By David Douglas

NEW YORK (Reuters Health) - Asthmatics who do not respond well to asthma treatment are likely to also have moderate-to-severe nasal inflammation or "rhinitis," Brazilian researchers have observed.

There is "strong evidence for an association between moderate-to-severe rhinitis and uncontrolled asthma," senior investigator Dr. Alvaro A. Cruz told Reuters Health.

Asthma and rhinitis share many similarities and the prevalence of rhinitis among asthmatics is high, note Cruz, of Universidade Federal de Bahia, and colleagues in the medical journal Allergy.

To further investigate ties between the two conditions, the researchers studied 557 patients with severe asthma. In all, 31 percent had moderate-to-severe rhinitis, 54 percent had mild rhinitis and 15 percent had no rhinitis.

Compared to the other subjects, patients with moderate-to-severe rhinitis were more than 3 times as likely to visit the emergency room during the 12 months that they were followed.

By the end of follow-up, they were also almost 3 times as likely to show a less than 10 percent improvement in asthma symptoms and were more than 12 times as likely to have uncontrolled asthma.

The team also found a positive correlation between the severity of rhinitis and severity of asthma.

"Taking into consideration that the patients were receiving the best treatment options for asthma and rhinitis," Cruz said, "the most likely explanation for the observed inter-relationship is that both rhinitis and asthma were manifestations of the same disease affecting the entire airway, for which the degree of severity of the upper and lower airway processes is correlated."

SOURCE: Allergy, May 2008.

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