A review: quality of life of patients with allergic rhinitis receiving various treatment

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The high prevalence of allergic rhinitis in a population, the link between this disease and asthma, and a significantly higher economic burden of the disease, causing a negative impact on the patients’ quality of life, have resulted in increased attention to the problem of allergic rhinitis at the global level. Nowadays optimal allergic rhinitis treatment and management include disease control, consisting of assessing the level of disease control and selecting a treatment scheme based on this assessment. Current studies are focused on the development of questionnaires and testing systems for assessing the level of disease control, especially given the absence of a standardized control assessment procedure tool. Studies also address the possibility of using the indicators of quality of life to measure the level of disease control. The present review deals with the issue of understanding of using this parameter to measure the effectiveness of pharmacotherapy of different groups of patients with allergic rhinitis. The review includes randomized clinical trials covering the period 2010−2019 including the following keywords: “Rhinitis Quality of Life”, “Allergic Rhinitis Quality of Life”, “Allergic Rhinitis Questionnaire”, “RQLQ”. In total, 4.407 publications were identified and analyzed, only 60 publications were selected for comparative analysis after a second review. According to the results, in general, it can be concluded that the indicator of the quality of life allows us to identify the advantages of pharmacotherapeutic regimens in the long term (for example, allergen-specific immunotherapy, alternative therapy). Moreover, it demonstrates a correlation with objectivistic indicators in randomized clinical trials of standard treatment. It is still necessary, however, to address the question of whether it would be possible to use the assessment of the quality of life as a part of allergic rhinitis treatment in everyday clinical practice to select a group of drugs, their dosages, and correct regimes in dynamics. Using the indicator of the quality of life for managing patients with allergic rhinitis in Russia requires tremendous work in terms of cross-cultural adaptation of questionnaires and large-scale population-based pharmacoepidemiological studies.

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About the authors

Denis S. Tyufilin

Siberian State Medical University

Author for correspondence.
Email: dtufilin@gmail.com
ORCID iD: 0000-0002-9174-6419
SPIN-code: 7995-1025
Scopus Author ID: 56989983200
ResearcherId: L-4242-2017

Russian Federation, 2, Moscowski Trakt, Tomsk, 634050

Ivan A. Deev

Siberian State Medical University

Email: ivandeyev@yandex.ru
ORCID iD: 0000-0002-4449-4810
SPIN-code: 2730-0004

Russian Federation, 2, Moscowski Trakt, Tomsk, 634050

MD, PhD, Professor

Olga S. Kobyakova

Siberian State Medical University

Email: olga_kobyakova@rambler.ru
ORCID iD: 0000-0003-0098-1403
SPIN-code: 1373-0903

Russian Federation, 2, Moscowski Trakt, Tomsk, 634050

MD, PhD, Professor

Ekaterina K. Tagina

Siberian State Medical University

Email: taginaekaterina@gmail.com
ORCID iD: 0000-0002-9075-429X
SPIN-code: 6604-6298

Russian Federation, 2, Moscowski Trakt, Tomsk, 634050

Evgeny S. Kulikov

Siberian State Medical University

Email: evgeny.s.kulikov@gmail.com
ORCID iD: 0000-0002-0088-9204
SPIN-code: 9934-1476

