• Humans
• Asthma/epidemiology
• Asthma/therapy
• Multimorbidity
• Quality of Life
• Comorbidity
• Gastroesophageal Reflux/epidemiology
• Pulmonary Disease, Chronic Obstructive/epidemiology
• Depression/epidemiology
• Obesity/epidemiology
• Obesity/therapy
• Sinusitis/epidemiology
• Anxiety/epidemiology
• Bronchiectasis/epidemiology

• Allergic rhinitis
• Consensus
• Epidemiology
• Evidence-based medicine
• Phenotypes
• Rhinitis
• Treatment

• Humans
• Rhinitis/diagnosis
• Rhinitis/therapy
• Brazil
• Consensus
• Risk Factors
• Severity of Illness Index
• Quality of Life

• Allergen immunotherapy
• Allergic rhinitis
• Bronchial asthma
• Subcutaneous immunotherapy
• Sublingual immunotherapy

• asthma
• asthma natural history
• pre-asthma
• predisposition
• quality of life
• risk factors

• Asthma
• Bayesian mixed-effects
• Causal inference
• Comorbidities
• Length of stay
• Racial disparities
• Readmission

• Humans
• Asthma/therapy
• Bayes Theorem
• Length of Stay
• Patient Readmission
• Population Health
• Race Factors
• Retrospective Studies
• United States/epidemiology

• OT2 OD026556 NIH HHS
• U2C OD023196 NIH HHS
• OT2 OD025315 NIH HHS
• OT2 OD026551 NIH HHS
• U24 OD023121 NIH HHS
• OT2 OD026552 NIH HHS
• OT2 OD026549 NIH HHS
• OT2 OD025337 NIH HHS
• OT2 OD025277 NIH HHS
• OT2 OD026555 NIH HHS
• OT2 OD026550 NIH HHS
• OT2 OD026553 NIH HHS
• OT2 OD023205 NIH HHS
• OT2 OD025276 NIH HHS
• OT2 OD026554 NIH HHS
• U24 OD023163 NIH HHS
• OT2 OD023206 NIH HHS
• U24 OD023176 NIH HHS
• OT2 OD026548 NIH HHS
• OT2 OD026557 NIH HHS
• R01 HG011411 NHGRI NIH HHS
• National Institutes of Health (NIH)

• Allergic rhinitis
• allergen-specific immunotherapy
• asthma
• comorbidity
• medication reduction
• severity

• Humans
• Rhinitis, Allergic/drug therapy
• Asthma/drug therapy
• Histamine Antagonists/therapeutic use
• Comorbidity
• Steroids/therapeutic use

• Female
• Pregnancy
• Humans
• Nitric Oxide
• Asthma/therapy
• Asthma/drug therapy
• Anti-Asthmatic Agents/therapeutic use
• Biomarkers
• Desensitization, Immunologic

• Humans
• Asthma/diagnosis
• Asthma/epidemiology
• Asthma/therapy
• Comorbidity
• Bronchiectasis/epidemiology

• Allergie
• Allergy
• Asthma
• Asthme
• Fonction respiratoire
• Lung function
• Management
• Prevention and control
• Prévention et contrôle

• United airway disease
• allergen immunotherapy
• allergic rhinitis
• allergic rhinitis treatment
• asthma
• asthma comorbidities
• respiratory allergies

The incidence of allergic diseases is increasing, and research on their epidemiology, pathophysiology, and the prevention of onset is urgently needed. The onset of allergic disease begins in infancy with atopic dermatitis and food allergy and develops into allergic asthma and allergic rhinitis in childhood; the process is defined as “atopic march”. Atopic march is caused by multiple immunological pathways, including allergen exposure, environmental pollutants, skin barrier dysfunction, type 2 inflammation, and oxidative stress, which promote the progression of atopic march. Using recent evidence, herein, we explain the involvement of allergic inflammatory conditions and oxidative stress in the process of atopic march, its epidemiology, and methods for prevention of onset.

