The Journal of Allergy and Clinical Immunology
Volume 113, Issue 3 , Pages 415-419, March 2004

Rhinitis therapy and the prevention of hospital care for asthma:

A case-control study

  • Jonathan Corren, MD

      Affiliations

    • Allergy Research Foundation, Los Angeles, Calif, and the Department of Medicine, University of California, Los Angeles, calif, USA
    • Corresponding Author InformationReprint requests: Jonathan Corren, MD, Allergy Research Foundation, 11620 Wilshire Blvd, Suite 200, Los Angeles, CA 90025
    • ,
  • Beatrice E. Manning, PhD

      Affiliations

    • Andover Newton Theological School, Newton Centre, Mass, USA
    • ,
  • Stephen F. Thompson, MS

      Affiliations

    • Schering-Plough, Kenilworth, NJ, USA
    • ,
  • Sean Hennessy, PharmD, PhD

      Affiliations

    • Department of Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pa, USA
    • ,
  • Brian L. Strom, MD, MPH

      Affiliations

    • Department of Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pa, USA

Received 21 April 2003; received in revised form 6 November 2003; accepted 25 November 2003.

Abstract 

Background

Although clinical trials have demonstrated that rhinitis therapy improves subjective and objective measures of asthma, it is uncertain whether treatment of allergic rhinitis significantly affects the frequency of asthma exacerbations.

Objective

The objective of this study was to determine whether treatment with intranasal corticosteroids and/or second-generation antihistamines is associated with changes in rates of asthma exacerbations resulting in emergency room visits and/or hospitalizations in patients with asthma and allergic rhinitis.

Methods

This was a nested, case-control study.

Results

Treatment with either nasal corticosteroids or second-generation antihistamines was associated with a lower risk of asthma-related emergency room treatment and hospitalization (adjusted odds ratio [OR], 0.51; 95% CI, 0.34 to 0.77 and 0.34, 0.18 to 0.62, respectively). Patients who used nasal cortico-steroids had a significantly lower risk of both asthma-related emergency room treatment and hospitalization (adjusted OR, 0.75; 95% CI, 0.62 to 0.91 and 0.56, 0.42 to 0.76, respectively), whereas there was a trend toward lower risk of emergency room treatment and hospitalization in patients who used second-generation antihistamines (adjusted OR, 0.88; 95% CI, 0.62 to 1.26 and 0.68, 0.40 to 1.14, respectively). Combined treatment with both medications was associated with a further lowering of the risk of both emergency room treatment and hospitalization (adjusted OR, 0.37; 95% CI, 0.19 to 0.73 and 0.22, 0.07 to 0.63).

Conclusions

In patients with asthma, treatment of concomitant allergic rhinitis was associated with significant reductions in risk of emergency room treatment and hospitalization for asthma.

Keywords:  Allergic rhinitis, asthma, emergency room, hospitalization, corticosteroid, antihistamine

 

 Integrated Therapeutics Group, Inc, Supported by Schering-Plough, Kenilworth, NJ.

PII: S0091-6749(03)02755-6

doi:10.1016/j.jaci.2003.11.034

The Journal of Allergy and Clinical Immunology
Volume 113, Issue 3 , Pages 415-419, March 2004

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