Allergic rhinitis and co-morbid asthma: perspective from India -- ARIA Asia-Pacific Workshop report

In India, allergic rhinitis (AR) is considered to be a trivial disease, despite the fact that symptoms of rhinitis were present in 75% of children and 80% of asthmatic adults. Traditionally, AR was also divided into seasonal or perennial, based on the time of occurrence of symptoms during the year. The ARIA workshop report proposed that patients be categorized as "intermittent" and "persistent" while severity was classified as "mild" and "moderate-severe". Patients with AR, depending on their predominant symptom, can also be categorized as "sneezers-runners" and "blockers". On sketching their clinical profile, it was observed that "blockers" had significantly higher sinusitis and had higher sensitization to fungi. Skin allergy testing in Indian adults showed that in patients with AR house dust mite (Dermatophagoides farinae) was the most common allergen. Studies conducted in India have shown that AR often restricts the patient's quality of life (QOL). It can affect the physical, psychological and social aspects of the patients' life and can also impact their functions at work. Furthermore, AR adversely affects sleep related QOL. Topical corticosteroids are now considered as the cornerstone of the treatment for AR. In spite of causing a major impact on the QOL in Indian patients, AR is rarely given the importance it deserves.