• alarmin
• allergic asthma
• allergic rhinitis
• atopic dermatitis
• atopic march
• early intervention
• emollient
• epidemiology
• food allergy
• group 2 innate lymphoid cells
• oxidative stress
• phenotype
• skin barrier dysfunction
• specific biomarker
• type 2 inflammation

Allergen immunotherapy (AIT) is a specific treatment involving the administration of relevant allergens to allergic patients, with subtypes including subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). In asthma, AIT using the house dust mite (HDM) alleviates clinical symptoms and decreases airway hyper responsiveness and medication dose. In addition, AIT can improve the natural course of asthma. For example, the effects of AIT can be preserved for at least a few years, even after ending treatment. AIT may increase the remission rate of asthma in children and suppress sensitization to new allergens. If AIT is introduced in pollinosis, AIT may prevent the development of asthma. Moreover, AIT can control other allergic diseases complicated by asthma, such as allergic rhinitis, which also improves the control of asthma. The indication of HDM-SCIT for asthma is mild-to-moderate HDM-sensitized allergic asthma in a patient with normal respiratory function. To date, HDM-SLIT is applicable in Japan for allergic rhinitis, not for asthma. However, the effect of SLIT on asthma has been confirmed internationally, and SLIT is available for asthma in Japan if allergic rhinitis is present as a complication.

• allergen immunotherapy
• bronchial asthma
• subcutaneous immunotherapy
• sublingual immunotherapy

• Asthma
• chronic rhinitis
• management
• outcomes
• systematic assessment
• treatment

Severe asthma is a major burden on health-economic resources; hence, knowing the epidemiology of these patients is important in planning and provision of asthma care. In addition, identifying and managing the comorbidities helps improve symptoms and reduce associated morbidity and mortality.

Epidemiology of difficult asthma has not been well studied in the Middle East, so in this study, we present the demographic and clinical characteristics of severe asthma in the United Arab Emirates (UAE).

We retrospectively reviewed the notes of severe asthma patients attending three tertiary care hospitals between May 2015 and December 2019. Data on baseline demographics, asthma characteristics, treatment, and comorbidities were collected.

We reviewed the notes of 458 patients (271 females and 187 males) that fulfilled the 2019 Global Initiative for Asthma guidelines for the diagnosis of severe asthma. The mean age was 47.7 (standard deviation 17.2) years. Males had significantly higher asthma control test scores (17.9 vs. 16, P = 0.01) and mean blood eosinophils (0.401 vs. 0.294, P <0.01) than females. The most common comorbidity observed was allergic rhinitis (52.2%) followed by gastroesophageal reflux disease (27.1%). In total, 109 (23.8%) patients were on biological therapies with most patients being on omalizumab and dupilumab (29 and 18 patients, respectively). Most patients were nonsmokers (97.2%), and majority were of TH2-high phenotype (75.7%).

In this first report of severe asthma characteristics in the UAE, we found a pattern of female preponderance and most patients having a Th2-high phenotype. The findings are likely to help optimize asthma care in the region in the era of biologic therapies.

• Airflow obstruction
• Th1/Th2
• allergic asthma
• asthma
• asthma epidemiology
• severe asthma epidemiology

Background: Allergic rhinitis (AR) is the most common IgE-mediated allergic disease. Multiple clinical trials have demonstrated promising results on the AR treatment with biologics, in particular with the use of omalizumab – an anti-IgE antibody. Omalizumab has also been established in the routine management of allergic asthma and chronic idiopathic urticaria. However, currently there is no approved license for the use of biologics in AR in Germany. Materials and methods: A systematic literature review has been completed including randomized controlled trials, meta-analyses, and reviews on the treatment of AR with omalizumab. Results: The systematic review demonstrates strong evidence supporting the use of omalizumab in the treatment of AR with regard to symptom control, safety profile, and management of comorbidities. Conclusion: Omalizumab is a good and safe option in the treatment of AR in terms of symptom control and the management of pre-existing comorbidities. Further clinical trials with other biologics in the management of AR are needed and are expected to follow soon.

