Association of asthma control with allergic rhinitis severity in adult patients

Background: Upper and lower respiratory tract disease have strong interaction, particularly between asthma and allergic rhinitis (AR). However, skin prick test (SPT) and nasal endoscopy were not always used as tools for diagnosing AR. Aim: This study aimed to describe association of asthma control with AR severity classified by the ARIA system. Methods: A cross sectional study in 185 adult patients with asthma. Using nasal endoscopy to collect data of the anatomical condition of nose and orificium of sinus paranasal objectively. Asthma control test (ACT) questionnaire to assess asthma control degree and allergic reactions were measured using SPT with 12 allergens. Results: This study showed that 54 asthma patients (29.2%) had AR. The most causative allergens were house dust mite (38.8%), house dust (37.3%), and human skin dander (32.8%). Result from nasal endoscopy showed deviated septum (56.6%), pale concha (50.9%), edema concha (22.6%), hypertrophy concha (18.9%), sinusitis and polyp in 16.9% each. ACT scores less and equal with 19 (uncontrolled asthma) found in 45.9%pts, partially control in 47%pts and controlled asthma in 7%pts. Severity of AR were mild intermittent (46.3%), mild persistent (46.3%), and moderate-severe persistent (7.4%). There was significantly correlation between AR severity and asthma control (p=0.006). Conclusions: Allergic rhinitis is common comorbidity of asthma that interrelated to asthma control. Identifiable allergens could be detected AR in asthma by SPT. Therefore, reduction of allergens exposure could become preventive approach for asthma patients with AR.