Allergic rhinitis and asthma symptoms in a real-life study of MP-AzeFlu to treat multimorbid allergic rhinitis and asthma

David Price; Ludger Klimek; Gabriella Gálffy; Melanie Emmeluth; Arkady Koltun; Ferdinand Kopietz; Duc Tung Nguyen; Ranny van Weissenbruch; Wolfgang Pohl; Hans-Christian Kuhl; Glenis Scadding; Joaquim Mullol

doi:10.1186/s12948-020-00130-9

Allergic rhinitis and asthma symptoms in a real-life study of MP-AzeFlu to treat multimorbid allergic rhinitis and asthma

Clin Mol Allergy. 2020 Aug 6:18:15. doi: 10.1186/s12948-020-00130-9. eCollection 2020.

Authors

David Price^{1

2

3}, Ludger Klimek⁴, Gabriella Gálffy⁵, Melanie Emmeluth⁶, Arkady Koltun⁷, Ferdinand Kopietz⁶, Duc Tung Nguyen⁶, Ranny van Weissenbruch⁸, Wolfgang Pohl⁹, Hans-Christian Kuhl⁶, Glenis Scadding¹⁰, Joaquim Mullol¹¹

Affiliations

¹ Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZD UK.
² Optimum Patient Care, Cambridge, UK.
³ Observational and Pragmatic Research Institute (OPRI), Pte | #02-05 883 North Bridge Road, Singapore, 198785 Singapore.
⁴ Zentrum für Rhinologie und Allergologie, Wiesbaden, Germany.
⁵ Pulmonology Hospital, Törökbálint, Hungary.
⁶ MEDA Pharma GmbH & Co. KG (A Mylan Company), Bad Homburg, Germany.
⁷ Mylan, Inc, Canonsburg, PA USA.
⁸ Wilhelmina Ziekenhuis Assen, Assen, The Netherlands.
⁹ Karl Landsteiner Gesellschaft, Institut für Klinische und experimentelle Pneumologie, Vienna, Austria.
¹⁰ Royal National Ear, Nose Throat Hospital, London, England.
¹¹ Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic Barcelona, IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Catalonia Spain.

Abstract

Background: Asthma affects up to nearly 40% of patients with allergic rhinitis (AR). Poor control of AR symptoms is associated with poor asthma control. The goal of this study was to evaluate the effect of AR treatment with MP-AzeFlu on symptoms of AR as well as symptoms of asthma.

Methods: This prospective study used a visual analog scale (VAS) to assess symptoms of AR and asthma before and after treatment with MP-AzeFlu (Dymista^®; azelastine hydrochloride plus fluticasone propionate; 1 spray in each nostril twice daily for 2 weeks). Participants suffered from moderate-to-severe AR according to Allergic Rhinitis and its Impact on Asthma criteria, with acute AR symptoms (AR-VAS scores ≥ 50 mm) on inclusion day. In addition to symptom assessment, patients recorded the impact of AR symptoms on quality-of-life measures before, during, and at the conclusion of the treatment period (approximately 14 days). Patients self-reported change in frequency of their usage of asthma reliever medication on the last day of treatment.

Results: Of 1103 study participants, 267 (24.2%) had comorbid asthma. These participants reported using a mean of 5.1 puffs of asthma reliever medication in the week before treatment with MP-AzeFlu. A total of 81.8% of patients with comorbid asthma responded to AR therapy (AR-VAS < 50 mm on at least 1 study day). Among patients with AR and comorbid asthma, MP-AzeFlu was associated with improved VAS scores across all study parameters, including AR symptom severity, asthma symptom severity, sleep quality, daily work or school activities, daily social activities, and daily outdoor activities. Asthma symptom severity decreased from a mean of 48.9 mm to 24.1 mm on the VAS. Self-reported frequency of asthma reliever medication use was reduced for 57.6% of participants (n = 139/241).

Conclusion: MP-AzeFlu used to relieve AR symptoms was associated with reduced asthma symptom VAS scores and frequency of asthma reliever medication usage. Changes in overall symptoms of AR and asthma were correlated.

Keywords: Allergic rhinitis; Asthma; Comorbidity; Daily activity; MP-AzeFlu; Sleep quality; Visual analog scale.