• allergen immunotherapy
• allergic rhinitis
• anti-IgE
• biologics
• omalizumab

MP-AzeFlu (Dymista®; spray of azelastine/fluticasone propionate) is the most effective allergic rhinitis (AR) treatment available. Its effect on asthma outcomes in patients with AR and asthma is unknown.

This pre-post historical cohort study, using the Optimum Patient Care Research Database, included patients aged ≥12 years, from UK general practice with active asthma (defined as a recorded diagnosis, with ≥1 prescription for reliever or controller inhaler) in the year before or at the initiation date. The primary study outcome was change in number of acute respiratory events (i.e. exacerbation or antibiotic course for a respiratory event) between baseline and outcome years. The effect size of MP-AzeFlu was quantified as the difference in % of patients that improved and worsened.

Of the 1,188 patients with AR and asthma included, many had a record of irreversible obstruction (67%), and uncontrolled asthma (70.4%), despite high mean daily doses of reliever/controller therapy and acute oral corticosteroid use, in the year pre-MP-AzeFlu initiation. MP-AzeFlu initiation was associated with fewer acute respiratory events (effect size (e) = 5.8%, p = 0.0129) and a reduction in daily use of short-acting β₂-agonists, with fewer patients requiring >2 SABA puffs/week (e = 7.7% p < 0.0001). More patients had well-controlled asthma 1-year post-MP-AzeFlu initiation (e = 4.1%; p = 0.0037), despite a reduction in inhaled corticosteroids (e = 4.8%; p = 0.0078).

This study provides the first direct evidence of the beneficial effect of MP-AzeFlu on asthma outcomes in co-morbid patients in primary care in the United Kingdom.

EUPAS30940. Registered August 13, 2019.

• ADEPT, Anonymized data ethics & protocol transparency
• AR, Allergic rhinitis
• ATS, American Thoracic society
• BEC, Blood eosinophil count
• CRS, Chronic rhinosinusitis
• Control
• ERS, European respiratory society
• Exacerbations
• FEV1, forced expiratory volume in 1 s
• FVC, Forced vital capacity
• GERD, Gastroesophageal reflux disease
• GINA, Global initiative for asthma
• ICS, Inhaled corticosteroid
• INS, Intranasal corticosteroid
• NP, Nasal polyps
• OAC, Overall asthma control
• OAH, Oral anti-histamine
• OCS, Oral corticosteroid
• OPCRD, Optimum patient care research database
• OTC, Over the counter
• PEF, Peak expiratory flow rate
• RCT, Randomized controlled trial
• RDAC, Risk domain asthma control
• Rescue medication
• SABA, Short-acting β2-agonist
• SMD, Standardised mean difference
• UK, United Kingdom

• United airways disease
• allergic rhinitis
• chronic rhinosinusitis (CRS)
• chronic rhinosinusitis with nasal polyposis
• chronic rhinosinusitis without nasal polyps (CRSsNP)
• nasal hyper-reactivity
• non-allergic rhinitis
• olfaction

Most patients with asthma, either allergic or non-allergic, usually exhibit some level of concurrent rhinitis. Treatments for rhinitis and asthma can affect both conditions.

The present study aimed to examine asthma-specific outcomes in patients with chronic rhinitis (CR) and asthma after surgery for nasal obstruction, and to identify the patient group most likely to experience improved asthma control after surgery.

Asthmatic patients with CR and nasal obstruction were prospectively recruited for evaluations of nasal and asthma-specific outcomes before and after surgery for nasal obstruction.

Twenty-eight participants were enrolled. There was a significant association between the Asthma Control Test (ACT) and the Sino-Nasal Outcome Test-22 scores, both at the preoperative and 3-month postoperative assessments. Patients demonstrating ACT improvement after nasal surgery had worse preoperative ACT scores and predicted forced expiratory volume in 1 s.

