Rinitis y Rinosinusitis, “rasgos tratables” del asma.
Resumen
Las rinitis y rinosinusitis crónicas son comorbilidades muy frecuentes del asma, que se han asociado con su gravedad y mal control. Son enfermedades muy prevalentes y a menudo poco atendidas, ya que no ponen en peligro la vida de los pacientes. Sin embargo, causan un gran impacto sobre los pacientes que la sufren y sobre las administraciones sanitarias desde un punto de vista socioeconómico, debido a sus elevados costes directos e indirectos.
Un porcentaje muy elevado de pacientes con asma grave no controlado sufren rinitis o rinosinusitis crónicas, en muchas ocasiones infradiagnosticadas e infratratadas, lo que lleva a debatir con frecuencia si estas comorbilidades puedan estar determinando el mal control.
Se ha demostrado una correlación entre la gravedad de las rinitis y las rinosinusitis y la gravedad y el control del asma, y hay muchos indicios de que el tratamiento de estas comorbilidades podría mejorar parámetros clínicos, de calidad de vida y de control de los pacientes con asma. El advenimiento de nuevos medicamentos biológicos, mucho más precisos y dirigidos contra mediadores muy relevantes del proceso inflamatorio común para la vía aérea superior e inferior, abre un nuevo abanico de posibilidades de tratamiento conjunto con un mayor grado de eficacia y seguridad.
Referencias
Zeiger RS, Schatz M, Dalal AA, Qian L, Chen W, Ngor
EW, et al. Utilization and Costs of Severe Uncontrolled
Asthma in a Managed-Care Setting. J Allergy Clin
Immunol Pract. 2016;4:120–9.
Quirce S, Plaza V, Picado C, Vennera M, Casafont J.
Prevalence of uncontrolled severe persistent asthma in
pneumology and allergy hospital units in Spain. J Investig
Allergol Clin Immunol. 2011;21:466–71.
Comité Ejecutivo de la GEMA. GEMA 4.0. Guía española
para el manejo del asma. Luzán 5 SA, 2015.
Chipps BE, Haselkorn T, Paknis B, Ortiz B, Bleecker ER,
Kianifard F, et al.; Epidemiology and Natural History of
Asthma: Outcomes and Treatment Regimens Study Group.
More than a decade follow-up in patients with severe or
difficult-to-treat asthma: The Epidemiology and Natural
History of Asthma: Outcomes and Treatment Regimens
(TENOR) II. J Allergy Clin Immunol. 2018;141:1590–7.
Tay TR, Hew M. Comorbid “treatable traits” in difficult
asthma: Current evidence and clinical evaluation. Allergy.
;73:1369–82.
Clark VL, Gibson PG, Genn G, Hiles SA, Pavord ID,
McDonald VM. Multidimensional assessment of severe
asthma: A systematic review and meta-analysis. Respirology.
;22:1262–75.
Brussino L, Solidoro P, Rolla G. Is it severe asthma or
asthma with severe comorbidities? J Asthma Allergy.
;10:303–5.
Wise SK, Lin SY, Toskala E, Orlandi RR, Akdis CA, Alt
JA, et al. International Consensus Statement on Allergy and
Rhinology: Allergic Rhinitis. Int Forum Allergy Rhinol.
;8:108–352.
Colás C, Brosa M, Antón E, Montoro J, Navarro A, Dordal
MT, et al.; Rhinoconjunctivitis Committee of the Spanish
Society of Allergy and Clinical Immunology. Estimate of
the total costs of allergic rhinitis in specialized care based on
real-world data: the FERIN Study. Allergy. 2017;72:959–
Shaaban R, Zureik M, Soussan D, Neukirch C, Heinrich J,
Sunyer J, et al. Rhinitis and onset of asthma: a longitudinal
population-based study. Lancet. 2008;372:1049–57.
Giavina-Bianchi P, Aun MV, Takejima P, Kalil J, Agondi
RC. United airway disease: current perspectives. J Asthma
Allergy. 2016;9:93–100.
De Farias CF, Amorim MM, Dracoulakis M, Caetano LB,
Santoro IL, Fernandes AL. Nasal lavage, blood or sputum:
Which is best for phenotyping asthma? Respirology.
;22:671–7.
