Allergic rhinitis; Asthma; mHealth; Humans; Male; Female; Adult; Cross-Sectional Studies; Middle Aged; Severity of Illness Index; Young Adult; Adolescent; Comorbidity; Aged; Asthma/epidemiology; Rhinitis, Allergic/epidemiology; Rhinitis, Allergic; Immunology and Allergy; Immunology
Abstract :
[en] [en] BACKGROUND AND OBJECTIVES: The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines classify rhinitis as "intermittent" or "persistent" and "mild" or "moderate-severe". Objectives: To assess ARIA classes in a real-world study in terms of phenotypic differences and their association with asthma.
METHODS: We performed a cross-sectional real-world study based on users of the MASK-air® app who reported data for at least 3 different months. We assessed the frequency of users according to the ARIA classes and compared these classes in terms of rhinitis symptoms, use of comedication, frequency of comorbid asthma, and the association between comorbid asthma and rhinitis control.
RESULTS: A total of 2273 users (180 796 days) were assessed. Most users had moderate-severe rhinitis (n=2003; 88.1%) and persistent rhinitis (n=1144; 50.3%). The frequency of patients with probable asthma was 35.7% (95%CI, 34.5%-37.0%) for intermittent rhinitis and 48.5% (95%CI, 47.1%-49.9%) for persistent rhinitis. The maximum values on the visual analog scale (VAS) for rhinitis symptoms and the combined symptom-medication score were lower in patients with mild rhinitis than in those with moderate-severe rhinitis (irrespective of whether they had persistent or intermittent rhinitis). In most ARIA classes, VAS nose and VAS eye and rhinitis comedication were more frequent in patients with rhinitis+asthma than in those with rhinitis alone.
CONCLUSIONS: This study suggests that the presence of asthma is more closely related to persistence of rhinitis than to severity and that the presence of comorbid asthma may be associated with poorer control of rhinitis across the different ARIA classes.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Sousa-Pinto, B; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal ; CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
Savouré, M; Université de Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
Vieira, R J; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal ; CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
Amaral, R; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal ; CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal ; Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal ; Department of Women´s and Children´s Health, Paediatric Research, Uppsala University, Uppsala, Sweden
Czarlewski, W; Medical Consulting Czarlewski, Levallois, France ; MASK-air, Montpellier, France ; ARIA, Montpellier, France
Bedbrook, A; MASK-air, Montpellier, France ; ARIA, Montpellier, France
Valiulis, A; Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania ; Clinic of Asthma, Allergy and Chronic Lung Diseases, Vilnius, Lithuania
Kvedariene, V; Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania ; Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
Brussino, L; Department of Medical Sciences, University of Torino, Torino, Italy ; Allergy and Clinical Immunology Unit, Mauriziano Hospital, Torino, Italy
Gemicioglu, B; Department of Pulmonary Diseases, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey ; Institute of Pulmonology and Tuberculosis, Istanbul University-Cerrahpaşa, Istanbul, Turkey
Haahtela, T; Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
Klimek, L; Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany ; Center for Rhinology and Allergology, Wiesbaden, Germany
Kraxner, H; Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
Larenas-Linnemann, D E; Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
Pfaar, O; Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
Regateiro, F S; Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal ; Center for Innovative Biomedicine and Biotechnology (CIBB), Faculty of Medicine, University of Coimbra, Portugal ; Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal ; UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
Samolinski, B; Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
Taborda-Barata, L; UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal ; Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
Toppila-Salmi, S; Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland ; Department of Allergy, Skin and Allergy Hospital, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Ventura, M T; Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy ; Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy
Ansotegui, I J; Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
Braido, F; Department of Internal Medicine (DIM), University of Genoa, Genoa, Italy ; Respiratory and Allergy Clinic, IRCCS - Policlinico San Martino, Genoa, Italy
Canonica, G W; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy ; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
Cecchi, L; SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
Cruz, A A; Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
Devillier, P; VIM Suresnes, UMR 0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
Fokkens, W J; Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands
Gil-Mata, S; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal ; CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
Giuliano, A Fm; Department of Internal Medicine ´A. Murri´ and Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
Ivancevich, J C; Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
