepracor, Marlborough, MA, 3Princeton Center for Clinical Research, Skillman, NJ. RATIONALE: To assess whether pulmonary function improvements and decreases in albuterol use in patients with mild-to-moderate asthma treated with ciclesonide varies by baseline FEV1. METHODS: This was a multicenter, double-blind, placebo-controlled, parallel-group study. Patients aged 12 years (FEV1 60-85% predicted) with uncontrolled persistent asthma were randomized to ciclesonide 80 mg twice daily (CIC80bid; n 5 170), ciclesonide 160 mg once daily (CIC160qd; n 5 173) or placebo (n 5 177) for 16 weeks or CIC80bid for 4 weeks followed by CIC160qd for 12 weeks (CIC80/160; n 5 171). Exclusion criteria included oral corticosteroid use 6 months and/or ICS use 30 days before screening. The primary endpoint was change in morning FEV1 from baseline to the average of Weeks 12 and 16. Albuterol use was assessed from baseline to Week 16. RESULTS: In the subgroup of patients with baseline FEV1 70% predicted, FEV1 significantly improved with CIC80bid versus placebo (10.22L [p 5 0.0004]) and showed numerically greater increases for CIC160qd (10.07L [p 5 0.2554]) and CIC80/160 (10.10L [p 5 0.0853]). In patients with baseline FEV1 >70% predicted, FEV1 improved significantly in all ciclesonide groups versus placebo (CIC80bid, 0.26L [p <0.0001]; CIC160qd, 0.17L [p 5 0.0019]; CIC80/160, 0.13L [p 5 0.0166]). Albuterol use was significantly reduced versus placebo in all ciclesonide groups in both baseline FEV1 subgroups (p 0.0360) except for the CIC160qd group with FEV1 70% predicted. CONCLUSIONS: In patients not currently using an ICS with baseline FEV1 >70% predicted, CIC80bid and CIC160qd significantly improved pulmonary function and decreased albuterol use versus placebo. In patients with a lower baseline FEV1 (70% predicted), only the CIC80bid significantly improved pulmonary function and albuterol use versus placebo.
1015
Prevalence of Allergic Rhinitis among Medical School Students in Edirne (Turkey) and the Impact of Symptoms on Quality of Life M. Yazicioglu1, S. Yildirim1, H. Celik1, B. Kaptan1, B. Teloren1, H. Aylanc1, M. Ture2; 1Department of Pediatrics, Trakya University, Edirne, Turkey, 2Department of Biostatistics, Trakya University, Edirne, Turkey. RATIONALE: To investigate the self-reported prevalence of symptoms, diagnosis, treatment of allergic rhinitis (AR) and its impact on quality of life among medical school students in Trakya University (Edirne, Turkey). METHODS: A questionnaire based on ISAAC core questions on rhinitis, with additional questions on medicine used and treatment adherence was distributed to medical students. Health-related quality of life was assessed using the Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ). RESUTS: Of 915 questionnaires distributed, 599 were utilized. The prevalence of symptoms in the past year and the lifetime was 23.9% and 25.5%, respectively. Prior physician diagnoses existed for 44 of 599 (7.35%) students. Mini-RQLQ scores for activity limitations, practical problems, nose symptoms, eye symptoms, non-nose/eye symptoms were 1.5 6 1.3, 2.7 6 1.4, 2.4 6 1.6, 1.7 6 1.6, and 2.1 6 1.6, respectively. The most commonly used drugs were antihistamines (30.1%), decongestants (25.2%), and nasal steroids (23.1%). Forty-two percent of the cases were compliant to prescribed treatment. Patients reporting high scores for nose symptom in mini-RQLQ were more compliant to regular treatment (p 5 0.016). CONCLUSIONS: In medical students with AR, the most effected parameter in mini-RQLQ was practical problems. The adherence to regular medical treatment was low. Patients suffering more severe nose symptoms showed better compliance with therapy.
1016
TUESDAY
Co-morbidity and Health-Related Quality of Life in NonAllergic Rhinitis C. Rondon1, I. Don˜a1, M. Torres1, P. Campo1, J. Romero1, P. Chaves2, J. Cornejo2, M. Blanca1; 1Carlos Haya Hospital, Ma´laga, Spain, 2Carlos Haya Hospital-Fundacion IMABIS, Ma´laga, Spain. RATIONALE: Allergic rhinitis (AR) is frequently associated to other comorbidities, and has a great impact on the quality of life of patients; however, few data are available in non-allergic rhinitis (NAR). The purpose of this study was to determinate the persistence of symptoms, co-morbidities and health-related quality of life (HRQOL) in non-allergic rhinitis (NAR) and compare to AR patients. METHODS: A cross-sectional study was conducted among rhinitis patients in our allergy service. SPT, serum specific-IgE, and clinical, sociodemographic, co-morbidity and HRQOL questionnaires were performed. RESULTS: A total of 110 NAR patients and 282 AR patients were randomly selected. Patients with NAR showed a predominance of women (NAR: 74,5%, AR: 55,5%, p < 0.05), non-smokers, no family history of atopy, and lived in the city or on the coast. According to ARIA classification the majority of NAR patients reported persistent symptoms and moderate-severe rhinitis. Co-morbidities data showed that an important number of NAR patients associated conjunctivitis (45.5%) and sinusitis (30.5%) and bronchial asthma (18.8%) but less frequently than AR patients (57.8%, 39.6%, p < 0.05). NAR patients showed a higher impair of HRQOL (99.1%) compared with AR patients (89’7%, p < 0.05), affecting general symptoms, emotional, job and sleep domains. AR were affected practical daily problems, leisure and home working domains more frequently than NAR. CONCLUSIONS: The most subjects with NAR showed moderate-severe rhinitis with persistent symptoms, associated to conjunctivitis and impairment of HRQOL more frequently than AR patients. More studies with a greater number of subjects are needed to cofirm these findings.
