There is a dearth of research regarding the prevalence and nature of patient-reported rhinitis and its relationship with asthma exacerbations risk. This study aimed to (i) determine the prevalence, severity, and treatment of self-reported rhinitis symptoms among adults aged ≥ 18 years with asthma treated at Global Initiative for Asthma (GINA) Step 3 and above and (ii) compare the demographics, clinical characteristics, medication use, side-effects and healthcare practitioner review between patients who report rhinitis symptoms and those who do not and (iii) determine whether patient-reported rhinitis is associated with risk of asthma exacerbations in the total patient sample.
This analysis used data from the iHARP asthma review service – a cross-sectional observational study in seven countries that captured patient demographics, rhinitis symptoms, asthma symptoms, indicators of exacerbations, medication use, oropharyngeal effects, and side-effects, using practitioner- and patient-reported questionnaires. Comparisons between patients with and without rhinitis were tested. Univariate logistic regression was used to identify variables associated with the risk of exacerbations for entry into multivariable logistic regression. This report contains data from 4274 patients: 67.4% reported rhinitis symptoms and of which 65.7% had not received a doctor diagnosis; 36.5% had moderate-severe rhinitis, 12.4% had used intranasal corticosteroids, and 19.8% oral antihistamines. Patients with coexisting moderate-severe rhinitis were more likely to have GINA-defined uncontrolled asthma than those with mild rhinitis or no rhinitis. Moderate-severe rhinitis was associated with a 40% increased risk of asthma exacerbations.
This study identified a significant gap in the diagnosis and management of rhinitis in a cohort of people with asthma treated at GINA Step 3 and above who are managed in general practice. It highlights the need for practitioners to identify, evaluate, and optimally treat rhinitis in adults with asthma, which is a significant factor associated with exacerbation risk.