Russian Federation, 2, Moscowski Trakt, Tomsk, 634050

MD, PhD, Professor


  1. Gupta R, Springston EE, Warrier MR, et al. The prevalence, severity and distribution of childhood food allergy in the United States. Pediatrics. 2011;128(1):е9–17. doi: 10.1542/ped.2011-0204.
  2. Pawankar R, Canonica GW, Holgate ST, Lockey RF. WAO, white book on allergy. Research Gate; 2012.
  3. Meltzer EO. Quality of life in adults and children with allergic rhinitis. J Allergy Clin Immunol. 2001;108(1 Suppl):45–53. doi: 10.1067/mai.2001.115566.
  4. Wang Y, Zhu R, Liu G, et al. Prevalence of uncontrolled allergic rhinitis in Wuhan, China: a prospective cohort study. Am J Rhinol Allergy. 2014;28(5):397–403. doi: 10.2500/ajra.2014.28.4079.
  5. Lourenço O, Calado S, Sá-Sousa A, Fonseca J. Evaluation of allergic rhinitis and asthma control in a Portuguese community pharmacy setting. J Manag Care Spec Pharm. 2014;20(5):513–522. doi: 10.18553/ jmcp.2014.20.5.513.
  6. Аллергический ринит у детей. Клинические рекомендации. ― М.: Союз педиатров России, Российская ассоциация аллергологов и клинических иммунологов, 2016. [Allergicheskii rinit u detei. Klinicheskie rekomendatsii. Moscow: Soiuz pediatrov Rossii, Rossiiskaia assotsiatsiia allergologov i klinicheskikh immunologov; 2016. (In Russ).] Доступно по: https://base.garant.ru/72196496/. Ссылка активна на 27.01.2020.
  7. Аллергический ринит. Клинические рекомендации. ― М.: Российская ассоциация аллергологов и клинических иммунологов, 2018. [Allergicheskii rinit. Klinicheskie rekomendatsii. Moscow: Rossiiskaia assotsiatsiia allergologov i klinicheskikh immunologov; 2018. (In Russ).] Доступно по: http://nrcii.ru/docs/2.allergic_rhinitis.pdf. Ссылка активна на 27.01.2020.
  8. Bateman ED, Hurd SS, Barnes PJ, et al. Global strategy for asthma management and prevention: GINA executive summary. Zar Eur Respir J. 2008;31:143–178. doi: 10.1183/13993003.51387-2007.
  9. Koshak EA. Classification of asthma according to revised 2006 GINA: Evolution from severity to control. Ann Thorac Med. 2007;2(2):45–46. doi: 10.4103/1817-1737.32228.
  10. Uzzaman A, Metcalfe DD, Komarow HD. Acoustic rhinometry in the practice of allergy. Ann Allergy Asthma Immunol. 2006;97(6):745−751; quiz 751-752, 799. doi: 10.1016/S1081-1206(10)60964-7.
  11. Muliol J, Maurer M, Bousquet J. Sleep and allergic rhinitis. J Investig Allergol Clin Immunol. 2008;18(6):415−419.
  12. Новик А.А., Ионова Т.И. Руководство по исследованию качества жизни в медицине. 2-е изд. / Под ред. Ю.Л. Шевченко. ― М.: Олма Медиа Групп, 2007. ― 320 с. [Novik AA, Ionova TI. Rukovodstvo po issledovaniiu kachestva zhizni v meditsine. 2nd ed. Ed by Iu.L. Shevchenko. Moscow: Olma Media Grupp; 2007. 320 p. (In Russ).]
  13. Ушаков И.Б. Качество жизни и здоровье человека. ― М.: Истоки, 2005. ― 130 с. [Ushakov IB. Kachestvo zhizni i zdorov’e cheloveka. Moscow: Istoki; 2005. 130 p. (In Russ).]
  14. Juniper EF, Guyatt GH, Andersson B, Ferrie PJ. Comparison of powder and aerosolized budesonide in perennial rhinitis: validation of rhinitis quality of life questionnaire. Ann Allergy. 1993;70(3):225–230.
  15. Juniper EF, Thompson AK, Ferrie PJ, Roberts JN. Development and validation of the mini Rhinoconjunctivitis Quality of Life Questionnaire. Clin Exp Allergy. 2000;30(1):132–140. doi: 10.1046/j.1365-2222.2000.00668.x.
  16. Juniper EF, Thompson AK, Ferrie PJ, Roberts JN. Validation of the standardized version of the Rhinoconjunctivitis Quality of Life Questionnaire. J Allergy Clin Immunol 1999;1:364–369. doi: 10.1016/S0091-6749(99)70380-5.
  17. Braido F, Baiardini I, Stagi E, et al. Rhin Asthma Patient Perspective: a short daily asthma and rhinitis QoL assessment. Allergy. 2012;67(11):1443–1450. doi: 10.1111/all.12014.
  18. Piccirillo JF, Edwards D, Haiduk A, et al. Psychometric and clinimetric validity of the 31-Item rhinosinusitis outcome measure (RSOM-31). Am J Rhinology. 1995;9(6):297–308. doi: 10.2500/105065895781808711.
