  Treat
allergic rhinitis to manage asthma
Effective asthma management involves accurate
recognition and appropriate treatment of
allergic rhinitis. Alone, allergic rhinitis can
significantly affect individuals’ daily
activities and impair quality of life; when it
occurs in a patient with asthma, it contributes
to airway symptoms and must be considered in the
management plan.
Contrary to the previous belief that allergic
rhinitis was mainly a disorder of adults, it is
now known to affect almost 8% of Australian
children and adolescents.1
| Rhinitis occurs in an
estimated 75–80% of patients with asthma,2
with high rates reported in both atopic and
non-atopic asthma.3,4 Conversely,
20–30% of patients with known allergic
rhinitis also have asthma.3,5,6
Allergic rhinitis is now recognised as a
risk factor for developing asthma.3,4,7–9
A comprehensive approach to asthma
management includes investigation for
allergic rhinitis and effective treatment.
The presence of allergic rhinitis is
associated with worse asthma control in
children and adults.10,11
Treatment of allergic rhinitis with
intranasal corticosteroids (INCS) reduces
the risk of asthma-related emergency
department visits and hospitalisation in
patients with asthma and co-existing
allergic rhinitis12 <Level II> and may
improve lung function.13
<Level II>
Studies
assessing specific immunotherapy in children
with allergic rhinitis (mainly pollen
allergies) suggest that arresting the
allergic response may reduce the risk of
developing asthma.14,15 <Level II> (See
Immunomodulatory therapy) |
 |
Practice
points |
 |
-
In
patients with persistent
allergic rhinitis,
investigate for asthma
(history, chest
examination, pre-and
post-bronchodilator
spirometry if
indicated).
-
In
patients with asthma,
investigate for rhinitis
(history and physical
examination).
-
In
patients with both
allergic rhinitis and
asthma, treat with a
combination of INCS and
inhaled corticosteroids
(ICS) at doses
appropriate to symptom
severity.
|
|
|
Allergic rhinitis in Australia1,16,17 The prevalence of allergic
rhinitis is increasing.
Approximately 16% of Australians
have allergic rhinitis, including:
-
about 19% of
working-aged adults
-
about one in
four younger adults (25–44
years)
-
one in five
adolescents (13–14 years)
-
one in eight
primary school-aged children
(6–7 years)
Approximately 10% of all
Australians and 14–16% of Australian
children have asthma. |
 |
