Rhinitis therapy and the prevention of hospital care for asthma: a case-control study.
BACKGROUND
Although clinical trials have demonstrated that rhinitis therapy improves subjective and objective measures of asthma, it is uncertain whether treatment of allergic rhinitis significantly affects the frequency of asthma exacerbations.


OBJECTIVE
The objective of this study was to determine whether treatment with intranasal corticosteroids and/or second-generation antihistamines is associated with changes in rates of asthma exacerbations resulting in emergency room visits and/or hospitalizations in patients with asthma and allergic rhinitis.


METHODS
This was a nested, case-control study.


RESULTS
Treatment with either nasal corticosteroids or second-generation antihistamines was associated with a lower risk of asthma-related emergency room treatment and hospitalization (adjusted odds ratio [OR], 0.51; 95% CI, 0.34 to 0.77 and 0.34, 0.18 to 0.62, respectively). Patients who used nasal corticosteroids had a significantly lower risk of both asthma-related emergency room treatment and hospitalization (adjusted OR, 0.75; 95% CI, 0.62 to 0.91 and 0.56, 0.42 to 0.76, respectively), whereas there was a trend toward lower risk of emergency room treatment and hospitalization in patients who used second-generation antihistamines (adjusted OR, 0.88; 95% CI, 0.62 to 1.26 and 0.68, 0.40 to 1.14, respectively). Combined treatment with both medications was associated with a further lowering of the risk of both emergency room treatment and hospitalization (adjusted OR, 0.37; 95% CI, 0.19 to 0.73 and 0.22, 0.07 to 0.63).


CONCLUSIONS
In patients with asthma, treatment of concomitant allergic rhinitis was associated with significant reductions in risk of emergency room treatment and hospitalization for asthma.
Allergy Research Foundation, Los Angeles, CA 90025, USA.
Jonathan
J
Corren
Beatrice E
BE
Manning
Stephen F
SF
Thompson
Sean
S
Hennessy
Brian L
BL
Strom
D000281:Administration, Intranasal; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D001249:Asthma / Q000150:complications* / Q000517:prevention & control / Q000628:therapy; D016022:Case-Control Studies; D002648:Child; D004632:Emergency Medical Services; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012221:Rhinitis, Allergic, Perennial / Q000150:complications* / Q000188:drug therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications* / Q000188:drug therapy*
D000305:Adrenal Cortex Hormones; D039563:Histamine H1 Antagonists, Non-Sedating