Search

Some patients with allergic rhinitis (AR) may prefer a 'dry' intranasal corticosteroid aerosol to avoid certain sensory perceptions such as the 'wet feeling in the nose' and the 'dripping down the throat' associated with aqueous nasal sprays. A nonaqueous hydrofluoroalkane-propelled beclomethasone dipropionate (BDP) nasal aerosol with an established efficacy and safety profile was approved to treat the nasal symptoms associated with AR in adult and adolescent patients. This study was designed to evaluate ease of use and patient satisfaction with the BDP nasal aerosol device in patients with perennial AR (PAR). In this phase 3, randomized, double-blind, parallel-group, placebo-controlled study, eligible patients (≥12 years of age) with PAR were randomly assigned to receive BDP nasal aerosol at 320 micrograms/day or placebo for 6 weeks. At the end of the treatment period, patients assessed device ease of use and satisfaction with the device using a questionnaire with a 5-point representative scale (not at all, not very, neither nor, somewhat, very [certain/easy/satisfactory]). Nearly all patients (89.7%) reported that the BDP nasal aerosol device with integrated dose counter was 'very easy' or 'somewhat easy' to use. The majority of patients (87.5%) also indicated that it was 'very easy' or 'somewhat easy' to tell when the device was empty, compared with only 42.3% who were 'very certain' or 'somewhat certain' of being able to tell when previously used aqueous nasal spray devices were empty. Overall, patient satisfaction with the BDP nasal aerosol device was high: 65.7% responded that they were 'very satisfied' or 'somewhat satisfied' and only 3.6% were 'not satisfied at all' or 'not very satisfied.' These results indicate that the majority of patients considered the BDP nasal aerosol device easy to use and reported a high degree of satisfaction with the device compared with other nasal sprays they had used in the past. [ABSTRACT FROM AUTHOR]

Allergic rhinitis is a chronic, allergen-induced inflammatory reaction. Patients often differentiate intranasal treatments based on sensory attributes. The purpose of this study was to evaluate the sensory attributes of olopatadine HCl nasal spray 0.6% (OLO) relative to azelastine HCl nasal spray 0.1% (AZE). This was a multicenter, double-blind, randomized, crossover comparison of OLO versus AZE in adult, symptomatic patients with at least a 2-year history of allergic rhinitis. Patients received each of the treatments separately with a washout between exposures, evaluated their sensory perceptions immediately after and 45 minutes postdosing with each treatment, and evaluated their perceptions of the two medications after administering both therapies. The mean age of the 110 patients was 42.4 years; 67% were women. OLO was superior to AZE in overall aftertaste (60.6% versus 30.3%; p = 0.0005), patient preference (62.4% versus 33.9%; p = 0.0001), and likelihood of extended use (60.9% versus 34.5%; p = 0.0004). OLO was superior to AZE in perceptions of immediate taste (1.9 U versus 3.2 U, respectively; p < 0.0001). Perceptions of additional attributes after administration of both treatments were significant and favored OLO (p ≤ 0.0036 for all variables). In these assessments, respectively, 54.1 and 32.1% of patients favored the taste and smell of OLO compared with 27.5 and 11.9% who favored AZE. Both treatments were well tolerated. The sensory attributes of OLO are superior to AZE in terms of immediate taste postdosing, overall aftertaste, overall patient preference, and likelihood of use. This outcome could lead to greater patient compliance and improved treatment effect. [ABSTRACT FROM AUTHOR]

Background: Although research demonstrates that allergy immunotherapy (IT) improves allergic rhinitis (AR) outcomes, little is known about IT patterns of care and associated resource use and costs among US children with diagnoses of AR. Objective: We sought to examine characteristics associated with receiving IT, patterns of IT care, and health care use and costs incurred in the 6 months before versus after IT. Methods: We performed retrospective Florida Medicaid claims data (1997-2004) analysis of children (<18 years of age) given new diagnoses of AR. Results: Of 102,390 patients with new diagnoses of AR, 3048 (3.0%) received IT. Male patients, Hispanic patients, and those with concomitant asthma were significantly more likely to receive IT. Approximately 53% completed less than 1 year and 84% completed less than 3 years of IT. Patients who received IT used significantly less pharmacy (12.1 vs 8.9 claims, P < .0001), outpatient (30.7 vs 22.9 visits, P < .0001), and inpatient (1.2 vs 0.4 admissions, P = .02) resources in the 6 months after versus before IT. Pharmacy ($330 vs $60, P < .0001), outpatient ($735 vs $270, P < .0001), and inpatient ($2441 vs $1, P < .0001) costs (including costs for IT care) were significantly reduced after IT. Conclusion: Despite suboptimal treatment persistence (only 16% of patients completed 3 years of IT), resource use and costs after treatment were significantly reduced from pre-IT levels. [Copyright &y& Elsevier]

Intranasal steroids (INSs) are recommended as first-line treatment for allergic rhinitis (AR) and a wealth of data exist supporting them as safe and effective. Our goal was to develop a consensus to help physicians choose between INSs by focusing on clinical profiles and patient preferences and providing expert advice on choosing the appropriate INS for each patient. Experts from specialties that manage patients with AR attended a roundtable meeting to discuss INS therapy. Besides comparisons with other pharmacologic agents, they examined the effects of INS on nasal anatomy, patient preferences for INS, and benefits of product selection based on patient profile. The literature on INSs in AR was reviewed, examining properties of the various drugs, delivery devices, formulations, and patient preference data. Nasal anatomy and physiology must be considered to optimize INS deposition in the nose. Teaching patients proper technique for using INS devices is important to prevent nasal injury and may help concentrate drug effect on affected tissues. INS therapies differ somewhat in biological properties and specific formulation; however, all are considered safe and effective treatment for AR. Patients exhibit different clinical profiles, which play a role in INS selection. Patients can clearly identify sensory characteristics of INS and therefore establish product preference. Patient preference also can guide physicians in choosing the appropriate agent for each patient. Control of AR requires a systematic approach to treatment selection and follow-up. Treatment selection should be matched with clinical profile and patient preferences. [ABSTRACT FROM AUTHOR]

The article presents the updated codes from the Joint Council of Allergy, Asthma and Immunology (JCAAI). The codes are for their members for them to use in reimbursing the services they performed. The codes are used to designate the services by all physicians. The payment of the services and the rules that determine what services these physicians can provide are tied to these codes. These codes are still the most widely accepted standard for billing.