Kuna, P; Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
Kupczyk, M; Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
Louis, Gilles ; Université de Liège - ULiège > Département des sciences cliniques > Pneumologie - Allergologie
Louis, Renaud ; Université de Liège - ULiège > Département des sciences cliniques > Pneumologie - Allergologie
Makris, M; Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece
Morais-Almeida, M; Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal
Mullol, J; Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
Nadif, R; Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France ; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France
Niedoszytko, M; Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
Okamoto, Y; Chiba Rosai Hospital, Chiba, Japan ; Chiba University Hospital, Chiba, Japan
Ollert, M; Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg ; Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
Papadopoulos, N G; Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
Patella, V; Division of Allergy and Clinical Immunology, Department of Medicine, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy ; Agency of Health ASL, Salerno, Italy ; Postgraduate Programme in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy
Pawankar, R; Department of Pediatrics, Nippon Medical School, Tokyo, Japan
Pereira, A M; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal ; CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal ; Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
Pétré, Benoît ; Université de Liège - ULiège > Département des sciences de la santé publique > Education thérapeutique du patient au service des soins intégrés
Pham-Thi, N; Ecole Polytechnique de Palaiseau, Palaiseau, France ; IRBA (Institut de Recherche Bio-Médicale des Armées), Brétigny sur Orge, France ; Université Paris Cité, Paris, France
Roche, N; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France ; Pneumologie, AP-HP Centre Université de Paris Cité, Hôpital Cochin, Paris, France ; UMR 1016, Institut Cochin, Paris, France
Rouadi, P W; Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon ; Department of Otorhinolaryngology-Head and Neck Surgery, Dar Al Shifa Hospital, Salmiya, Kuwait
Sastre, J; Allergy Service, Fundación Jiménez Díaz, Autónoma University of Madrid, CIBERES-ISCIII, Madrid, Spain
Scichilone, N; PROMISE Department, University of Palermo, Palermo, Italy
Sheikh, A; Usher Institute, The University of Edinburgh, Edinburgh, UK
Sova, M; Department of Respiratory Medicine and Tuberculosis, University Hospital, Brno, Czech Republic
Todo-Bom, A; Imunoalergologia, Centro Hospitalar Universitário de Coimbra, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
Yorgancioglu, A; Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
Zidarn, M; University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia ; University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
Anto, J M; ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain ; Universitat Pompeu Fabra (UPF), Barcelona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
Zuberbier, T; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany ; Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
Fonseca, J A; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal ; CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
Bousquet, Jean ; MASK-air, Montpellier, France ; ARIA, Montpellier, France ; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France ; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany ; Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
Bousquet J, Van Cauwenberge P, Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001;108(5 Suppl):S147-334.
Ciprandi G, Capasso M. Association of childhood perennial allergic rhinitis with subclinical airflow limitation. Clin Exp Allergy. 2010;40(3):398-402.
Bousquet J, Annesi-Maesano I, Carat F, Leger D, Rugina M, Pribil C, et al. Characteristics of intermittent and persistent allergic rhinitis: DREAMS study group. Clin Exp Allergy. 2005;35(6):728-32.
del Cuvillo A, Montoro J, Bartra J, Valero A, Ferrer M, Jauregui I, et al. Validation of ARIA duration and severity classifications in Spanish allergic rhinitis patients-The ADRIAL cohort study. Rhinology. 2010;48(2):201-5.
Pite H, Pereira AM, Morais-Almeida M, Nunes C, Bousquet J, Fonseca JA. Prevalence of asthma and its association with rhinitis in the elderly. Respir Med. 2014;108(8):1117-26.
Antonicelli L, Braschi MC, Bresciani M, Bonifazi M, Baldacci S, Angino A, et al. The complex link between severity of asthma and rhinitis in mite allergic patients. Respir Med. 2013;107(1):23-9.
Moitra S, Simoni M, Baldacci S, Maio S, Angino A, Silvi P, et al. Symptom control and health-related quality of life in allergic rhinitis with and without comorbid asthma: A multicentre European study. Clin Transl Allergy. 2023;13(2):e12209.
Antonicelli L, Micucci C, Voltolini S, Feliziani V, Senna GE, Di Blasi P, et al. Allergic rhinitis and asthma comorbidity: ARIA classification of rhinitis does not correlate with the prevalence of asthma. Clin Exp Allergy. 2007;37(6):954-60.
Bousquet J, Anto JM, Sousa-Pinto B, Czarlewski W, Bedbrook A, Haahtela T, et al. Digitally-enabled, patient-centred care in rhinitis and asthma multimorbidity: The ARIA-MASK-air((R)) approach. Clin Transl Allergy. 2023;13(1):e12215.
Bousquet J, Bedbrook A, Czarlewski W, Onorato GL, Arnavielhe S, Laune D, et al. Guidance to 2018 good practice: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma. Clin Transl Allergy. 2019;9:16.
