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Analysis of comorbidities and therapeutic approach for allergic rhinitis in a pediatric population in Spain

Authors

  • María Dolores Ibáñez,

    Corresponding author
    • Allergy Section, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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  • Antonio Luis Valero,

    1. Servei de Pneumologia i Al·lèrgia Respiratòria, Hospital Clínic, Barcelona, Spain
    2. Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), IDIBAPS, Barcelona, Spain
    3. Immunoallèrgia Respiratòria Clínica i Experimental (IRCE) Institut, Barcelona, Spain
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  • Javier Montoro,

    1. Hospital Universitario Arnau de Vilanova, Facultad de Medicina Universidad Católica de Valencia “San Vicente Mártir”, Valencia, Spain
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  • Ignacio Jauregui,

    1. Servicio de Alergia, Hospital de Basurto, Bilbao, Spain
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  • Marta Ferrer,

    1. Allergy Department, Clínica Universitaria de Navarra, Pamplona, Spain
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  • Ignacio Dávila,

    1. Immunology and Allergy Service, Hospital Clínico, Salamanca, Spain
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  • Joan Bartra,

    1. Servei de Pneumologia i Al·lèrgia Respiratòria, Hospital Clínic, Barcelona, Spain
    2. Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), IDIBAPS, Barcelona, Spain
    3. Immunoallèrgia Respiratòria Clínica i Experimental (IRCE) Institut, Barcelona, Spain
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  • Alfonso del Cuvillo,

    1. Rhinology Section, UGC ORL, Hospital de Jérez, Cádiz, Spain
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  • Joaquim Mullol,

    1. Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), IDIBAPS, Barcelona, Spain
    2. Immunoallèrgia Respiratòria Clínica i Experimental (IRCE) Institut, Barcelona, Spain
    3. Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia, Spain
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  • Joaquín Sastre

    1. Allergy Service, Fundación Jiménez Díaz, Madrid, Spain
    2. Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Correspondence

María Dolores Paloma Ibáñez, Hospital Infantil Universitario Niño Jesús, Servicio de Alergia, Menéndez Pelayo 65, 28009 Madrid, Spain

Tel.: 34915035900 Ext 495

E-mail: mibanezs@salud.madrid.org

Abstract

Background

Allergic rhinitis (AR) is the most common chronic disease in children. The main objective of this study was to analyze the comorbidities and therapeutic approaches for AR in a Spanish pediatric population.

Methods

Children aged 6 to 12 years with AR were included in an observational, cross-sectional, multicenter study.

Results

1,275 children were recruited from 271 centers. AR was intermittent in 59.5% of cases, persistent in 40.5%, seasonal in 60.7%, and perennial in 39.3% of patients. The most frequent comorbidities were conjunctivitis (53.6%), asthma (49.5%), atopic dermatitis (40%), rhinosinusitis(26.1%), otitis media (23.8%), and adenoid hypertrophy (17.3%). Overall, patients with persistent, moderate or severe, AR were more likely to present comobidities, except for food allergy and urticaria. The most common drugs used for treatment of AR were oral antihistamines(76%), nasal corticosteroids(49%) and a combination of both (45%). Antihistamines and nasal corticosteroids were used on demand (<18 days) in 38 and 41% of patients, respectively; for 18–30 days in 22 and 27%; for 1–3 months in 31 and 29%; and for more than 3 months in 8 and 3%, respectively. Eye drops were used in 32% and specific immunotherapy in 21% of patients.

Conclusion

Comorbidities are frequent in children with AR, supporting the notion of allergy as a systemic disease. Severity and duration of AR were significantly associated with presence of most of comorbidities. The most common drugs used for AR treatment were oral antihistamines, followed by nasal corticosteroids and a combination of both used on demand.

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