Relationship between specific rhinitis symptom and control status of asthma
Hiroyuki Nagase1, Naoya Sugimoto1, Yuuta Koizumi1, Yusuke Tanaka1, Hisanao Yoshihara1, Michio Kuramochi1, Hidenori Arai1, Masao Yamaguchi1 and Ken Ohta2
1Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan, 2Department of Respiratory Medicine, National Hospital Organization Tokyo National Hospital, Kiyose, Japan
Introduction: Epidemiological studies have revealed that asthma and rhinitis frequently coexist and severity of nasal symptoms is associated with asthma severity. But it has been unclear what kind of nasal symptom is related to asthma severity.
Aim: The aim of the present study is to investigate the relationship between specific rhinitis symptom and control status of asthma.
Method: One hundred and nineteen asthma patients with specific serum IgE were recruited. The Self Assessment of Allergic Rhinitis and Asthma (SACRA) questionnaire, which GINA and ARIA Japan committees developed, was used for the diagnosis and assessment of severity by visual analogue scale (VAS). SACRA also ask specific rhinitis symptoms defined in ARIA, including rhinorrhea, nasal obstruction, sneezing, itchy nose, and conjunctivitis.
Result: Seventy-five asthma patients (63%) had more than one rhinitis symptoms. Visual analogue scale of rhinitis and asthma was positively correlated irrespective of rhinitis treatment. Although there were no significant differences in asthma VAS between patients with one (n=21, 11.7 mm) and two rhinitis symptoms, asthma VAS was significantly worse in patient with three rhinitis symptoms (n=18, 44.8 mm). Among five rhinitis symptoms, nasal obstruction was the most contributing factor (odds ratio 4.18 (1.28-14.7)) to asthma VAS>30 mm, which suggest insufficient control of asthma.
Conclusions: Nasal obstruction was most related to insufficient control of asthma suggesting the common underlying pathway between nasal obstruction and poor asthma control. Asking and treating nasal obstruction in daily practice might be potentially important to improve asthma control.