The impact of concomitant allergic rhinitis and asthma on quality of life in italian patients of general practitioners: ARGA study

Background: epidemiological studies show that allergic rhinitis is very common in patients with asthma, and that the co-presence of these two diseases can worsen the patients' quality of life.

Aims: to evaluate the impact of the concomitance of asthma and rhinitis (AR) on quality of life in Italian patients of general practitioners (GP).

Methods: prospective observational study in different Italian areas. 107 GP enrolled patients with asthma/rhinitis diagnosis and with anti-asthmatic or anti-rhinitic therapy or symptoms in the last 12 months. Questionnaires were used to collect data on respiratory allergic diseases. The Rhinasthma questionnaire was used to assess the patients' quality of life.

Univariate analyses were used to assess the relationship between presence of only asthma, AR or AR and any one among other allergic diseases (sinusitis, conjunctivitis, atopic dermatitis and nasal polyposis) (AROAD) and quality of life, disease severity levels and asthma symptoms. Linear regression analysis was used to assess the relationship between quality of life and presence of AR or AROAD adjusting for age, gender, smoking habits and asthma severity levels.

Results: 46.8% of 936 subjects had only asthma, 36.2% AR and 17.0% AROAD. Univariate analyses showed a significantly higher frequency of moderate-severe asthma (36.0% vs 33.8%) and asthma symptoms (95.4% vs 89.9% for wheeze, 93.5% vs 88.7% for attacks of shortness of breath, 92.8% vs 85.4% for asthma symptoms in the last 12 month) in subjects with AROAD with respect to those with only asthma; the presence of AR or AROAD, with respect to only asthma, was associated with a significantly worse quality of life (mean values of global score derived from Rhinasthma questionnaire: 19.8±14.6, 20.2±14.3, 29.9±16.3, respectively). The multivariate linear regression analysis confirmed that the presence of AR or AROAD is an independent risk factor for a worse quality of life (beta coefficient: 0.253, p-value <0.001).

Conclusions: this study confirms that the concomitance of asthma and rhinitis can affect in a negative way the patients' quality of life; this effect can increase with the co-presence of further allergic diseases like sinusitis, conjunctivitis, atopic dermatitis and nasal polyposis.

This work was supported by the Italian Medicines Agency (AIFA)”, within the independent drug research program, contract no. FARM5JYS5A".