  19. Anderson ER, Murphy MP, Weymuller EA. Clinimetric evaluation of the sinonasal outcome Test-16. student research award 1998. Otolaryngol Head Neck Surg. 1999;121:702–707. doi: 10.1053/hn.1999.v121.a100114.
  20. Piccirillo JF, Merritt MG, Richards ML. Psychometric and clinimetric validity of the 20-Item Sino-Nasal Outcome Test (SNOT-20). Otolaryngol Head Neck Surg. 2002;126(1):41–47. doi: 10.1067/mhn.2002.121022.
  21. Benninger MS, Senior BA. The development of the rhinosinusitis disability index. Arch Otolaryngol Head Neck Surg. 1997;123(11):1175–1179. doi: 10.1001/archotol.1997.01900110025004.
  22. Atlas SJ, Metson RB, Singer DE, et al. Validity of a new health-related quality of life instrument for patients with chronic sinusitis. Laryngoscope. 2005;115(5):846–854. doi: 10.1097/01.MLG.0000157693.92975.02.
  23. Abu Ruz SM, Bulatova NR, Tawalbeh MI. Development and validation of the Arabic allergic rhinitis quality of life questionnaire. Saudi Med J. 2009;30(12):1577−1583.
  24. Roberts G, Hurley C, Lack G. Development of a quality-of-life assessment for the allergic child or teenager with multisystem allergic disease. J Allergy Clin Immunol. 2003;111(3):491−497. doi: 10.1067/mai.2003.138.
  25. Kiotseridis H, Cilio CM, Bjermer L, et al. Swedish translation and validation of the Pediatric Allergic Disease Quality of Life Questionnaire (PADQLQ). Acta Paediatr. 2011;100(2):242−247. doi: 10.1111/j.1651-2227.2010.02028.x.
  26. Valero A. Development and Validation of a New Spanish Instrument to Measure Health-Related Quality of Life in Patients with Allergic Rhinitis: The ESPRINT Questionnaire. Value Health. 2007;10(6):466–477. doi: 10.1111/j.1524-4733.2007.00202.x.
  27. Baiardini I, Pasquali M, Giardini A, et al. Rhinasthma: a new specific QoL questionnaire for patients with rhinitis and asthma. Allergy. 2003;58(4):289–294. doi: 10.1034/j.1398-9995.2003.00079.x.
  28. Higaki T, Okano M, Kariya S, et al. Determining minimal clinically important differences in Japanese cedar/cypress pollinosis patients. Allergol Int. 2013;62(4):487−493. doi: 10.2332/allergolint.13-OA-0570.
  29. Okuda M, Ohkubo K, Goto M, et al. Comparative study of two Japanese rhinoconjunctivitis quality-of-life questionnaires. Acta Otolaryngol. 2005;125(7):736−744. doi: 10.1080/00016480510026944.
  30. Juniper EF, Rohrbaugh T, Meltzer EO. A questionnaire to measure quality of life in adults with nocturnal allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2003;111(3):484–490. doi: 10.1067/mai.2003.137.
  31. Juniper EF, Howland WC, Roberts NB, et al. Measuring quality of life in children with rhinoconjunctivitis. J Allergy Clin Immunol. 1998;101(2 Pt 1):163−170. doi: 10.1016/s0091-6749(98)70380-x.
  32. Mavroudi A, Chrysochoou EA, Boyle RJ, et al. Validation study of the pediatric allergic rhinitis quality of life questionnaire. Asian Pac J Allergy Immunol. 2016;34(2):159−165. doi: 10.12932/AP0651.34.2.2016.
  33. Santilli J, Nathan R, Glassheim J, et al. Validation of the rhinitis outcomes questionnaire (ROQ). Ann Allergy Asthma Immunol. 2001;86(2):222–225. doi: 10.1016/S1081-1206(10)62695-6.
  34. Calderón MA, Casale TB, Demoly P. Validation of patient-reported outcomes for clinical trials in allergic rhinitis: a systematic review. J Allergy Clin Immunol Pract. 2019;7(5):1450−1461.e6. doi: 10.1016/j.jaip.2019.01.015.
  35. Pfaar O, Demoly P, van Wijk RG, et al. Recommendations for the standardization of clinical outcomes used in allergen immunotherapy trials for allergic rhinoconjunctivitis: an EAACI Position Paper. Allergy. 2014;69(7):854–867. doi: 10.1111/all.12383.
  36. Ciprandi G, Klersy C, Cirillo I, Marseglia GL. Quality of life in allergic rhinitis: relationship with clinical, immunological, and functional aspects. Clin Exp Allergy. 2007;37(10):1528−1535. doi: 10.1111/j.1365-2222.2007.02809.x
