Determinants of Incomplete Asthma Control in Patients with Allergic Rhinitis and Asthma

详细信息    查看全文

• 作者：Asako Oka ; MD ; PhD^a ; Tsunahiko Hirano ; MD ; PhD^b ; ^{tsuna@yamaguchi-u.ac.jp} ; Yoshikazu Yamaji ; MD^b ; Kosuke Ito ; MD^b ; Keiji Oishi ; MD ; PhD^c ; Nobutaka Edakuni ; MD ; PhD^b ; Reo Kawano ; MS^d ; Kazuto Matsunaga ; MD ; PhD^b
• 关键词：Airflow limitation ; Airway inflammation ; Atopy ; Exhaled nitric oxide ; Inhaled corticosteroids ; Nasal corticosteroids
• 刊名：The Journal of Allergy and Clinical Immunology: In Practice
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：5
• 期：1
• 页码：160-164
• 全文大小：323 K
• 卷排序：5

文摘

Characterizing associations between the upper and lower airways is important for asthma management.ObjectivesThis study aimed to assess the determinants of incomplete asthma control in patients with allergic rhinitis (AR) and asthma.MethodsMultiple factors including age, sex, atopy, smoking history, medication use, Asthma Control Questionnaire (ACQ) score, FEV1, fraction of exhaled nitric oxide (Feno), and rhinitis questionnaire score were examined. AR was defined by rhinitis symptoms and the sensitization to inhaled allergens. ACQ was used to dichotomize the subjects into the incompletely controlled group (ACQ score ≥0.75) and the well-controlled group. The factors that contribute to incomplete asthma control were assessed by a multivariate analysis.ResultsA total of 260 patients with AR and asthma were enrolled and 108 patients (42%) were classified as incomplete asthma control. The incompletely controlled group was older (P < .05), and had more airflow limitation, more airway inflammation, and more severe rhinitis symptoms (all P < .001). In contrast, the well-controlled group was more likely to be taking nasal corticosteroids (NCSs) (P < .01). In a multivariate model adjusted by age, asthma treatment, airflow limitation, and Feno, persistence and severity of rhinitis (odds ratio [OR], 2.57; 95% CI, 1.41-4.70, and OR, 2.00; 95% CI, 1.10-3.65) and nonuse of NCSs (OR, 3.83; 95% CI, 1.50-9.81) were independently associated with incomplete asthma control.ConclusionsThe persistence and severity of AR and the use of NCSs were associated with the level of asthma control in patients with AR and asthma. Further studies are required to determine whether appropriate treatment of rhinitis would improve asthma control.