Cingi C, Muluk NB, Cobanoglu B, Çatli T, Dikici
O. Nasobronchial interaction. World J Clin Cases.
;3:499–503.
Lohia S, Schlosser RJ, Soler ZM. Impact of intranasal
corticosteroids on asthma outcomes in allergic rhinitis: a
meta-analysis. Allergy. 2013;68:569–79.
Dhami S, Kakourou A, Asamoah F, Agache I, Lau S,
Jutel M, et al. Allergen immunotherapy for allergic
asthma: A systematic review and meta-analysis. Allergy.
;72:1825–48.
Hellings PW, Klimek L, Cingi C, Agache I, Akdis C,
Bachert C, et al. Non-allergic rhinitis: Position paper of the
European Academy of Allergy and Clinical Immunology.
Allergy. 2017;72:1657–65.
Del Cuvillo A, Santos V, Montoro J, Bartra J, Dávila I,
Ferrer M, et al. Allergic rhinitis severity can be assessed
using a visual analogue scale in mild, moderate and severe.
Rhinology. 2016;55:34–8.
Valero A, Ferrer M, Baró E, Sastre J, Navarro AM, Martí-
Guadaño E, et al. Discrimination between moderate and
severe disease may be used in patients with either treated or
untreated allergic rhinitis. Allergy. 2010;65:1609–13.
Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody
FM, Bonner JR, et al.; Guideline Otolaryngology
Development Group. AAO-HNSF. Clinical Practice
Guideline: Allergic Rhinitis. Otolaryngol Head Neck Surg.
;152:S1–43.
Gelardi M, Landi M, Ciprandi G. Nasal cytology: a
Precision Medicine tool in clinical practice. Clin Exp
Allergy. 2018;48:96–7.
Bernstein JA. Allergic and mixed rhinitis: Epidemiology
and natural history. Allergy Asthma Proc. 2010;31:365–9.
Shargorodsky J, Bhattacharyya N. What is the role of
nasal endoscopy in the diagnosis of chronic rhinosinusitis?
Laryngoscope. 2013;123:4–6.
Scadding G, Hellings P, Alobid I, Bachert C, Fokkens W,
Van Wijk RG, et al. Diagnostic tools in Rhinology EAACI
position paper. Clin Transl Allergy. 2011;1:2.
De Greve G, Hellings PW, Fokkens WJ, Pugin B, Steelant
B, Seys SF. Endotype-driven treatment in chronic upper
airway diseases. Clin Transl Allergy. 2017;7:22.
Valovirta E, Myrseth SE, Palkonen S. The voice of the
patients: allergic rhinitis is not a trivial disease. Curr Opin
Allergy Clin Immunol. 2008;8:1–9.
Hellings PW, Fokkens WJ, Akdis C, Bachert C, Cingi C,
Dietz de Loos D, et al. Uncontrolled allergic rhinitis and
chronic rhinosinusitis: where do we stand today? Allergy.
;68:1–7.
Demoly P, Calderón MA, Casale T, Scadding G, Annesi-
Maesano I, Braun JJ, et al. Assessment of disease control in
allergic rhinitis. Clin Transl Allergy. 2013;3:7.
Caimmi D, Baiz N, Tanno LK, Demoly P, Arnavielhe
S, Murray R, et al.; MASK Study Group. Validation of
the MASK-rhinitis visual analogue scale on smartphone
screens to assess allergic rhinitis control. Clin Exp Allergy.
;47:1526–33.
Mullol J, Valero A, Alobid I, Bartra J, Navarro AM, Chivato
T, et al. Allergic Rhinitis and its Impact on Asthma update
(ARIA 2008). The perspective from Spain. J Investig
Allergol Clin Immunol. 2008;18:327–34.
Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S,
Canonica GW, Casale TB, et al.; Global Allergy and
Asthma European Network; Grading of Recommendations
Assessment, Development and Evaluation Working Group.
Allergic Rhinitis and its Impact on Asthma (ARIA)
guidelines: 2010 Revision. J Allergy Clin Immunol.
;126:466–76.
Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C,
Bosnic-Anticevich S, et al. Allergic Rhinitis and its Impact
on Asthma (ARIA) guidelines—2016 revision. J Allergy
Clin Immunol. 2017;140:950–8.