Integrating Care to Prevent and Manage Chronic Diseases: Best Practices in Public Health, OECD. Éditions OCDE, Paris, https://doiorg/101787/9acc1b1d-en. 2023.
Bousquet J, Sousa-Pinto B, Anto JM, Amaral R, Brussino L, Canonica GW, et al. Identification by cluster analysis of patients with asthma and nasal symptoms using the MASK-air(R) mHealth app. Pulmonology. 2022;29:292-305.
Digital consent around the world-Taylor Wessing’s Global Data Hub [Available from: https://globaldatahub. taylorwessing.com/article/digital-consent-around-the-world].
Bousquet J, Sousa-Pinto B, Regateiro FS, Pereira AM, Brussino L, Kvedariene V, et al. MASK-air(R) direct patient data support the ARIA-MeDALL hypothesis on allergic phenotypes. Allergy. 2023;78:2790-4.
Laune D, Arnavielhe S, Viart F, Bedbrook A, Mercier J, Lun San Luk G, et al. [Adaptation of the General Data Protection Regulation (GDPR) to a smartphone app for rhinitis and asthma (MASK-air(R))]. Rev Mal Respir. 2019;36(9):1019-31. French.
Samreth D, Arnavielhe S, Ingenrieth F, Bedbrook A, Onorato GL, Murray R, et al. Geolocation with respect to personal privacy for the Allergy Diary app-a MASK study. World Allergy Organ J. 2018;11(1):15.
Bousquet J, Agache I, Aliberti MR, Angles R, Annesi-Maesano I, Anto JM, et al. Transfer of innovation on allergic rhinitis and asthma multimorbidity in the elderly (MACVIA-ARIA)-Reference Site Twinning (EIP on AHA). Allergy. 2017;73(1):77-92.
Sousa-Pinto B, Azevedo LF, Jutel M, Agache I, Canonica GW, Czarlewski W, et al. Development and validation of combined symptom-medication scores for allergic rhinitis. Allergy. 2022;77(7):2147-62.
Bousquet J, Arnavielhe S, Bedbrook A, Bewick M, Laune D, Mathieu-Dupas E, et al. MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidence. Clin Transl Allergy. 2018;8:45.
Bousquet J, Arnavielhe S, Bedbrook A, Fonseca J, Morais Almeida M, Todo Bom A, et al. The ARIA score of allergic rhinitis using mobile technology correlates with quality-of-life: The MASK study. Allergy. 2018;73:505-10.
Bousquet J, Caimmi DP, Bedbrook A, Bewick M, Hellings PW, Devillier P, et al. Pilot study of mobile phone technology in allergic rhinitis in European countries: the MASK-rhinitis study. Allergy. 2017;72(6):857-65.
Bedard A, Basagana X, Anto JM, Garcia-Aymerich J, Devillier P, Arnavielhe S, et al. Treatment of allergic rhinitis during and outside the pollen season using mobile technology. A MASK study. Clin Transl Allergy. 2020;10(1):62.
Cohen J. Statistical Power Analysis for the Behavioral Sciences. New York: Taylor and Francis Group; 1988. 567 p.
Savoure M, Bousquet J, Leynaert B, Ribet C, Goldberg M, Zins M, et al. Asthma is associated with increased severity and duration of rhinitis: A study with the Allergic Rhinitis and its Impact on Asthma classes in the Constances cohort. Clin Transl Allergy. 2023;13(11):e12316.
Bousquet J, Melen E, Haahtela T, Koppelman GH, Togias A, Valenta R, et al. Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis. Allergy. 2023;78(5):1169-203.
Burte E, Bousquet J, Varraso R, Gormand F, Just J, Matran R, et al. Characterization of Rhinitis According to the Asthma Status in Adults Using an Unsupervised Approach in the EGEA Study. PloS One. 2015;10(8):e0136191.
Sanchez-Hernandez MC, Dordal MT, Navarro AM, Davila I, Fernandez-Parra B, Colas C, et al. Severity and duration of allergic conjunctivitis: are they associated with severity and duration of allergic rhinitis and asthma? Eur Ann Allergy Clin Immunol. 2022;54(6):277-83.
Bousquet J, Neukirch F, Bousquet PJ, Gehano P, Klossek JM, Le Gal M, et al. Severity and impairment of allergic rhinitis in patients consulting in primary care. J Allergy Clin Immunol. 2006;117(1):158-62.
