title: Treatment and outcomes in patients with asthma and allergic rhinitis in the United kingdom.
abstract: BACKGROUND
  Since allergic rhinitis in asthma patients is associated with worse asthma control, the treatment of the comorbid condition may improve outcomes.
  
  
  METHODS
  A 1-year retrospective study using the UK Mediplus database (2001-2004) included asthmatic patients aged 15-55 with allergic rhinitis. Patients starting therapy based on the Global Initiative for Asthma guidelines, defined as an increase in inhaled corticosteroids (high-dose inhaled corticosteroids, hdICS), or the addition of montelukast (ICS+MON) or long-acting beta-agonists (ICS+LABA) to ICS, were studied. Univariable and multiple logistic regressions evaluated asthma-related outcomes.
  
  
  RESULTS
  Among 2,596 asthma and allergic rhinitis patients, 83.2% initiated ICS+LABA, 12.1% hdICS and 4.7% ICS+MON. The mean age was 34 years and 60% were female. ICS+MON patients had more moderate-severe asthma (p = 0.04). Approximately 84% of the ICS+LABA patients experienced an asthma control failure compared to 50% in the other groups (p < 0.0001). The proportions of patients requiring treatment change were 73.8, 22 and 27.3% in the ICS+LABA, hdICS and ICS+MON groups, respectively (p = 0.001). Asthma-related resource use was similar among all groups. The ICS+MON group received fewer mean prescriptions for oral corticosteroids (p = 0.024) than the other groups (p = 0.026).
  
  
  CONCLUSIONS
  In asthma and allergic rhinitis, treatment with ICS+MON or hdICS was associated with lower rates of asthma control failure and fewer treatment changes than the ICS+LABA group. MON users also required fewer oral corticosteroids.
authors.affiliation: Merck & Co., Whitehouse Station, NJ 08889-0100, USA. qiaoyi_zhang@merck.com
authors.forename: Qiaoyi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Michael
authors.initials: M
authors.lastname: Thomas
authors.forename: Tami
authors.initials: T
authors.lastname: Wisniewski
authors.forename: Vasilisa
authors.initials: V
authors.lastname: Sazonov Kocevar
authors.forename: David
authors.initials: D
authors.lastname: Price
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D000730:Androstadienes / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology; D001507:Beclomethasone / Q000627:therapeutic use; D019819:Budesonide / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D003521:Cyclopropanes; D004359:Drug Therapy, Combination; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D008875:Middle Aged; D011804:Quinolines / Q000627:therapeutic use; D012220:Rhinitis / Q000188:drug therapy* / Q000453:epidemiology; D013440:Sulfides; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000085:Acetates; D000318:Adrenergic beta-Agonists; D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D011804:Quinolines; D013440:Sulfides; D019819:Budesonide; D000068298:Fluticasone; D001507:Beclomethasone; C093875:montelukast