  37. Prus-Ostaszewska M, Wysocki J, Niemczyk K, Balcerzak J. The correlation of the results of the survey SNOT-20 of objective studies of nasal obstruction and the geometry of the nasal cavities. Otolaryngol Pol. 2017;71(2):1−7. doi: 10.5604/01.3001.0009.8408.
  38. Poletti D, Iannini V, Casolari P, et al. Nasal inflammation and its response to local glucocorticoid regular treatment in patients with persistent non-allergic rhinitis: a pilot study. J Inflammation. 2016;13(1). doi: 10.1186/s12950-016-0134-3.
  39. Brożek JL, Bousquet J, Agache I, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines – 2016 revision. J Allergy Clin Immunol. 2017;140(4):950–958. doi: 10.1016/j.jaci.2017.03.050.
  40. Kim CH, Kim JK, Kim HJ, et al. Comparison of intranasal ciclesonide, oral levocetirizine, and combination treatment for allergic rhinitis. Allergy Asthma Immunol Res. 2015;7(2):158−166. doi: 10.4168/aair.2015.7.2.158.
  41. Yang Q, Wang F, Li B, et al. The efficacy and safety of ciclesonide for the treatment of perennial allergic rhinitis: a systematic review and meta-analysis. Braz J Otorhinolaryngol. 2019;85(3):371−378. doi: 10.1016/j.bjorl.2018.10.008.
  42. Ilyina NI, Edin AS, Astafieva NG, et al. Efficacy of a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate, delivered in a single spray, for the treatment of seasonal allergic rhinitis: results from Russia. Int Arch Allergy Immunol. 2019;178(3):255−263. doi: 10.1159/000494507.
  43. Berger W, Meltzer EO, Amar N, et al. Efficacy of MP-AzeFlu in children with seasonal allergic rhinitis: Importance of paediatric symptom assessment. Pediatr Allergy Immunol. 2016;27(2):126–133. doi: 10.1111/pai.12540.
  44. Carr WW, Ratner P, Munzel U, et al. Comparison of intranasal azelastine to intranasal fluticasone propionate for symptom control in moderate-to-severe seasonal allergic rhinitis. Allergy Asthma Proc. 2012;33(6):450–458. doi: 10.2500/aap.2012.33.3626.
  45. Tatar EÇ, Sürenoğlu UA, Ozdek A, et al. The effect of combined medical treatment on quality of life in persistent allergic rhinitis. Indian J Otolaryngol Head Neck Surg. 2013;65(Suppl 2):333−337. doi: 10.1007/s12070-012-0486-9.
  46. Lu Y, Yin M, Cheng L. [Meta-analysis of leukotriene receptor antagonist montelukast in the treatment of allergic rhinitis. (In Chinese)]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014;49(8):659−667.
  47. Bachert C, Bousquet J, Canonica GW, et al. Levocetirizine improves quality of life and reduces costs in long-term management of persistent allergic rhinitis. J Allergy Clin Immunol. 2004;114(4):838–844. doi: 10.1016/j.jaci.2004.05.070.
  48. Canonica GW, Bousquet J, van Hammée G, et al; XPERT Study Group. Levocetirizine improves health-related quality of life and health status in persistent allergic rhinitis. Respir Med. 2006;100(10):1706−1715.
  49. Segall N, Gawchik S, Georges G, Haeusler JM. Efficacy and safety of levocetirizine in improving symptoms and health-related quality of life in US adults with seasonal allergic rhinitis: a randomized, placebo-controlled study. Ann Allergy Asthma Immunol. 2010;104(3):259−267. doi: 10.1016/j.anai.2009.12.003.
  50. Skoner DP, LaForce CF, Nathan RA, et al. Effect of cetirizine on symptom severity and quality of life in perennial allergic rhinitis. Allergy Asthma Proc. 2014;35(4):338–345. doi: 10.2500/aap.2014.35.3760.
  51. Ciebiada M, Ciebiada MG, Kmiecik T, et al. Quality of life in patients with persistent allergic rhinitis treated with montelukast alone or in combination with levocetirizine or desloratadine. J Investig Allergol Clin Immunol. 2008;18(5):343−349.
  52. Erdoğan BA, Şanlı A, Paksoy M, et al. Quality of life in patients with persistent allergic rhinitis treated with desloratadine monotherapy or desloratadine plus montelucast combination. Kulak Burun Bogaz Ihtis Derg. 2014;24(4):217−224. doi: 10.5606/kbbihtisas.2014.48108.