Nasal symptom severity was closely associated with the extent of asthma control in asthmatic patients with CR and nasal obstruction. Assessment of CR and nasal obstruction in patients with poorly controlled asthma should be considered an essential approach to improve the response to treatment and patients’ quality of life.

• SNOT-22
• asthma
• patient-reported outcome measure
• quality of life
• rhinitis

There is a dearth of research regarding the prevalence and nature of patient-reported rhinitis and its relationship with risk of asthma exacerbations. The aim of this study was to (i) determine the prevalence, severity and treatment of self-reported rhinitis symptoms among adults aged ≥18 years with asthma treated at Global Initiative for Asthma (GINA) Step 3 and above and (ii) compare the demographics, clinical characteristics, medication use, side-effects and healthcare practitioner review between patients who report rhinitis symptoms and those who do not and (iii) determine whether patient-reported rhinitis is associated with risk of asthma exacerbations in the total patient sample.

This analysis used data from the iHARP (Initiative Helping Asthma in Real-life Patients) asthma review service – a cross-sectional observational study (2011 and 2014) in seven countries that captured data on patient demographics, rhinitis symptoms, asthma symptoms, indicators of exacerbations, medication use, oropharyngeal effects and side-effects, using practitioner- and patient-reported questionnaires. Comparisons between patients with and without rhinitis were tested. Univariate logistic regression was used to identify variables associated with risk of exacerbations for entry into multivariable logistic regression.

This report contains data from 4274 patients: 67.4% (2881/4274) reported rhinitis symptoms and of which 65.7% (1894/2881) had not received a doctor diagnosis; 36.5% (1052/2881) had moderate-severe rhinitis, 12.4% (358/2881) had used intranasal corticosteroids and 19.8% (569/2881) oral antihistamines. Patients with coexisting moderate-severe rhinitis were more likely to have GINA-defined uncontrolled asthma than those with mild rhinitis or no rhinitis. Moderate-severe rhinitis was associated with 40% increased risk of asthma exacerbations (OR=1.40, 95% CI: 1.02–1.90).

This study identified a major gap in the diagnosis and management of rhinitis in a cohort of people with asthma treated at GINA Step 3 and above who are managed in general practice. It highlights the need for practitioners to identify, evaluate and optimally treat rhinitis in adults with asthma, which is a significant factor associated with exacerbation risk.

• asthma symptom control
• comorbidities
• oral steroids
• preventer
• reliever
• side-effects

• %FEV1
• Allergic asthma
• Cysteinyl leukotrienes
• Exhaled breath condensate
• Japanese cedar pollen

• Adult
• Aged
• Allergens/immunology
• Asthma/metabolism
• Asthma/physiopathology
• Breath Tests
• Cross-Sectional Studies
• Cryptomeria/immunology
• Eicosanoids/metabolism
• Female
• Forced Expiratory Volume
• Humans
• Male
• Middle Aged
• Nitric Oxide/metabolism
• Pollen/immunology
• Rhinitis, Allergic, Seasonal/metabolism
• Rhinitis, Allergic, Seasonal/physiopathology
• Seasons

• Allergic rhinitis
• Asthma
• Comorbidity
• Daily activity
• MP-AzeFlu
• Sleep quality
• Visual analog scale

Budesonide, a poorly water‐soluble corticosteroid, is currently marketed as a suspension. Budesolv is a novel aqueous formulation containing dissolved budesonide showing increased local availability in preclinical models. Budesolv contains ~85% less corticosteroid than the marketed comparator.

The study (EudraCT:2018‐001324‐19) was designed to assess non‐inferiority of Budesolv compared to Rhinocort® Aqua 64 (RA) and early onset of action.

