title: Allergic rhinitis and asthma comorbidity: ARIA classification of rhinitis does not correlate with the prevalence of asthma.
abstract: BACKGROUND
  Allergic rhinitis and asthma comorbidity is supported by both the similar underlying pathogenesis and immunologic mechanisms. The aim of this study was to verify whether the characteristics of rhinitis classified according to the new Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines correlate with the prevalence of asthma.
  
  
  METHODS
  From 1 March to 30 June 2002, a multi-centre cross-sectional study was conducted by 154 allergists chosen from throughout Italy. Duration, severity of rhinitis (according to the ARIA classification) and the type of allergic sensitizations were compared with the prevalence of asthma.
  
  
  RESULTS
  One thousand three hundred and twenty-one consecutive rhinitis-allergic patients aged 18 years or older were enrolled for the study. The majority of patients, 1060 (80.24%), were on medication at the time of their specialist visit. Mild intermittent rhinitis was diagnosed in 7.7% of patients, moderate/severe intermittent in 17.1%, mild persistent in 11.6%, and moderate/severe persistent in 63.6%. The prevalence of asthma was 48% in patients with mild intermittent rhinitis, 49.6% in moderate-severe intermittent rhinitis, 36.6% in mild persistent rhinitis and 47.5% in moderate severe persistent patients. No correlation between the ARIA categories of rhinitis and the prevalence of asthma was found. A multivariate analysis, after adjustment for age, sex, type of sensitization, level of severity and duration of rhinitis classified according to the ARIA guidelines, demonstrated that age, over 41 years [risk ratio (RR) 1.260, 95% confidence interval (CI) 1.072-1.482] and especially over 51 years (RR 1.460, 95% CI 1.237-1.723), sensitization to indoor allergens (mite and cat), (RR 1.203, 95% CI 1.060-1.366), and polysensitization (RR 1.178, 95% CI 1.004-1.383) are significant risk factors for asthma.
  
  
  CONCLUSIONS
  In allergic rhinitis (AR) patients referred to a specialist, the features of AR as defined by the ARIA classification are not able to predict the presence of asthma, therefore all such patients should be assessed for asthma.
authors.affiliation: Allergy Unit, Department of Internal Medicine, Immuno-Allergic and Respiratory Diseases, Ospedali Riuniti di Ancona, Ancona, Italy. l.antonicelli@ao-umbertoprimo.marche.it
authors.forename: L
authors.initials: L
authors.lastname: Antonicelli
authors.forename: C
authors.initials: C
authors.lastname: Micucci
authors.forename: S
authors.initials: S
authors.lastname: Voltolini
authors.forename: V
authors.initials: V
authors.lastname: Feliziani
authors.forename: G E
authors.initials: GE
authors.lastname: Senna
authors.forename: P
authors.initials: P
authors.lastname: Di Blasi
authors.forename: G
authors.initials: G
authors.lastname: Visonà
authors.forename: R
authors.initials: R
authors.lastname: De Marco
authors.forename: F
authors.initials: F
authors.lastname: Bonifazi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015995:Prevalence; D006255:Rhinitis, Allergic, Seasonal / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D012307:Risk Factors; D012737:Sex Factors; D015599:Trauma Severity Indices
chemical_list: D000485:Allergens