Rondon C, et al. – The natural history of a population with local allergic rhinitis (LAR), the potential conversion to allergic rhinitis (AR) with systemic atopy, and the development of asthma during 10 years were prospectively gauged. With a low rate of development of systemic atopy, LAR was a well–differentiated clinical entity. It was a natural evolution towards worsening and a risk factor for suffering asthma.

Methods

• 176 patients with LAR of recent onset and 115 age- and sex-matched healthy controls prospectively evaluated from 2005 to 2016 were incorporated in this second phase of a 10 year follow-up study.
• Researchers assessed clinical-demographic questionnaire, spirometry, skin prick-test, and specific-IgE yearly.
• They conducted nasal allergen provocation tests (NAPT) with D. pteronyssinus, Alternaria alternata, Olea europaea, and grass pollen at baseline, and after 5 and 10 years.

Results

• After 10 years, results revealed a significant and clinically relevant worsening of the rhinitis, with increase of emergency assistance, development of asthma, loss of allergen tolerance, and impairment of the quality of life in LAR patients.
• Moreover, this worsening became significant after 5 years and progressed throughout 10 years.
• They detected a similar rate of development of AR with systemic atopy in patients and controls (9.7% vs 7.8%, Log-rank p=0.623).
• They observed conversion to systemic atopy >10 years (3%) in 5 patients.