In a three‐way cross‐over double‐blinded randomized trial, Budesolv 10 was compared to RA and placebo in grass pollen allergic rhinoconjunctivitis volunteers (n = 83 (ITT); n = 75 (PP)). On day 1, participants entered the Vienna Challenge Chamber (VCC) for 6 hours; first treatment took place at 1:45 hours after entry. Participants treated themselves for further 6 days; on day 8, the last treatment was applied before entering the VCC. Subjective symptom scores, nasal airflow and nasal secretion were measured regularly during allergen challenge.

Budesolv 10 was equally effective compared to RA with respect to TNSS and nasal airflow after eight days of treatment with a strongly reduced dose (more than 80% reduction). After first dose, only Budesolv 10 showed a significant reduction of nasal and respiratory symptoms starting 90 minutes (P < .05) and 15 minutes (P < .05) after application onwards, respectively, demonstrating an early onset of efficacy. A clinically significant 1 point reduction in nasal symptom score was reached at 195 minutes (P < .05) after application.

The novel preservative‐free, aqueous low‐dose budesonide formulation is highly efficacious even after an initial single treatment. Thus, Budesolv 10 appears to be an effective acute treatment for allergic rhinitis as well as for AR comorbidities like mild asthma and conjunctivitis.

• allergic rhinitis
• budesonide
• challenge chamber
• early onset
• inflammation
• intranasal glucocorticoids
• nasal spray
• preservative-free

• Airway epithelium
• biological processes
• gene expression
• transcriptomics
• unified airway hypothesis

Asthma is a highly prevalent chronic inflammatory airways disease, with a considerable impact on quality of life (QoL). To express the effects of asthma on patients’ subjective experience, patient-reported outcomes (PROs) represent an important instrument. The asthma QoL questionnaire (AQLQ) is one of the main PROs among these.

To identify long-term asthma-related QoL outcomes associated with omalizumab therapy in patients with moderate-to-severe asthma, we developed a systematic review according to the PRISMA guidelines. Published real-world effectiveness studies of adults or adolescents (12 years or older) with moderate-to-severe allergic asthma treated with omalizumab for at least 48 weeks were reviewed. Sources used were Medline (PubMed), the Cochrane Library and Google Scholar up to February 2018. In addition, a cross-referencing search was conducted to complete the revision.

A total of 255 potential papers were identified in the first search through the database. After full-text viewing, eight articles were finally included in the review. We summarized the results according to the study design, patient baseline characteristics and effectiveness outcomes assessed by AQLQ score results: variation from baseline to the end of study. Results confirmed the long-term benefits of omalizumab as an add-on therapy in patients with uncontrolled moderate-to-severe allergic asthma. Since there is a lot of evidence on omalizumab effectiveness, we aimed to focus on how a therapy can change patient’s QoL in a long time period. Data showed long-term effects of omalizumab treatment on subjective (PROs) and objective (lung function, corticosteroid use, hospitalizations, asthma exacerbation) effectiveness measures.

Studies included in our review were observational trials that, due to their design, present a potential risk of selection bias in the patients included. Beyond this limit, the evaluation of QoL using the AQLQ showed a clear increase over time, following both 48 weeks and 9 years of observation, where QoL improvements still were significant over baseline values.

• Ashtma
• omalizumab
• quality of life
• review

Prevalence of diseases associated with ageing is rising; among these are the rhinologic problems. Chronic rhinitis appears as one of the most common worrisome nasal disorders in this age group. At the same time, the allergic form diminishes because of the immunosenescence.

This study aimed to evaluate the effect of a corticosteroid nasal spray (mometasone furoate) over nasal patency and the severity of rhinitis and its impacts on quality of life as compared with the saline nasal spray.

This open label-trial randomized subjects ≥60y with chronic rhinitis (allergic and nonallergic rhinitis) with mometasone spray 100mcg/d and isotonic saline nasal spray or saline alone for two weeks. The primary endpoint was the improvement in nasal patency evaluated by the peak nasal inspiratory flow (PNIF). Secondary outcomes included the severity of symptoms and the quality of life assessed by a visual analogic scale (VAS) and the sinonasal outcome test (SNOT-22), respectively.

