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Is response to allergen immunotherapy a good phenotypic marker for differentiating between allergic rhinitis and mixed rhinitis?

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Abstract:

This study was designed to determine if patients with allergic rhinitis (AR) and mixed rhinitis (MR) subtypes have similar treatment outcomes after a full course of allergen immunotherapy (AIT). A historical pre- and posttreatment study design was used to identify all AR patients in a large allergy practice who started AIT in 2001 and completed at least a 3-year course. One reviewer compiled data through chart review using a standardized form that recorded allergic and nonallergic irritant triggers, symptoms, and medication requirements before and after completion of ≥3 years of AIT. Other than age, there were no significant differences in baseline demographic characteristics, allergic triggers, or rhinitis symptoms between the AR and MR groups. Both groups experienced reduced episodes of sinusitis after AIT. Although both groups also had a significant decrease in the mean number of rhinitis medications after AIT (p < 0.001), the reduction in number of medications was significantly greater for the AR versus the MR group (1.24 ± 1.09 versus 2.09 ± 1.55; p = 0.0023). AIT is a very effective treatment for AR and MR patients. However, these data support the classification of MR as a distinct rhinitis phenotype because MR patients required significantly more medications after a full course of AIT to control their nonallergic-induced symptoms.

Keywords: Allergic rhinitis; immunotherapy; irritant triggers; mixed rhinitis; outcomes; phenotypes; treatment

Document Type: Research Article

DOI: https://doi.org/10.2500/aap.2011.32.3400

Affiliations: Division of Immunology, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Publication date: 2011-01-01

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  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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