Lack of control of severe asthma is associated with co-existence of moderate-to-severe rhinitis.
BACKGROUND
Retrospective studies provide evidence that rhinitis is associated with more severe asthma. The aim of this study was to evaluate prospectively whether rhinitis is a predictor of increased asthma severity.


METHODS
Five hundred and fifty-seven patients with severe asthma were enrolled. During 1 year of follow-up, each patient was evaluated every 3 months with a record of emergency room visits and supply of topical corticosteroids for asthma and rhinitis. In the 1 year of follow-up visit, the patients were checked for rhinitis diagnosis, severity and answered questionnaires for asthma symptoms and quality of life.


RESULTS
Eighty-two (15%) patients had no rhinitis, 299 (54%) had mild rhinitis and 176 (31%) moderate/severe rhinitis. In logistic regression models, moderate/severe rhinitis was a predictor for any emergency room visit in the follow-up period [3.83 (2.00-7.35)], for the presence of uncontrolled asthma after 1 year of follow-up [12.68 (1.73-92.85)], for <10% improvement of the airway obstruction [2.94 (1.48-5.85)] and <50% reduction in the number of emergency room visits [2.90 (1.02-8.26)] in the year of follow-up. It was also associated with a smaller chance of more than 90% reduction in the number of emergency room visits in the year of follow-up [0.27 (0.12-0.60)]. In a multivariate linear regression model, severity of rhinitis was positively correlated with a score of asthma severity and inversely correlated to an index of quality of life.


CONCLUSIONS
In a population with severe asthma, moderate/severe rhinitis is a strong predictor for greater severity of asthma.
Ponte
E V
EV
Universidade Federal da Bahia - Programa de Pós Graduação em Medicina e Saúde, Rua Padre Feijó, Canela, Salvador, Bahia, Brazil.
Franco
R
R
Nascimento
H F
HF
Souza-Machado
A
A
Cunha
S
S
Barreto
M L
ML
Naspitz
C
C
Cruz
A A
AA
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011788:Quality of Life; D012129:Respiratory Function Tests; D012220:Rhinitis / Q000175:diagnosis / Q000503:physiopathology; D012720:Severity of Illness Index; D012882:Skin Tests; D011795:Surveys and Questionnaires
D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents