MyMedR

Fulltext Recent trends in the diagnosis and management of allergic rhinitis

Elango S

Med J Malaysia, 2005 Dec;60(5):672-6; quiz 677.

Allergic rhinitis is a global health issue and its prevalence is increasing. Allergic rhinitis and asthma coexist in many patients. Allergic rhinitis is an Ig E mediated reaction. Prostaglandins and Leukotriens do not play a significant role in the pathogenesis of allergic rhinitis. Skin prick test and Enzyme linked immunosorbent assays (ELISA) are useful as diagnostic tests. The three major modalities of treatment for allergic rhinitis are allergen avoidance, pharmacotherapy and immunotherapy.

Matched MeSH terms: Rhinitis, Allergic, Seasonal/diagnosis*; Rhinitis, Allergic, Seasonal/therapy*

Fulltext Rhinocort vs Eltair: a comparative review of a patented and generic drug

Gurdeep SM, Philip R, Rosalind S

Trop Biomed, 2005 Dec;22(2):221-4.

PMID: 16883291 MyJurnal

Rhinocort and Eltair are both the patented and generic equivalent of the topical nasal steroid budesonide. A study consisting of 42 patients was conducted at the ENT department of Hospital Ipoh to compare the response of patients who were using Rhinocort prior to Eltair. The results show statistically significant symptomatic response and lower complications with Rhinocort compared to Eltair.

Matched MeSH terms: Rhinitis, Allergic, Seasonal/drug therapy*

Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis

Dhami S, Nurmatov U, Arasi S, Khan T, Asaria M, Zaman H, et al.

Allergy, 2017 Nov;72(11):1597-1631.

PMID: 28493631 DOI: 10.1111/all.13201

BACKGROUND: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing Guidelines on Allergen Immunotherapy (AIT) for Allergic Rhinoconjunctivitis. To inform the development of clinical recommendations, we undertook a systematic review to assess the effectiveness, cost-effectiveness, and safety of AIT in the management of allergic rhinoconjunctivitis.

METHODS: We searched nine international biomedical databases for published, in-progress, and unpublished evidence. Studies were independently screened by two reviewers against predefined eligibility criteria and critically appraised using established instruments. Our primary outcomes of interest were symptom, medication, and combined symptom and medication scores. Secondary outcomes of interest included cost-effectiveness and safety. Data were descriptively summarized and then quantitatively synthesized using random-effects meta-analyses.

RESULTS: We identified 5960 studies of which 160 studies satisfied our eligibility criteria. There was a substantial body of evidence demonstrating significant reductions in standardized mean differences (SMD) of symptom (SMD -0.53, 95% CI -0.63, -0.42), medication (SMD -0.37, 95% CI -0.49, -0.26), and combined symptom and medication (SMD -0.49, 95% CI -0.69, -0.30) scores while on treatment that were robust to prespecified sensitivity analyses. There was in comparison a more modest body of evidence on effectiveness post-discontinuation of AIT, suggesting a benefit in relation to symptom scores.

CONCLUSIONS: AIT is effective in improving symptom, medication, and combined symptom and medication scores in patients with allergic rhinoconjunctivitis while on treatment, and there is some evidence suggesting that these benefits are maintained in relation to symptom scores after discontinuation of therapy.

Matched MeSH terms: Rhinitis, Allergic, Seasonal/therapy*

Nasopharyngeal carcinoma and nasal allergy: any correlation?

Prepageran N, Lingham OR, Krishnan G, Jalaludin MA, Raman R

Ear Nose Throat J, 2003 Jun;82(6):438-40.

PMID: 12861869

Although it has been observed that nasal allergy is rarely seen in patients who have nasopharyngeal carcinoma, to our knowledge, no actual study of such a lack of association has been previously reported. To fill this void, we conducted a pilot study to investigate any such inverse relationship. We conducted skin-prick allergen tests on 22 patients with newly diagnosed but not-yet-treated nasopharyngeal carcinoma. Combining these test results with findings on the history and clinical examination, we concluded that only one of the 22 cancer patients (4.5%) had allergic rhinitis. Our study also confirmed the validity of using findings on the history, clinical examination, and skin-prick testing as a reliable means of diagnosing allergic rhinitis.

Matched MeSH terms: Rhinitis, Allergic, Seasonal/complications; Rhinitis, Allergic, Seasonal/diagnosis*; Rhinitis, Allergic, Seasonal/epidemiology*

Prevalence of asthma, eczema and allergic rhinitis: two surveys, 6 years apart, in Kota Bharu, Malaysia

Quah BS, Wan-Pauzi I, Ariffin N, Mazidah AR

Respirology, 2005 Mar;10(2):244-9.

PMID: 15823193

This study was undertaken to determine the prevalence of asthma, eczema, and allergic rhinitis in school children in Kota Bharu, Malaysia, and in so doing to determine the differences in symptom prevalence rates of asthma, and atopic diseases in Kota Bharu school children between 1995 and 2001.

Matched MeSH terms: Rhinitis, Allergic, Seasonal/epidemiology*; Rhinitis, Allergic, Seasonal/pathology

Anaphylaxis to Malaysian meat loaf

Moritz KB, Kopp T, Stingl G, Bublin M, Breiteneder H, Wöhrl S

Allergol Immunopathol (Madr), 2011 Jul-Aug;39(4):244-5.

PMID: 21741147 DOI: 10.1016/j.aller.2010.06.010

Matched MeSH terms: Rhinitis, Allergic, Seasonal/diagnosis*; Rhinitis, Allergic, Seasonal/immunology*; Rhinitis, Allergic, Seasonal/physiopathology

Asthma, allergy, and atopy in three south-east Asian populations

Leung R, Ho P

Thorax, 1994 Dec;49(12):1205-10.

PMID: 7878553

Whilst many recent reports have suggested a rise in the prevalence of asthma and allergic disease in Western countries, little is known about the epidemiology of these common conditions in south-east Asia. This study compared the prevalence of asthma and allergic disease amongst secondary school students in three south-east Asian populations--Hong Kong, Kota Kinabalu in Malaysia, and San Bu in China--and investigated the associations with atopy and family history.

Matched MeSH terms: Rhinitis, Allergic, Seasonal/epidemiology

Hypnosis in general medical practice in Singapore

MUN CT

Am J Clin Hypn, 1964 Apr;6:340-4.

PMID: 14136309

Matched MeSH terms: Rhinitis, Allergic, Seasonal*

Fulltext Efficacy and safety of loratadine compared with astemizole in Malaysian patients with allergic rhinitis

Lee ST, Amin MJ

Singapore Med J, 1994 Dec;35(6):591-4.

PMID: 7761882

Nonsedating selective peripheral H1 receptor antagonists are an important advance in antihistaminic therapy in allergic patients. This is a randomised, double-blind parallel group study comparing the use of two such agents viz loratadine 10mg daily and astemizole 10mg daily for two weeks in 39 Malaysian allergic rhinitis patients. At these dosages, both drugs were demonstrated to be efficacious (p < 0.05) for controlling nasal symptoms and safe in terms of short term biochemical and haematological changes and adverse effects noted. Evaluating efficacy criteria utilised in this study loratadine and astemizole were comparable but loratadine was significantly more effective in three areas viz: (i) in diminishing nasal symptoms after 2 weeks of treatment (p = 0.03); (ii) physician's efficacy evaluation after 2 weeks' treatment (p = 0.009); (iii) patient's efficacy evaluation after 2 weeks' treatment (p = 0.019).
Study site: Allergy clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Rhinitis, Allergic, Seasonal/drug therapy*

Nasal allergies in the Asian-Pacific population: results from the Allergies in Asia-Pacific Survey

Katelaris CH, Lai CK, Rhee CS, Lee SH, Yun WD, Lim-Varona L, et al.

Am J Rhinol Allergy, 2011 Sep-Oct;25 Suppl 1:S3-15.

PMID: 22185687 DOI: 10.2500/ajra.2011.25.3674

The Allergies in Asia-Pacific Survey describes the symptoms, impact, and treatment of allergic rhinitis (AR) across Australia, China, Hong Kong, Malaysia, Singapore, Taiwan, Vietnam, and the Philippines. The Allergies in Asia-Pacific Survey was undertaken to further clarify the prevalence of physician-diagnosed nasal allergies (NAs), impact on quality-of-life (QOL), existing treatment paradigms and gaps, and NA medications currently used in treatment.

Matched MeSH terms: Rhinitis, Allergic, Seasonal/drug therapy; Rhinitis, Allergic, Seasonal/epidemiology*

Skin prick test reactivity to foods in adult Malaysians with rhinitis

Gendeh BS, Murad S, Razi AM, Abdullah N, Mohamed AS, Kadir KA

Otolaryngol Head Neck Surg, 2000 May;122(5):758-62.

PMID: 10793361

The aim of the study was to determine the incidence of food and house dust mite (HDM) allergy in patients with nasal congestion and rhinorrhea attending the Otorhinolaryngology Clinic, National University of Malaysia, Kuala Lumpur. This was a prospective matched, controlled study of patients skin prick tested with commercial food and common aeroallergens. The participants were 148 Malaysian adults with symptoms of nasal congestion and rhinorrhea and 113 adult Malaysian control subjects without rhinitis symptoms. The skin prick test (SPT) was used to evaluate 11 foods common to the Malaysian diet and 3 HDM inhalants. Forty-eight percent of the patients with rhinitis had positive SPT results to foods, compared with 4.4% of control subjects (P < 0.05). The most commonly implicated foods were shrimp (48%) and rice (30%), which are common in the Malaysian diet. Seventy-two percent of rhinitis patients had positive SPT results to HDM, compared with 22.2% of control subjects (P < 0.05). Patients with rhinitis also had significantly more gastrointestinal problems than control subjects (P < 0.05). The incidences of HDM and food allergy are significantly greater in Malaysian adults with rhinitis symptoms than in control subjects without rhinitis. The effect of avoidance or immunotherapy awaits further study.
Study site: Otorhinolaryngology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Rhinitis, Allergic, Seasonal/complications*

Quality of life assessment in patients with moderate to severe allergic rhinitis treated with montelukast and/or intranasal steroids: a randomised, double-blind, placebo-controlled study

Goh BS, Ismail MI, Husain S

J Laryngol Otol, 2014 Mar;128(3):242-8.

PMID: 24618303 DOI: 10.1017/S002221511400036X

This study investigated improvements in quality of life associated with eight weeks of montelukast and/or intranasal steroid treatment for moderate to severe allergic rhinitis.

Matched MeSH terms: Rhinitis, Allergic, Seasonal/diagnosis; Rhinitis, Allergic, Seasonal/drug therapy*

Fulltext Treatment of allergic rhinitis and urticaria: a review of the newest antihistamine drug bilastine

Wang XY, Lim-Jurado M, Prepageran N, Tantilipikorn P, Wang de Y

Ther Clin Risk Manag, 2016;12:585-97.

PMID: 27110120 DOI: 10.2147/TCRM.S105189

Allergic rhinitis and urticaria are common allergic diseases that may have a major negative impact on patients' quality of life. Bilastine, a novel new-generation antihistamine that is highly selective for the H1 histamine receptor, has a rapid onset and prolonged duration of action. This agent does not interact with the cytochrome P450 system and does not undergo significant metabolism in humans, suggesting that it has very low potential for drug-drug interactions, and does not require dose adjustment in renal impairment. As bilastine is not metabolized and is excreted largely unchanged, hepatic impairment is not expected to increase systemic exposure above the drug's safety margin. Bilastine has demonstrated similar efficacy to cetirizine and desloratadine in patients with seasonal allergic rhinitis and, in a Vienna Chamber study, a potentially longer duration of action than fexofenadine in patients with asymptomatic seasonal allergic rhinitis. It has also shown significant efficacy (similar to that of cetirizine) and safety in the long-term treatment of perennial allergic rhinitis. Bilastine showed similar efficacy to levocetirizine in patients with chronic spontaneous urticaria and can be safely used at doses of up to fourfold higher than standard dosage (80 mg once daily). The fourfold higher than standard dose is specified as an acceptable second-line treatment option for urticaria in international guidelines. Bilastine is generally well tolerated, both at standard and at supratherapeutic doses, appears to have less sedative potential than other second-generation antihistamines, and has no cardiotoxicity. Based on its pharmacokinetic properties, efficacy, and tolerability profile, bilastine will be valuable in the management of allergic rhinitis and urticaria.

Matched MeSH terms: Rhinitis, Allergic, Seasonal

Prevalence of Atopic Dermatitis and Pattern of Drug Therapy in Malaysian Children

Goh YY, Keshavarzi F, Chew YL

Dermatitis, 2018 5 16;29(3):151-161.

PMID: 29762208 DOI: 10.1097/DER.0000000000000376

BACKGROUND: Atopic dermatitis (AD) is a chronic relapsing, noncontagious skin inflammation characterized by dry skin and itch. Mutation in filaggrin gene leads to defective skin barrier, allowing entry of allergen and eliciting immunological response.

OBJECTIVES: The aims of this study were to investigate the prevalence of AD in Malaysian children and to understand the pattern of drug therapy. Such information could be useful to establish the relationship between ethnicity and family history of atopy and the development of associated signs and symptoms.

METHODS: A cross-sectional survey was conducted among children attending kindergartens and nurseries. Standardized questionnaires were filled out by parents.

RESULTS: Overall prevalence of AD was 13.4%. Of 384 participants recruited, the highest prevalence was observed in males, Malays, participants younger than 2 years, and those with atopic background such as asthma, hay fever, and family history of atopic diseases. Calamine and white soft paraffin were the preferred choice of nonprescription drugs, whereas topical hydrocortisone seemed to be the preferred choice of prescription drug in the management of AD.

CONCLUSIONS: The overall prevalence is comparable to that reported in the International Study of Asthma and Allergies in Childhood Phase One. There is an association between ethnicity and AD prevalence. Topical corticosteroids and emollients are the mainstay of AD management among Malaysians.

Matched MeSH terms: Rhinitis, Allergic, Seasonal

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