@article{2888e05a456a4429854f73e6f646d180,
title = "Rhinitis in children and adolescents with asthma: Ubiquitous, difficult to control, and associated with asthma outcomes",
abstract = "Background: Rhinitis and asthma are linked, but substantial knowledge gaps in this relationship exist. Objective: We sought to determine the prevalence of rhinitis and its phenotypes in children and adolescents with asthma, assess symptom severity and medication requirements for rhinitis control, and investigate associations between rhinitis and asthma. Methods: Seven hundred forty-nine children with asthma participating in the Asthma Phenotypes in the Inner-City study received baseline evaluations and were managed for 1 year with algorithm-based treatments for rhinitis and asthma. Rhinitis was diagnosed by using a questionnaire focusing on individual symptoms, and predefined phenotypes were determined by combining symptom patterns with skin tests and measurement of serum specific IgE levels. Results: Analyses were done on 619 children with asthma who completed at least 4 of 6 visits. Rhinitis was present in 93.5%, and phenotypes identified at baseline were confirmed during the observation/management year. Perennial allergic rhinitis with seasonal exacerbations was most common (34.2%) and severe. Nonallergic rhinitis was least common (11.3%) and least severe. The majority of children remained symptomatic despite use of nasal corticosteroids with or without oral antihistamines. Rhinitis was worse in patients with difficult-to-control versus easy-to-control asthma, and its seasonal patterns partially corresponded to those of difficult–to-control asthma. Conclusion: Rhinitis is almost ubiquitous in urban children with asthma, and its activity tracks that of lower airway disease. Perennial allergic rhinitis with seasonal exacerbations is the most severe phenotype and most likely to be associated with difficult-to-control asthma. This study offers strong support to the concept that rhinitis and asthma represent the manifestations of 1 disease in 2 parts of the airways.",
keywords = "Rhinitis prevalence, asthma, rhinitis management, rhinitis phenotypes, rhinoconjunctivitis",
author = "Alkis Togias and Gergen, {Peter J.} and Hu, {Jack W.} and Babineau, {Denise C.} and Wood, {Robert A.} and Cohen, {Robyn T.} and Makhija, {Melanie M.} and {Khurana Hershey}, {Gurjit K.} and Kercsmar, {Carolyn M.} and Gruchalla, {Rebecca S.} and Liu, {Andrew H.} and Emily Wang and Haejin Kim and Lamm, {Carin I.} and Bacharier, {Leonard B.} and Dinesh Pillai and Sigelman, {Steve M.} and Gern, {James E.} and Busse, {William W.}",
note = "Funding Information: This project has been funded in whole or in part with Federal funds from the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Department of Health and Human Services , under contract nos. HHSN272200900052C and HHSN272201000052I . Additional support was provided by the National Center for Research Resources and National Center for Advancing Translational Sciences under grants NCRR /NIH UL1TR001079 , UL1TR000451 , UL1TR001105 , 1UL1RR025780 , UL1TR000075 , NCATS /NIH UL1TR000150 , UL1TR000077-04 , UL1 TR000154 , UL1TR001082 , and UL1TR000040 . GlaxoSmithKline provided Ventolin HFA, Flonase, Flovent, Advair under a clinical trial agreement with the NIH/NIAID. Funding Information: Disclosure of potential conflict of interest: R. A. Wood has consultant arrangements with Stallergens; has received grants from DBV, Aimmune, Astellas, and HAL-Allergy; and receives royalties from UpToDate. C. M. Kercsmar has received personal fees from GlaxoSmithKline. R. S. Gruchalla has received personal fees from the Consulting Massachusetts Medical Society and serves as an unpaid special government employee for the Center for Biologics Evaluation and Research. A. H. Liu has received personal fees from Merck Sharp & Dohme and has served as a Data Monitoring Committee member for GlaxoSmithKline. L. B. Bacharier has consultant arrangements with Aerocrine, GlaxoSmithKline, Genentech/Novartis, Cephalon, Teva, and Boehringer Ingelheim and has received personal fees from Merck, DBV Technologies, AstraZeneca, WebMD/Medscape, Sanofi, Vectura, and Circassia. J. E. Gern has consultant arrangements with Janssen, Regeneron, PReP Biosciences and has received travel support from Boehringer Ingelheim. W. W. Busse has consultant arrangements with Novartis, GlaxoSmithKline, Genentech, Roche, Boehringer Ingelheim, Sanofi Genzyme, AstraZeneca, Teva, 3M, PrEPBiopharm, Circassia, Regeneron, and Peptinnovate; serves as a board member for Boston Scientific DSMB and ICON Study Oversight Committee; and has received editor fees from Elsevier. The rest of the authors declare that they have no relevant conflicts of interest. Funding Information: This project has been funded in whole or in part with Federal funds from the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Department of Health and Human Services, under contract nos. HHSN272200900052C and HHSN272201000052I. Additional support was provided by the National Center for Research Resources and National Center for Advancing Translational Sciences under grants NCRR/NIH UL1TR001079, UL1TR000451, UL1TR001105, 1UL1RR025780, UL1TR000075, NCATS/NIH UL1TR000150, UL1TR000077-04, UL1 TR000154, UL1TR001082, and UL1TR000040. GlaxoSmithKline provided Ventolin HFA, Flonase, Flovent, Advair under a clinical trial agreement with the NIH/NIAID.Disclosure of potential conflict of interest: R. A. Wood has consultant arrangements with Stallergens; has received grants from DBV, Aimmune, Astellas, and HAL-Allergy; and receives royalties from UpToDate. C. M. Kercsmar has received personal fees from GlaxoSmithKline. R. S. Gruchalla has received personal fees from the Consulting Massachusetts Medical Society and serves as an unpaid special government employee for the Center for Biologics Evaluation and Research. A. H. Liu has received personal fees from Merck Sharp & Dohme and has served as a Data Monitoring Committee member for GlaxoSmithKline. L. B. Bacharier has consultant arrangements with Aerocrine, GlaxoSmithKline, Genentech/Novartis, Cephalon, Teva, and Boehringer Ingelheim and has received personal fees from Merck, DBV Technologies, AstraZeneca, WebMD/Medscape, Sanofi, Vectura, and Circassia. J. E. Gern has consultant arrangements with Janssen, Regeneron, PReP Biosciences and has received travel support from Boehringer Ingelheim. W. W. Busse has consultant arrangements with Novartis, GlaxoSmithKline, Genentech, Roche, Boehringer Ingelheim, Sanofi Genzyme, AstraZeneca, Teva, 3M, PrEPBiopharm, Circassia, Regeneron, and Peptinnovate; serves as a board member for Boston Scientific DSMB and ICON Study Oversight Committee; and has received editor fees from Elsevier. The rest of the authors declare that they have no relevant conflicts of interest. Publisher Copyright: {\textcopyright} 2018 American Academy of Allergy, Asthma & Immunology",
year = "2019",
month = mar,
doi = "10.1016/j.jaci.2018.07.041",
language = "English",
volume = "143",
pages = "1003--1011.e10",
journal = "Journal of Allergy and Clinical Immunology",
issn = "0091-6749",
number = "3",
}