Rhinitis and onset of asthma: a longitudinal population-based study

Rafea Shaaban, Mahmoud Zureik, David Soussan, Catherine Neukirch, Joachim Heinrich, Jordi Sunyer, Matthias Wjst, Isa Cerveri, Isabelle Pin, Jean Bousquet, Deborah Jarvis, Peter G. Burney, Françoise Neukirch, Bénédicte Leynaert

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Abstract

Background: A close relation between asthma and allergic rhinitis has been reported by several epidemiological and clinical studies. However, the nature of this relation remains unclear. We used the follow-up data from the European Community Respiratory Health Survey to investigate the onset of asthma in patients with allergic and non-allergic rhinitis during an 8·8-year period. Methods: We did a longitudinal population-based study, which included 29 centres (14 countries) mostly in western Europe. Frequency of asthma was studied in 6461 participants, aged 20-44 years, without asthma at baseline. Incident asthma was defined as reporting ever having had asthma confirmed by a physician between the two surveys. Atopy was defined as a positive skin-prick test to mites, cat, Alternaria, Cladosporium, grass, birch, Parietaria, olive, or ragweed. Participants were classified into four groups at baseline: controls (no atopy, no rhinitis; n=3163), atopy only (atopy, no rhinitis; n=704), non-allergic rhinitis (rhinitis, no atopy; n=1377), and allergic rhinitis (atopy+rhinitis; n=1217). Cox proportional hazards models were used to study asthma onset in the four groups. Findings: The 8·8-year cumulative incidence of asthma was 2·2% (140 events), and was different in the four groups (1·1% (36), 1·9% (13), 3·1% (42), and 4·0% (49), respectively; p1), log total IgE, family history of asthma, and smoking, the adjusted relative risk for asthma was 1·63 (95% CI 0·82-3·24) for atopy only, 2·71 (1·64-4·46) for non-allergic rhinitis, and 3·53 (2·11-5·91) for allergic rhinitis. Only allergic rhinitis with sensitisation to mite was associated with increased risk of asthma independently of other allergens (2·79 [1·57-4·96]). Interpretation: Rhinitis, even in the absence of atopy, is a powerful predictor of adult-onset asthma. Funding: UCB Institute of Allergy and Agence Nationale de la Recherche.

Original languageEnglish
Pages (from-to)1049-1057
Number of pages9
JournalLancet
Volume372
Issue number9643
DOIs
Publication statusPublished - 2008

ASJC Scopus subject areas

  • Medicine(all)

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    Shaaban, R., Zureik, M., Soussan, D., Neukirch, C., Heinrich, J., Sunyer, J., Wjst, M., Cerveri, I., Pin, I., Bousquet, J., Jarvis, D., Burney, P. G., Neukirch, F., & Leynaert, B. (2008). Rhinitis and onset of asthma: a longitudinal population-based study. Lancet, 372(9643), 1049-1057. https://doi.org/10.1016/S0140-6736(08)61446-4