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Alleigic Rhinitis Alleigic Rhinitis

W The definition of Alleigic Rhinitis (AR) was foimulated by


Hansel in 1929.
W Symptomatic nasal disoidei caused by alleigen exposuie
thiough an IgE-mediated immune iesponse against
alleigens.
W Seasonaloccuis paiticulaily duiing pollen seasons, usually
develop until aftei 6 yeais of age
W Peiennialoccuis thioughout the yeai. This type of alleigic
ihinitis is commonly seen in youngei childien,
AR AR
AR can be subdivided into
inteimittent (symptoms <4 days pei week oi foi <4
weeks)
Peisistent (symptoms >4 days pei week oi foi >4 weeks)
Chaiacteiized accoiding to seveiity as mild oi
modeiate/seveie.
AR and Asthma AR and Asthma
AR and Asthma aie linked epidemiologically,
pathologically, physiologically and theiapeutically
AR is moie dominant than Asthma
Euiopean AR pievalence 25%
consideied as iisk factoi foi development of Asthma.
8O% AR in Asthma patients
ackgiound ackgiound
The aetiology of AR is multi-factoiial and the
diagnostic and theiapeutic choices iemain diveise.
The aim of this questionnaiie suivey was to highlight
the tieatment tiends in he management of AR in the
UK
ethods ethods
Questionaiie
all iegisteied consultant membeis of the iitish
Association of Otoihinolaiyngologists - Head and
Neck Suigeons (AO-HNS)
Response Response
A total of 551 questionnaiies. Theie weie 3O9 ieplies (
56% iesponse iate).
All consultants weie familiai with the association
between AR and Asthma but only 63% of the
iespondents weie familiai with the ARIA (Alleigic
Rhinitis and It's Impact on Asthma)guidelines.
Result Result
Seventy seven (25%) of otolaiyngologists managed AR
patients which had associated symptoms oi a diagnosis
of Asthma
Result Result
The commonest investigation was skin piick testing
(81% of iespondents). 3% aiianged pulmonaiy
spiiometiy
Result Result
56% iespondent piefeiied the management pathway of
staiting tieatment and then dischaiging AR patients to
Ceneial Piactitioneis foi follow-up.
43% staits tieatment and follow up
1% consultants iefeiied AR patients to iespiiatoiy
physician
Result Result
In total two hundied and foity (78%) piovided patient
lifestyle changes including education and tips on
alleigens avoidance.
Tieatment Choice Tieatment Choice
W 99% use intia-nasal steioids to tieat AR. This tiend is suppoited
by seveial studies demonstiating that intia-nasal steioids aie the
most efficient and cost effective tieatment foi AR
W Wilson et al in a cochiane ieview showed sublingual
immunotheiapy to be a safe and effective option
W Caldeion et al in a iecently published meta-analysis the use of
alleigen injection immunotheiapy as an effective tieatment with a
low iisk of adveise effects in the management of AR
W Howevei, fuithei studies aie iequiied
Conclusion Conclusion
A combined tieatment stiategy
alleigen avoidance,
phaimacotheiapy,
immunotheiapy and
Education