Application of allergic rhinitis and its impact on asthma guidelines in terms of classification, risk factors, quality of life and co-morbidities in allergic rhinitis patients in Northern India

Anmol Kumar Agarwal, Rohit Sharma, Vinit Sharma


Background: Despite the high prevalence of allergic rhinitis, there are only few studies on application of ARIA (allergic rhinitis and its impact on asthma) guidelines.

Methods: It was a prospective study of 164 patients. Based on ARIA guidelines; patients were graded for severity, risk factors studied, co morbidities documented and quality of life assessed using rhinoconjunctivitis quality of life questionnaire (RQLQ).  

Results: A total of 164 cases were studied between the age group 10-72 years of which 56.1% were males. Most common trigger observed was dust (56.1%). Allergic conjunctivitis was most common co-morbidity associated. Using RQLQ it was observed that ARIA.

Conclusions: ARIA guidelines appropriately classify allergic rhinitis, determines risk factors and associated co-morbidities. RQLQ can be used to determine quality of life in allergic rhinitis.


ARIA, RQLQ, Comorbidities, Classification, Quality of life, Risk factors

Full Text:



Bousquet J, van Cauwenberge P, Khaltaev N. Allergic Rhinitis and Its Impact on Asthma. J Allergy Clin Immunol. 2001;108(5):147-334.

Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and Aller Gen). Allergy. 2008;63:8-160.

Pereira C, Valero A, Loureiro C, Davila I, Martinez-Cocera C, Murio C, et al. Iberian study of aeroallergens sensitization in allergic rhinitis. European Annals Allergy Clin Immunol. 2006;38:186-94.

Navarro A, Valero A, Julia B, Quirce S. Coexistence of Asthma and Allergic Rhinitis in Adult Patients Attending Allergy Clinics: ONEAIR Study. J Investigational Allergol Clin Immunol. 2008;18(4):233-8.

Cazzoletti L, Ferrari M, Olivieri M, Verlato G, Antonicelli L, Bono R, et al. The gender, age and risk factor distribution differs in self‑reported allergic and non‑allergic rhinitis: a cross‑sectional population‑based study. Allergy Asthma Clin Immunol. 2015;11:36.

Droste JHJ, Kerkhof M, De Monchy JGR, Schouten JP, Rijcken B. Association of skin test reactivity, specific IgE, total IgE, and eosinophils with nasal symptoms in a community-based population study. J Allergy Clin Immunol. 1996;97:922-32.

Olivieri M, Verlato G, Corsico A, Lo Cascio V, Bugiani M, Marinoni A et al. Prevalence and features of allergic rhinitis in Italy. Allergy. 2002;57:600-6.

Demoly P, Aubier M, Blay F, Wessel F, Clerson P, Maigret P. Evaluation of patients’ expectations and benefits in the treatment of allergic rhinitis with a new tool: the patient benefit index. Allergy, Asthma Clin Immunol. 2015;11:8.

Bousquet L, Annesi-Maesano I, Carat F. Characteristics of intermittent and persistent allergic rhinitis: DREAMS study group. Clin Exp Allergy. 2005;35(6):728-32.

Shafi M, Ghouri A, Aslam S, Hanif R. Frequency of Allergic Rhinitis in Patients with Bronchial Asthma at a Tertiary Care Hospital. Isra Med J. 2018;10(1):3-7.

Demoly P, Allaert FA, Lecasble M, Bousquet J. Validation of the classification of ARIA (allergic rhinitis and its impact on asthma). Allergy. 2003;58(7):672-5.

Bousquet J, Fokkens W, Burney P, Durham SR, Bachert C, Akdis CA et al. Important research questions in allergy and related diseases: nonallergic rhinitis: a GA2LEN paper. Allergy. 2008;63:842-53.

Mösges R, Klimek L. Today’s allergic rhinitis patients are different: new factors that may play a role. Allergy. 2007;62:969-75.

Gehring U, Wijga AH, Brauer M, Fischer P, de Jongste JC, Kerkhof M et al. Traffic-related air pollution and the development of asthma and allergies during the first 8 years of life. Am J Respir Crit Care Med. 2010;181:596-603.

Wyler C, Braun-Fahrländer C, Künzli N, Schindler C, Ackermann-Liebrich U, Perruchoud AP et al. Exposure to motor vehicle traffic and allergic sensitization. Epidemiology. 2000;11:450-6.

Cesaroni G, Badaloni C, Porta D, Forastiere F, Perucci CA. Comparison between various indices of exposure to traffic-related air pollution and their impact on respiratory health in adults. Occup Environ Med. 2008;65:683-90.

Passali D, Cingi C, Staffa P, Passali F, Muluk NB, Bellussi ML. The International Study of the Allergic Rhinitis Survey: outcomes from four geographical regions. Asia Pac Allergy. 2018;8(1):7.

Alyasin S, Amin R. The Evaluation of New Classification of Allergic Rhinitis in Patients Referred to a Clinic in the City of Shiraz. Iranian J Allergy Asthma Immunol. 2007;6(1):27-31.

Umapathy D, Alles R, Scadding GK. A community based questionnaire study on the association between symptoms suggestive of otitis media with effusion, rhinitis and asthma in primary school children. Int J Pediatr Otorhinolaryngol. 2007;71(11):705-12.

Bousquet J, Neukirch F, Bousquet P, Gehano P, Klossek J, Legal M et al. Severity and impairment of allergic rhinitis in patients consulting in primary care. J Allergy Clin Immunol. 2006;117(1):158-62.

La Grutta S, Landi M, Braido F, Montalbano L, Ferrante G, Malizia V. RHINASTHMA-Adolescents: a new quality of life tool for patients with respiratory allergy. Pediatr Allergy Immunol. 2014;25:450-5.

Blaiss M, Reigel T, Philpot E. A study to determine the impact of rhinitis on sufferers sleep and daily routine. J Allergy Clin Immunol. 2005;115:197.

Leger D, Annesi-Maesano I, Carat F, Rugina M, Chanal I, Pribil C, et al. Allergic rhinitis and its consequences on quality of sleep: An unexplored area. Arch Intern Med. 2006;166(16):1744-8.

Dziekanski M, Marcelino TF. Quality of Life in Pediatric Patients with Allergic Rhinitis treated at the Medical Clinic of Integrated Education - Unisul. Int Arch Otorhinolaryngol. 2017;21:371-6.

Bisaccioni C, Aun MV, Cajuela E, Kalil J, Agondi RC, Giavina-Bianchi P. Comorbidities in severe asthma: frequency of rhinitis, nasal polyposis, gastroesophageal reflux disease, vocal cord dysfunction and bronchiectasis. Clinics. 2009;64(8):769-73.

Meltzer EO, Farrar JR, Sennett C. Findings from an online survey assessing the burden and management of seasonal allergic rhinoconjunctivitis in US patients. J Allergy Clin Immunol Pract. 2017;5:779-89.

Valero A, Mullol J, Herdman M, Rosales MJ. Measuring outcomes in allergic rhinitis: psychometric characteristics of a Spanish version of the congestion quantifier seven-item test (CQ7). Health Qual Life Outcomes. 2011;9(01):14.

Nascimento Silva M, Naspitz C, Solé D. Evaluation of quality of life in children and teenagers with allergic rhinitis: adaptation and validation of the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Allergol Immunopathol. 2001;29(04):111-8.

Bousquet PJ, Demoly P, Devillier P,Mesbah K, Bousquet J. Impact of allergic rhinitis symptoms on quality of life in primary care. Int Arch Allergy Immunol. 2013;160(04):393-400.