J ALLERGY CLIN IMMUNOL FEBRUARY 2009
1017
Abnormal Pulmonary Function Test in Children with Allergic Rhinitis due to House Dust Mites Y. Rha1, S. Choi2; 1Kyung Hee Medical Center, Seoul, Republic of Korea, 2 Kyung Hee East West Neo-Medical Center, Seoul, Republic of Korea. RATIONALE: Many epidemiological studies have shown that asthma and rhinitis co-exist frequently and rhinitis patients may have abnormal airway function as demonstrated by an obstruction in the large or small airways. The purpose of this study was to investigate the presence of spirometric impairment in children with perennial allergic rhinitis due to HDM, without underlying asthma. METHODS: A cross-sectional study was performed. Seventy-five children with moderate/severe persistent allergic rhinitis due to HDM without asthma were assessed. The control group consisted of 20 matched healthy subjects. The forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), PEF, and forced expiratory flow at 25% to 75% of FVC (FEF25-75) were determined by spirometry. RESULTS: Expiratory airflow parameters including FVC, FEV1, PEFR were similar in both groups, however FEF25-75 were significantly lower in children with perennial allergic rhinitis due to HDM (p < 0.05). CONCLUSIONS: This study provides evidence that there is a reduction of FEF25-75 which could be a marker for early inflammatory involvement of the small airways in children with perennial allergic rhinitis due to HDM, without underlying asthma. Clinical and functional follow-up of these patients should assess the long-term consequences of this parameter and their clinical importance.
1018
Evaluating Pulmonary Function with Ciclesonide 80 mG Twice Daily or 160 mG Once Daily in the Morning in Patients with Mild-to-moderate Asthma Not Using an Inhaled Corticosteroid E. Kerwin1, W. Andrews2, A. Pedinoff3; 1Clinical Research Institute of Southern Oregon, Medford, OR, 2Sepracor, Marlborough, MA, 3Princeton Center for Clinical Research, Skillman, NJ. RATIONALE: To assess whether pulmonary function improvements and decreases in albuterol use in patients with mild-to-moderate asthma treated with ciclesonide varies by baseline FEV1. METHODS: This was a multicenter, double-blind, placebo-controlled, parallel-group study. Patients aged 12 years (FEV1 60-85% predicted) with uncontrolled persistent asthma were randomized to ciclesonide 80 mg twice daily (CIC80bid; n 5 170), ciclesonide 160 mg once daily (CIC160qd; n 5 173) or placebo (n 5 177) for 16 weeks or CIC80bid for 4 weeks followed by CIC160qd for 12 weeks (CIC80/160; n 5 171). Exclusion criteria included oral corticosteroid use 6 months and/or ICS use 30 days before screening. The primary endpoint was change in morning FEV1 from baseline to the average of Weeks 12 and 16. Albuterol use was assessed from baseline to Week 16. RESULTS: In the subgroup of patients with baseline FEV1 70% predicted, FEV1 significantly improved with CIC80bid versus placebo (10.22L [p 5 0.0004]) and showed numerically greater increases for CIC160qd (10.07L [p 5 0.2554]) and CIC80/160 (10.10L [p 5 0.0853]). In patients with baseline FEV1 >70% predicted, FEV1 improved significantly in all ciclesonide groups versus placebo (CIC80bid, 0.26L [p <0.0001]; CIC160qd, 0.17L [p 5 0.0019]; CIC80/160, 0.13L [p 5 0.0166]). Albuterol use was significantly reduced versus placebo in all ciclesonide groups in both baseline FEV1 subgroups (p 0.0360) except for the CIC160qd group with FEV1 70% predicted. CONCLUSIONS: In patients not currently using an ICS with baseline FEV1 >70% predicted, CIC80bid and CIC160qd significantly improved pulmonary function and decreased albuterol use versus placebo. In patients with a lower baseline FEV1 (70% predicted), only the CIC80bid significantly improved pulmonary function and albuterol use versus placebo.