Khattiyawittayakun L, Seresirikachorn K, Chitsuthipakorn
W, Kanjanawasee D, Snidvongs K. Effects of double-dose
intranasal corticosteroid for allergic rhinitis: a systematic
review and meta-analysis. Int Forum Allergy Rhinol.
;Sep 4. doi: 10.1002/alr.22204. [Epub ahead of print]
Seresirikachorn K, Chitsuthipakorn W, Kanjanawasee
D, Khattiyawittayakun L, Snidvongs K. Effects of H1
antihistamine addition to intranasal corticosteroid for
allergic rhinitis: a systematic review and meta-analysis. Int
Forum Allergy Rhinol. 2018;8:1083–92.
Pacheco Y, Freymond N, Devouassoux G. Impact of
montelukast on asthma associated with rhinitis, and other
triggers and co-morbidities. J Asthma. 2014;51:1–17.
Wahn U, Bachert C, Heinrich J, Richter H, Zielen S. Realworld
benefits of allergen immunotherapy for birch pollenassociated
allergic rhinitis and asthma. Allergy. 2018;Sep
doi: 10.1111/all.13598. [Epub ahead of print]
Asaria M, Dhami S, Van Ree R, Gerth van Wijk R, Muraro
A, Roberts G, et al. Health economic analysis of allergen
immunotherapy for the management of allergic rhinitis,
asthma, food allergy and venom allergy: A systematic
overview. Allergy. 2018;73:269–83.
Tsabouri S, Tseretopoulou X, Priftis K, Ntzani EE.
Omalizumab for the treatment of inadequately controlled
allergic rhinitis: a systematic review and meta-analysis of
randomized clinical trials. J Allergy Clin Immunol Pract.
;2:332–40.
Orlandi RR, Kingdom TT, Hwang PH, Smith TL, Alt JA,
Baroody FM, et al. International Consensus Statement on
Allergy and Rhinology: Rhinosinusitis. Int Forum Allergy
Rhinol. 2016;6 Suppl 1:S22-209.
Hirsch AG, Stewart WF, Sundaresan AS, Young AJ,
Kennedy TL, Scott Greene J, et al. Nasal and sinus
symptoms and chronic rhinosinusitis in a population-based
sample. Allergy. 2017;72:274–81.
Hastan D, Fokkens WJ, Bachert C, Newson RB,
Bislimovska J, Bockelbrink A, et al. Chronic rhinosinusitis
in Europe--an underestimated disease. A GA2LEN study.
Allergy. 2011;66:1216–23.
Smith KA, Orlandi RR, Rudmik L. Cost of adult chronic
rhinosinusitis: A systematic review. Laryngoscope.
;125:1547–56.
Jarvis D, Newson R, Lotvall J, Hastan D, Tomassen P, Keil
T, et al. Asthma in adults and its association with chronic
rhinosinusitis: The GA2LEN survey in Europe. Allergy.
;67:91–8.
Ek A, Middelveld RJM, Bertilsson H, Bjerg A, Ekerljung
L, Malinovschi A, et al. Chronic rhinosinusitis in asthma
is a negative predictor of quality of life: results from the
Swedish GA(2)LEN survey. Allergy. 2013;68:1314–21.
Rosati MG, Peters AT. Relationships among allergic
rhinitis, asthma, and chronic rhinosinusitis. Am J Rhinol
Allergy. 2016;30:44–7.
Rix I, Håkansson K, Larsen CG, Frendø M, Von Buchwald
C. Management of chronic rhinosinusitis with nasal polyps
and coexisting asthma: A systematic review. Am J Rhinol
Allergy. 2015;29:193–201.
De Bruin RJ, Hage R, Van der Zaag-Loonen H, Van
Benthem PP. Rapid review: sinonasal surgery vs. medical
therapy for asthma in patients with chronic rhinosinusitis
with or without nasal polyps. Eur Arch Otorhinolaryngol.
;273:2295–304.
Campbell AP, Phillips KM, Hoehle LP, Gaudin RA,
Caradonna DS, Gray ST, et al. Association between Asthma
and Chronic Rhinosinusitis Severity in the Context of
Asthma Control. Otolaryngol Neck Surg. 2018;158:386–
Banoub RG, Phillips KM, Hoehle LP, Caradonna DS,
Gray ST, Sedaghat AR. Relationship between chronic
rhinosinusitis exacerbation frequency and asthma control.
