Mylan at the EAACI Annual Congress 2017 - The Allergic Rhinitis Challenge: Perception and Control

HELSINKI, June 21, 2017 /PRNewswire/ --

The global respiratory community has met at the EAACI Annual Congress 2017 in Helsinki, during which Mylan sponsored an interactive symposium to discuss AR challenges in terms of perception, control and lack of real life effectiveness data and to highlight major patients' unmet needs.

The focus was on allergic rhinitis (AR), an inflammation of the nasal membranes characterized by sneezing, nasal congestion, itching and rhinorrhoea, in any combination.^[i] Up to 40% of the population experience its symptoms,^[ii] and the already high prevalence is continuing to rise.^[iii] AR is a socioeconomic public health issue: the cost of lost productivity due to allergic rhinitis was significantly different from the cost due to any other condition.^[iv] Symptoms affect sufferers' quality of life, emotional wellbeing and productivity.^[v],[vi] Those experiencing AR are also eight time more likely to have asthma, whose control is negatively affected to the same degree as smoking.^[vii] Nevertheless, patients often underestimate the severity of their symptoms and undertreat them. Up to 66.5% are unsatisfied with current AR treatment^[viii] and 70% relies on multiple therapies.^[ix]

New opportunities to face this challenge are given by the use of the Visual Analogue Scale (VAS), a psychometric response tool for subjective characteristics that has been used in a large variety of diseases. The wide score range and its high sensitivity and reproducibility can outperform linear scales.^[x],[xi] This simple measuring system underlies Allergy Diary App, a free app for patients developed to assess AR control by MACVIA-ARIA experts with also the financial support of Meda, a Mylan company since August 2016. This tool registers symptoms and therapies and plots results over time, supporting AR management and improving adherence to therapies.

"Simplification not complication is key to find a way to manage AR - explains Prof Jean Bousquet, Professor Emeritus of Pulmonary Medicine at the University of Montpellier, France - In this sense, the VAS offers a simple, quick and intuitive tool that can help assess AR control in seconds. Incorporating the VAS into the AR clinical decision support system (AR CDSS) creates a novel treatment algorithm that offers a chance to improve patient-healthcare provider communication."

The need for effective tools is greater when considering the major impact of AR on productivity. According to studies, 90% of AR patients report that work is influenced negatively with an average of 37.7 days/year lost for presentism and 4.1 days/year for absenteeism.^[xii]

"AR, when uncontrolled, negatively affects patients' quality of life, impairing productivity at work and at school and carrying a hefty price tag." - Adds Professor Mike Bewick, former deputy medical director of NHS England - "To achieve control of the symptoms, changing the perception of AR is a major challenge. In my experience as a senior clinical leader and commissioner in the NHS, targeting the problem with an early interventional approach would reduce disease progression; enhance the elimination of symptoms, ensuring a more productive contribution at work and in education".

The VAS in Allergy Diary, combined with effective medications, can empower patients and doctors to finally take control of AR symptoms.

i. Druce HM., Allergic and non-allergic rhinitis. Allergy principles and practice 1998 

ii. Bousquet et al., ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle. Clin Transl Allegy 2016 

iii. Bousquet et al., Allergic Rhinitis and its Impact on Asthma (ARIA). Allergy 2008 

iv. Lamb et al., Economic impact of workplace productivity losses due to allergic rhinitis compared with select medical conditions in the United States from an employer perspective. Curr Med Res Opin 2006 

v. Price  et al., The hidden burden of adult allergic rhinitis: UK healthcare resource utilisation survey. Clin Transl Allergy 2015 

vi. Valovirta et al., The voice of the patients: allergic rhinitis is not a trivial disease. Curr Opin Allergy Clin Immunol 2008. 

vii. Clatworthy J et al., The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control Prim Care Respir J 2009 

viii. Ciprandi et al., Patient-related factors in rhinitis and asthma: the satisfaction with allergy treatment survey. Cur Med Res Opin 2011 

ix. Price et al., The hidden burden of adult allergic rhinitis: UK healthcare resource utilisation survey. Clin Transl Allergy 2015 

x. Grant et al., A comparison of the reproducibility and the sensitivity to change of visual analogue scales, Borg scales, and Likert scales in normal subjects during submaximal exercise. Chest 1999 

xi. Reips and Funkle, Interval-level measurement with visual analogue scales in Internet-based research: VAS Generator. Behavior Research Methods 2008 

xii. Price et al., The hidden burden of adult allergic rhinitis: UK healthcare resource utilisation survey. Clin Transl Allegy 2015