A survey on features of allergic rhinitis in children

Abstract

Objective:

A number of epidemiologic studies evaluated the prevalence of allergic rhinitis (AR), but few data are available on its different clinical presentations. We addressed this survey to assess the features of AR in children and adolescents.

Methods:

Thirty-five centers in Italy included 2623 pediatric patients with rhinitis, of whom 2319 suffered from AR, while 304 had other kinds of rhinitis. For each patient a standardized questionnaire was filled in, including ARIA classification, the duration of symptoms, the allergen identified as clinically relevant, the co-morbidities, the kind of treatment, the response to treatment, the satisfaction with the treatment, and the feasibility of allergen immunotherapy (AIT).

Results:

Of the 2319 patients, 597 (25.7%) had mild intermittent, 701 (30.2%) mild persistent, 174 (7.5%) moderate–severe intermittent, and 773 (33.3%) moderate–severe persistent AR. The allergens most relevant were grass pollen and dust mites. The most frequently used drugs were oral antihistamines (83.1%) and topical corticosteroids (63.5%). The response to treatment was judged as excellent in 13.5%, good in 45.1%, fair in 30.8%, poor in 10%, and very bad in 0.6% of cases. The satisfaction with treatment was judged as very satisfactory in 15.2%, satisfactory in 61.8%, unsatisfactory in 22.4%, and very unsatisfactory in 0.5% of cases. AIT was considered indicated in 53.1% of patients with mild intermittent, 79.2% of moderate–severe intermittent, 72.6% of mild persistent, and 82.7% of moderate–severe persistent AR.

Conclusions:

The limitation of this study is that the population was not unselected and this prevents epidemiological significance. These results offer confirmation of the adequacy of ARIA guidelines in classifying patients with AR and of the association of severe phenotype with lack of success of drug treatment.

Keywords::

• Allergen immunotherapy
• Allergic rhinitis
• ARIA classification
• Drug treatment
• Phenotypes

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Erratum

Transparency

Declaration of funding

No external funding was secured for this study. Contributorship of authors: A.M.Z. conceptualized and designed the study, contributed to analysis and interpretation of data, critically reviewed the manuscript and approved the final manuscript as submitted; L.I. conceptualized and designed the study, contributed to analysis and interpretation of data, critically reviewed the manuscript and approved the final manuscript as submitted; G.D.C. conceptualized and designed the study, critically reviewed the manuscript and approved the final manuscript as submitted; C.I.: contributed to analysis and interpretation of data, drafted the initial manuscript, critically reviewed the manuscript and approved the final manuscript as submitted; F.F. conceptualized and designed the study, contributed to analysis and interpretation of data, drafted the initial manuscript, critically reviewed the manuscript and approved the final manuscript as submitted; I.D.’A. contributed to analysis and interpretation of data, critically reviewed the manuscript and approved the final manuscript as submitted; M.S. contributed to analysis and interpretation of data, critically reviewed the manuscript and approved the final manuscript as submitted; P.P. contributed to analysis and interpretation of data, critically reviewed the manuscript and approved the final manuscript as submitted; M.D. conceptualized and designed the study, contributed to analysis and interpretation of data, critically reviewed the manuscript and approved the final manuscript as submitted.

Declaration of financial/other relationships

F.F., P.P., I.D.’A. and M.S. are employees of Stallergenes Italy. C.I. is a scientific consultant for Stallergenes Italy. A.M.Z., L.I., G.D.C. and M.D. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

The authors acknowledge the Pediatric SURF Study Group: Ranta Ahmad, Claudia Alessandri, Elisa Anastasio, Ermanno Baldo, Salvatore Barberi, Roberto Bernardini, Arrigo Boccafogli, Attilio Boner, Luigia Brunetti, Carlo Caffarelli, Giovanni Capocasale, Lucetta Capra, Maria Palma Carbone, Carlo Cavaliere, Camilla Celani, Rosa Cervone, Azzurra Cesoni Marcelli, Loredana Chini, Gabriele Cortellini, Maria Teresa Costantino, Renato Cutrera, Iride Dello Iacono, Valentina De Vittori, Grazia Dinella, Susanna Esposito, Ettore Ferrarini, Fiamma Ferraro, Matteo Gelardi, Leo Gualtiero, Stefania La Grutta, Daniele Lietti, Valeria Lollobrigida, Maddalena Marinoni, Gian Luigi Marseglia, Simonetta Masieri, Domenico Minasi, Michele Miraglia Del Giudice, Viviana Moschese, Luigi Nespoli, Elio Novembre, Francesca Occasi, Manuela Pace, Giovanni Pajno, Maria Francesca Patria, Diego Peroni, Giampaolo Ricci, Luisa Ricciardi, Chiara Roncallo, Francesca Santamaria, Annalisa Santucci, Angelo Rito Sciacca, Guglielmo Scala, Giordano Taddeo, Giancarlo Tancredi, Mariangela Tosca, Attilio Varricchio and Stefania Zampogna.