Laryngoscope. 2018;128:1033–8.
Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I,
Baroody F, et al. European position paper on rhinosinusitis
and nasal polyps 2012. Rhinology. 2012;50:1–12.
Alobid I, Antón E, Armengot M, Chao J, Colás C, Del
Cuvillo A, et al.; Rhinoconjunctivitis Committee;
Spanish Society of Allergy and Clinical Immunology;
Rhinology and Allergy Commission: Spanish Society
of Otorhinolaryngology. SEAIC-SEORL. Consensus
Document on Nasal Polyposis. POLINA Project. J Investig
Allergol Clin Immunol. 2011;21 Suppl 1:1–58.
Hopkins C, Hettige R, Soni-Jaiswal A, Lakhani R, Carrie
S, Cervin A, et al. CHronic Rhinosinusitis Outcome
MEasures (CHROME), developing a core outcome set for
trials of interventions in chronic rhinosinusitis. Rhinology.
;56:22–32.
Soler ZM, Hyer JM, Ramakrishnan V, Smith TL, Mace
J, Rudmik L, et al. Identification of chronic rhinosinusitis
phenotypes using cluster analysis. Int Forum Allergy
Rhinol. 2015;5:399–407.
Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook
I, Ashok Kumar K, Kramper M, et al. Clinical Practice
Guideline (Update): Adult Sinusitis. Otolaryngol Neck
Surg. 2015;152:S1–39.
Steinke JW, Borish L. Chronic rhinosinusitis phenotypes.
Ann Allergy Asthma Immunol. 2016;117:234–40.
Snidvongs K, Heller GZ, Sacks R, Harvey RJ. Validity of
European position paper on rhinosinusitis disease control
assessment and modifications in chronic rhinosinusitis.
Otolaryngol Head Neck Surg. 2014;150:479–86.
Rudmik L, Soler ZM. Medical Therapies for Adult Chronic
Sinusitis: A Systematic Review. JAMA. 2015;314:926–39.
Yatera K, Yamasaki K, Noguchi S, Nishida C, Oda K,
Akata K, et al. Prevalence of sinusitis and efficacy of
intranasal corticosteroid treatment on asthmatic symptoms
in asthmatic patients with rhinosinusitis: a pilot study. Int
Forum Allergy Rhinol. 2016;6:398–406.
Nonaka M, Sakanushi A, Kusama K, Ogihara N, Yagi
T. One-year evaluation of combined treatment with an
intranasal corticosteroid and montelukast for chronic
rhinosinusitis associated with asthma. J Nippon Med Sch.
;77:21–8.
Bidder T, Sahota J, Rennie C, Lund VJ, Robinson
DS, Kariyawasam HH. Omalizumab treats chronic
rhinosinusitis with nasal polyps and asthma together-a real
life study. Rhinology. 2018;56:42–5.
Bachert C, Mannent L, Naclerio RM, Mullol J, Ferguson
BJ, Gevaert P, et al. Effect of Subcutaneous Dupilumab
on Nasal Polyp Burden in Patients With Chronic Sinusitis
and Nasal Polyposis: A Randomized Clinical Trial. JAMA.
;315:469–79.
Rivero A, Liang J. Anti-IgE and Anti-IL5 Biologic
Therapy in the Treatment of Nasal Polyposis: A Systematic
Review and Meta-analysis. Ann Otol Rhinol Laryngol.
;126:739–47.
Vashishta R, Soler ZM, Nguyen SA, Schlosser RJ.
A systematic review and meta-analysis of asthma
outcomes following endoscopic sinus surgery for chronic
rhinosinusitis. Int Forum Allergy Rhinol. 2013;3:788–94.
Zhang Z, Adappa ND, Doghramji LJ, Chiu AG, Lautenbach
E, Cohen NA, et al. Quality of life improvement from sinus
surgery in chronic rhinosinusitis patients with asthma and
nasal polyps. Int Forum Allergy Rhinol. 2014;4:885–92.
Enlaces refback
- No hay ningún enlace refback.