Forty patients underwent randomization, in equal number in each group of treatment, either with allergic (AR) and nonallergic rhinitis (NAR). At week 2, the mean PNIF score was 79.5 in the corticosteroid (CE) plus saline group and 82.0 in the saline group (p = 0.37). Also, SNOT-22 and VAS were not improved with the addition of mometasone furoate.

Treatment with mometasone furoate nasal spray plus isotonic saline is not superior to saline alone in elderly patients with rhinitis in respect of improving nasal patency, quality of life, and reducing the intensity of symptoms.

The trial is registered at the Brazilian Clinical Trials Registry (ReBEC) #RBR-498bnq. Registered 05 July 2017.

• AR, allergic rhinitis
• Aged
• CE, corticosteroids
• Immunosenescence
• Mometasone furoate
• NAR, nonallergic rhinitis
• PNIF, peak-nasal inspiratory flow
• Peak nasal inspiratory flow
• Rhinitis
• SNOT-22, sinonasal outcome test
• VAS, visual analogic scale

• Adolescents
• Allergic rhinitis
• Biologics
• Children
• Chronic rhinosinusitis

• Economics
• allergic
• asthma
• healthcare resource utilization
• non-allergic
• phenotypes
• productivity

• allergic rhinitis
• allergy
• atopic dermatitis
• children
• difficult-to-treat asthma
• food allergy
• severe asthma

Community pharmacists have a key role to play in the management of allergic rhinitis (AR). Their role is especially important because the majority of medications used to treat AR are available for purchase over-the-counter (OTC), allowing patients to self-select their own medications and bypass the pharmacists. Patients’ self-selection often results in suboptimal treatment selection, undertreated AR and poor clinical outcomes. In order for pharmacists to optimise the care for AR patients in the pharmacy, pharmacists need to be able to identify patient cohorts who self-select and are at high risk of mismanagement.

This study aimed to compare the demographics, clinical characteristics and medication selected, between pharmacy customers who choose to self-select and those who speak with a pharmacist when purchasing medication for their AR in a community pharmacy and identify factors associated with AR patients’ medication(s) self-selection behaviour.

A cross-sectional observational study was conducted in a convenience sample of community pharmacies from the Sydney metropolitan area. Demographics, pattern of AR symptoms, their impact on quality of life (QOL) and medication(s) selected, were collected. Logistic regressions were used to identify factors associated with participants’ medication self-selection behaviour.

Of the 296 recruited participants, 202 were identified with AR; 67.8% were female, 54.5% were >40 years of age, 64.9% had a doctor’s diagnosis of AR, and 69.3% self-selected medication(s). Participants with AR who self-select were 4 times more likely to experience moderate-severe wheeze (OR 4.047, 95% CI 1.155-14.188) and almost 0.4 times less likely to experience an impact of AR symptoms on their QOL (OR 0.369, 95% CI 0.188-0.727).

The factors associated with AR patients’ self-selecting medication(s) are the presence of wheeze and the absence of impact on their QOL due to AR symptoms. By identifying this cohort of patients, our study highlights an opportunity for pharmacists to engage these patients and encourage discussion about their AR and asthma management.

• Allergic
• Australia
• Community Pharmacy Services
• Multivariate Analysis
• Pharmacies
• Professional Role
• Quality of Life
• Rhinitis
• Seasonal
• Self Medication
• Surveys and Questionnaires

• Allergic rhinitis
• Asthma
• Chronic bronchitis
• Rhinosinusitis
• Tuberculosis

• Allergy
• Aspirin sensitivity
• Asthma
• Epidemiology
• Quality of life
• Rhinitis
• Rhinosinusitis
• Sinusitis

On 21st November 2016, Melbourne experienced an epidemic of ‘thunderstorm asthma.’ Although previously described in the literature, risk factors and natural history remain incompletely understood.

