Symptom control and health-related quality of life in allergic rhinitis with and without comorbid asthma: A multicentre European study

Background: Allergic rhinitis (AR) is a major non-communicable disease that affectsthe health-related quality of life (HRQoL) of patients. However, data on HRQoL andsymptom control in AR patients with comorbid asthma (AR + asthma) are lacking.Methods: In this multicentre, cross-sectional study, patients with AR were screenedand administered questionnaires of demographic characteristics and health conditions(symptoms/diagnosis of AR and asthma, disease severity level, and allergicconditions). HRQoL was assessed using a modified version of the RHINASTHMAquestionnaire (30, 'not at all bothered' - 150 'very much bothered') and symptomcontrol was evaluated by a modified version of the Control of Allergic Rhinitis/Asthma Test (CARAT) (0, 'no control' - 30, 'very high control').Results: Out of 643 patients with AR, 500 (78%) had asthma as a comorbidity, and54% had moderate-severe intermittent AR, followed by moderate-severe persistentAR (34%). Compared to the patients with AR alone, patients with AR + asthma had significantly higher RHINASTHMA (e.g., median RHINASTHMA-total score 48.5 vs.84, respectively) and a significantly lower CARAT score (median CARAT-total score23 vs. 16.5, respectively). Upon stratifying asthma based on severity, AR patientswith severe persistent asthma had worse HRQoL and control than those with mildpersistent asthma. The association was significantly higher among non-obese participantscompared to obese ones, with RHINASTHMA-upper symptoms score butnot with CARAT.Conclusions: Our observation of poorer HRQoL and symptoms control in AR patientswith comorbid asthma supports the importance of a comprehensive approachfor the management of AR in case of a comorbid allergic condition.