  53. Novakova SM, Staevska MT, Novakova PI, et al. Quality of life improvement after a three-year course of sublingual immunotherapy in patients with house dust mite and grass pollen induced allergic rhinitis: results from real-life. Health Quality Life Outcomes. 2017;15(1). doi: 10.1186/s12955-017-0764-z.
  54. Antolín-Amerigo D, Tabar IA, del Mar Fernández-Nieto M, et al. Satisfaction and quality of life of allergic patients following sublingual five-grass pollen tablet immunotherapy in Spain. Drugs Context. 2017;6:212309. doi: 10.7573/dic.212309.
  55. Yang G, Qiu SQ, Wang P, et al. [The influence of sublingual immunotherapy on quality of life in children with allergic rhinitis. (In Chinese)]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018;32(2):95−98. doi: 10.13201/j.issn.1001-1781.2018.02.004.
  56. Huang Y, Wang C, Cao F, et al. Comparison of long-term efficacy of subcutaneous immunotherapy in pediatric and adult patients with allergic rhinitis. Allergy Asthma Immunol Res. 2019;11(1):68−78. doi: 10.4168/aair.2019.11.1.68.
  57. Mösges R, Valero Santiago A, Allekotte S, et al. Subcutaneous immunotherapy with depigmented-polymerized allergen extracts: a systematic review and meta-analysis. Clin Transl Allergy. 2019;9:29. doi: 10.1186/s13601-019-0268-5.
  58. Schwanke T, Carragee E, Bremberg M, Reisacher WR. Quality-of-life outcomes in patients who underwent subcutaneous immunotherapy and sublingual immunotherapy in a real-world clinical setting. Am J Rhinol Allergy. 2017;31(5):310−316. doi: 10.2500/ajra.2017.31.4465.
  59. Duan CX, Tian Y, Zhang F, Tao ZZ. [Efficacy of sublingual immunotherapy and subcutaneous immunotherapy in children with allergic rhinitis. (In Chinese)]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016;30(17):1354−1358. doi: 10.13201/j.issn.1001-1781.2016.17.004.
  60. Li JH, Yang LH, Chen Y, Fan ZX. Acupuncture as an add-on therapy to sublingual allergen-specific immunotherapy for patients with allergic rhinitis. Medicine (Baltimore). 2019;98(1):e13945. doi: 10.1097/MD.0000000000013945.
  61. Mi J, Chen X, Lin X, et al. Treatment of persistent allergic rhinitis via acupuncture at the sphenopalatine acupoint: a randomized controlled trial. Trials. 2018;19(1):28. doi: 10.1186/s13063-017-2339-z.
  62. Dai L, Zhong LL, Kun W, et al. An external cam therapy (tian jiu) versus placebo in treatment of allergic rhinitis: a pilot single-blinded, three-arm, randomized controlled study. Evid Based Complement Alternat Med. 2019;2019:6369754. doi: 10.1155/2019/6369754.
  63. Zhaoguo I. English translation of traditional chinese medicine: theory and practice. 2013. Р. 11.
  64. Shiue H, Lee Y, Tsai C, et al. Treatment of allergic rhinitis with acupoint herbal plaster: an oligonucleotide chip analysis. BMC Complement Altern Med. 2016;16(1):436. doi: 10.1186/s12906-016-1418-0.
  65. Ye SF, Liu Z, Wang YF, et al. [The therapeutic effect of probiotics on allergic rhinitis:a meta-analysis. (In Chinese)]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017;31(6):467−474. doi: 10.13201/j.issn.1001-1781.2017.06.014.
  66. Li X, Liu Y, Zhang Q, et al. Effect of catgut implantation at acupoints for the treatment of allergic rhinitis: a randomized, sham-controlled trial. BMC Complement Altern Med. 2016;16(1):454. doi: 10.1186/s12906-016-1400-x.
  67. Tatar EÇ, Korkmaz H, Sürenoğlu UA, et al. Effects of rhinophototherapy on quality of life in persistant allergic rhinitis. Clin Exp Otorhinolaryngol. 2013;6(2):73–77. doi: 10.3342/ceo.2013.6.2.73.
  68. Zhong B, Li LK, Deng D, et al. Effect of high-intensity focused ultrasound versus plasma radiofrequency ablation on recurrent allergic rhinitis. Med Sci Monit. 2019;25:6775–6781. doi: 10.12659/MSM.916228.
  69. Gillman GS, Staltari GV, Chang YF, Mattos JL. A prospective study of outcomes of septoplasty with turbinate reductions in patients with allergic rhinitis. Otolaryngol Head Neck Surg. 2019;160(6):1118−1123. doi: 10.1177/0194599819838761.

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