title: Allergic Rhinitis Control Test questionnaire-driven stepwise strategy to improve allergic rhinitis control: a prospective study.
abstract: Allergic Rhinitis Control Test (ARCT) has been validated for assessing allergic rhinitis (AR) control and identifying severe AR. The aim of the study was to assess the ARCT questionnaire as a tool for stepwise pharmacotherapy.
  
  
  
  A standard pharmacotherapy regimen from Step 1 (oral second-generation H1 antihistamine as needed) to Step 5 (oral corticosteroid) was carried out prospectively in a Chinese AR population. The AR patients were initiated with Allergic Rhinitis and its Impact on Asthma (ARIA) appropriate step treatment and assessed with ARCT every 15 days. If ARCT score was equal or above 20 (controlled AR) and maintained for 15 days, the patient would finish the study; if ARCT score was strictly <20 (uncontrolled AR), the patient would receive higher step treatment according to a predefined open design up to Step 5. The different AR control subgroups were compared.
  
  
  
  A total of 255 patients were enrolled in the study; 5 patients dropped out and 2 (0.8%) were controlled at day 0, 85 (34.0%) at day 15, 177 (70.8%) at day 30, 222 (88.8%) at day 45, 241 (96.4%) at day 60 and 242 (96.8%) at day 75. Only 8 (3.2%) patients remained uncontrolled at the endpoint of the study. Patients with ARIA moderate/severe or persistent symptoms, moderate/severe impaired quality of life, asthma history, rhinorrhea and cough symptoms always needed up to Step 4 (nasal corticosteroid plus antihistamine) and prolonged treatments to achieve disease control.
  
  
  
  The majority of AR can be controlled with standard stepwise treatment. ARCT offers an objective criterion for the stepwise pharmacotherapy of AR.
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.|Allergy Division, Pulmonology Department, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier Cedex 5, France.|Laboratory of Biostatistics, Epidemiology and Public Health (EA2415), University of Montpellier, Montpellier Cedex 5, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: R
authors.initials: R
authors.lastname: Zhu
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: G
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: N
authors.initials: N
authors.lastname: Huang
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: L
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: S
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: S
authors.initials: S
authors.lastname: Qi
authors.affiliation: Laboratory of Biostatistics, Epidemiology and Public Health (EA2415), University of Montpellier, Montpellier Cedex 5, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Daurès
authors.affiliation: Allergy Division, Pulmonology Department, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier Cedex 5, France.|UPMC Paris 06, UMR-S 1136 INSERM, IPLESP, Equipe EPAR, Sorbonne Universités, Paris, France.
authors.forename: A M
authors.initials: AM
authors.lastname: Chiriac
authors.affiliation: Allergy Division, Pulmonology Department, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier Cedex 5, France. pascal.demoly@inserm.fr.|UPMC Paris 06, UMR-S 1136 INSERM, IPLESP, Equipe EPAR, Sorbonne Universités, Paris, France. pascal.demoly@inserm.fr.
authors.forename: P
authors.initials: P
authors.lastname: Demoly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D062486:Public Health Surveillance; D011788:Quality of Life; D065631:Rhinitis, Allergic / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control* / Q000628:therapy; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018926:Anti-Allergic Agents
keywords: Allergic Rhinitis Control Test; allergic rhinitis; allergic rhinitis and its impact on asthma; classification; stepwise pharmacotherapy