Our aim was to follow up those presenting to the 3 Emergency Departments (EDs) in our health service during the epidemic, and assess their history for previous asthma, rhinitis, and allergies.

ED notes of all respiratory presentations within 48 hours of the thunderstorm event were reviewed and patients with acute asthma included. A standardised questionnaire was devised encompassing asthma diagnosis, undiagnosed asthma symptoms and rhinitis severity. Patients were contacted by phone within 30 days of the event.

Three hundred forty-four patients were identified overall; 263 patients were contactable and completed a phone or mail questionnaire. The mean age was 32.7 ± 19.2 years (range, 6 months–87 years; 25% < 18 years) with 58% male sex. A previous diagnosis of asthma was present in 42% (n = 111), and there was no previous asthma diagnosis in 58% (n = 152). Of those who had no asthma diagnosis 53% had probable undiagnosed asthma. Overall, rhinitis prevalence was 88%, of which 72% were moderate or severe (Allergic Rhinitis and its Impact on Asthma guidelines) and 51% (n = 133) reported a history of grass pollen allergy.

Our data highlights the importance of atopy and rhinitis as risk factors for epidemic thunderstorm asthma. Better identification of undiagnosed asthma, and implementing treatment of asthma and rhinitis may be important.

• Asthma
• Rhinitis, allergic, seasonal
• Thunderstorm

• Allergic rhinitis
• Asthma
• Conjunctivitis
• Laryngitis
• Rhinosinusitis
• Unified airway
• United airway disease

Up to 80% of asthmatic children may experience upper airway symptoms which are often perceived as coming from the lower airways. Currently, there are no validated questionnaires to assess upper airway contribution to pediatric asthma symptoms. The Sino-Nasal 5 (SN-5) questionnaire was previously validated for identifying radiographic confirmed sinus disease in children. In this study, we hypothesize that significant SN-5 scores (≥3.5) are associated with abnormal National Asthma Education and Prevention Program (NAEPP) based asthma impairment and control in asthmatic children. Retrospective data collected on children with asthma referred for pulmonary evaluation included age, gender, ethnicity, NAEPP asthma severity, asthma control (Test for Respiratory and Asthma Control in Kids (TRACK) < 5 years, Asthma Control Test (ACT) 5 years) and pulmonary function testing. Associations between SN-5 scores and asthma impairment and control were identified. Seventy-six children were evaluated; 38% were female with a mean age of 6.9 years. Significant SN-5 scores were associated with decreased control of daytime symptoms (odds ratio (OR): 0.16 (95% confidence interval (CI): 0.06–0.44)), night time awakenings (0.09 (0.03–0.29)), activity interference (0.2 (0.06–0.68)), NAEPP defined asthma control (0.32 (0.12–0.85)) and poor asthma control based on TRACK (p < 0.001) and ACT (p < 0.001). This suggests upper airways may play a larger role in perceived lower airway symptoms, and SN-5 may be beneficial in assessing the contribution of upper airway conditions on asthma control.

• Sino-Nasal 5 score
• asthma
• rhinosinusitis
• screening

• Medicaid
• albuterol
• asthma
• levalbuterol
• pediatric

• allergen immunotherapy
• asthma
• prevention
• rhinitis

• allergic rhinitis
• asthma
• asthma control test (act)
• pulmonary function tests
• sacra questionnaire
• visual analogue scale

• Asthma/drug therapy
• Asthma/epidemiology
• Comorbidity
• Female
• Forced Expiratory Volume/drug effects
• Humans
• Japan/epidemiology
• Leukotriene Antagonists/therapeutic use
• Male
• Middle Aged
• Prospective Studies
• Respiratory Function Tests
• Rhinitis, Allergic/drug therapy
• Rhinitis, Allergic/epidemiology
• Self-Assessment
• Surveys and Questionnaires
• Vital Capacity/drug effects