The Allergic Rhinitis Control Test questionnaire is valuable in guiding step-down pharmacotherapy treatment of allergic rhinitis

Publication date: Available online 7 June 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Rongfei Zhu, Jingru Wang, Yuying Wu, Yongshi Yang, Nan Huang, Yaqi Yang, Rui Zhang, Dongxia Ma, Lin Yang, Pascal Demoly
BackgroundAllergic Rhinitis Control Test(ARCT) has been validated in allergic rhinitis(AR) step-up pharmacotherapy management approach.ObjectiveThe aim of our study was to evaluate the potential of ARCT in AR step-down pharmacotherapy.MethodsIn an open-labelled randomized controlled study, AR patients controlled with intranasal corticosteroid(INS) plus antihistamine(step 4) were included and randomized into an ARCT or a control group. In ARCT group, the patients were followed up every 15 days; if ARCT score was ≥20(controlled AR), the patient would step down to step 3(INS), step 2(daily antihistamine), step 1(antihistamine as needed) and step 0(no medication) consecutively; if ARCT score was strictly <20, the treatment would not be adjusted. In the control group, patients would be treated with step 4 medications during the whole study. Rhinitis Quality-of-Life Questionnaire(RQLQ), Morisky Questionnaire and Brief Illness-Perception-Questionnaire(B-IPQ) were completed at baseline and the end of the study. Medication use and side effects were recorded.ResultsA total of 255 AR patients were enrolled into the study, 27 patients dropped out. The control rates at D45 were 77.8% in ARCT group and 85.8% in control group(P>0.05). ARCT group had less mean medication use than control group(INS 1.27 vs. 2.22 bottle, antihistamines 35.9 vs. 61.4 tablets)(P<0.05). RQLQ, Morisky and B-IPQ score were significantly improved in both groups after treatment(P<0.05).ConclusionStepping down AR medications in controlled patients led to similar clinical outcomes at reduced cost compared with those who maintained their current treatment level. ARCT is an optimal tool for evaluating the step-down eligibility.