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Hospital de Órbigo, Spain

Jauregui I.,Hospital Universitario Basurto | Ferrer M.,Servicio de Alergia | Bartra J.,Unitat dAllergia | Del Cuvillo A.,Clinica Dr Lobaton | And 5 more authors.
Expert Opinion on Pharmacotherapy | Year: 2013

Introduction: Urticaria is a highly prevalent disease among people. First-choice treatment continues to be centred on the second-generation H1 antihistamines, including a wide group of drugs with a better therapeutic index (or risk:benefit ratio) than the classic ones, even in the high, off-label dosage occasionally required in chronic urticaria. Bilastine is a newly registered H1-antihistamine for treatment of allergic rhinoconjunctivitis and urticaria. With established antihistaminic and antiallergic properties, it is widely reviewed in the medical literature; however, to our knowledge, a specific review of bilastine's role in the treatment of urticaria was lacking. Areas covered: This article reviews the medical literature on the effectiveness and safety of bilastine in urticarial syndromes, either spontaneous or inducible, by means of a Medline search from 1990 to present, completed with some nonpublished data provided by the manufacturer. Expert opinion: Once-daily treatment with bilastine 20 mg is effective in managing symptoms and improving patient's quality of life in chronic urticaria, with at least comparable efficacy to levocetirizine. As far as studies in healthy volunteers, clinical assays, and recent clinical experience can establish, bilastine's safety profile is adequate, appearing to be entirely free from cardiovascular effects, and not impairing psychomotor performance or actual driving, even at twice the therapeutic dose. © 2013 Informa UK, Ltd. Source


Jauregui I.,Servicio de Alergologia | Davila I.,Servicio de Inmuno Alergia | Sastre J.,Servicio de Alergia | Sastre J.,Research Center Biomedica en Red en Enfermedades Respiratorias | And 9 more authors.
Pediatric Allergy and Immunology | Year: 2011

Allergic rhinitis (AR) is the commonest chronic disease in children. Allergic Rhinitis and its Impact on Asthma (ARIA) classification based on symptom duration (intermittent vs. persistent) and severity (mild vs. moderate/severe) has not been yet validated in children. Thus our objective was to validate ARIA classification in children, after determining the severity and duration of AR in a pediatric population, using ARIA definitions. Children aged 6-12 with a diagnosis of AR were included in an observational, cross-sectional, multicenter study. Patients were classified according to ARIA guidelines. AR symptoms were assessed using the Total Four Symptoms Score (T4SS). Severity was also evaluated by the patient using a visual analogue scale (VAS). Comparisons were made by means of a statistical analysis. One thousand two hundred and seventy-five children from 271 centers were included. Among them, 59.5% had intermittent and 40.5% persistent AR, while 60.7% seasonal and 39.3% perennial according to dated classification, with significant differences existing between one classification and another; 89.7% had moderate/severe rhinitis. Significantly higher T4SS and VAS scores were obtained in moderate/severe compared to mild AR. In our experience, the current ARIA classification can be considered a valid tool also in children from 6- to 12-yr old. © 2011 John Wiley & Sons A/S. Source


Valero A.,Unitat dAllergia | Valero A.,Institute dinvestigacions Biomediques August Pi i Sunyer IDIBAPS | Valero A.,Research Center Biomedica en Red en Enfermedades Respiratorias | Munoz-Cano R.,Unitat dAllergia | And 11 more authors.
Rhinology | Year: 2012

Introduction: Allergic rhinitis (AR) is a common disease with major socieconomic burden and a significant impact on quality of life. Objective: The objective of the study was to assess the impact of AR severity, using the modified ARIA (m-ARIA) severity criterion in order to discriminate among moderate and severe AR, in symptoms and quality of life assessed with the questionnaire ESPRINT-15. Methods: The specific quality of life questionnaire (ESPRINT-15) was applied in over thousand untreated AR patients. Severity was evaluated by the m-ARIA classification, which categorizes AR as mild, moderate, and severe. Nasal symptoms were evaluated by using categorized (none, low, middle, and high) Total Four Symptom Score (T4SS). Results: Using the m-ARIA severity classification, significant differences in quality of life, both global score and specific domains, and categorized T4SS were found among the AR severity groups. Conclusion: Modified ARIA severity classification in mild, moderate, and severe allergic rhinitis clearly discriminates the impact of AR in all domains of quality of life and categorized symptom's score. Source


Del Cuvillo A.,Clinica Dr Lobaton | Bartra J.,Unitat dAllergia | Bartra J.,Research Center Biomedica En Red Ciberes Of Enfermedades Respiratorias | Antonio Valero,Unitat dAllergia | And 6 more authors.
Rhinology | Year: 2010

Introduction: Allergic rhinitis (AR) is an increasingly prevalent worldwiDe disease, which has an important impact on quality of life and generates high social and health care costs. The ARIA classification, that consiDers both the duration and severity of AR, seems more appropriate than previous classifications of AR, but few studies exist on the validation of the severity criteria proposed by the ARIA classification. Objectives: To assess the ARIA duration and severity classification of AR in a large sample population of patients, by investigating whether different Degrees of severity correlate with differences in symptom score, quality of life or the patient's self evaluation of impairment. This study also assesses the relationship between AR severity and comorbidities. Material and Methods: An observational, cross-sectional, multicentre study conducted in Spain. AR was classified based on the ARIA criteria, and compared to the classical classification based on allergen exposure. Rhinitis was evaluated by the Total 4-Symptom Score (T4SS) scale, quality of life was measured using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and disease severity through a Visual Analogue Scale (VAS, 0-100 mm). Comorbidities were evaluated based both on the duration and severity of the symptoms of rhinitis. Results: AR patients, (n = 3,529; mean age 37.5 ± 13.4 years; 52.3% women) were incluDed in the study. AR patients were classified as intermittent (51.5%) and persistent (48.5%) based on the ARIA classification, and as seasonal (61.2%), perennial (35.1%), and occupational (3.7%) based on the allergen exposure classification. Significantly higher T4SS, RQLQ and VAS scores were obtained in moDerate/severe compared to mild AR. The inciDence of asthma was significantly higher in patients with persistent and moDerate/severe AR compared to intermittent and mild AR. Asthma was the only comorbidity to reach statistical significance. Conclusion: ARIA classification of severity reflects two different statuses of AR in terms of symptoms and quality of life. Asthma was the only concomitant pathology in which inciDence was related to ARIA categories in terms of duration or severity. Source


Mullol J.,Unitat de Rinologia i Clinica de lOlfacte | Mullol J.,Institute dinvestigacions Biomediques August Pi i Sunyer IDIBAPS | Mullol J.,Research Center Biomedica en Red en Enfermedades Respiratorias | Bartra J.,Unitat dAllergia | And 10 more authors.
Clinical and Experimental Allergy | Year: 2013

Background: Although the treatment of allergic rhinitis (AR) is now well established, its impact on severity has not yet been evaluated. Objective: The aim was to analyse specialist-based treatment on AR severity, nasal symptoms and quality of life. Methods: A longitudinal observational, prospective, multi-centre study with 4 weeks of follow-up was carried out by 141 allergologists and ENT specialists in Spain. Selection criteria were adult patients with AR, clinically diagnosed at least 2 years before, with a total nasal symptom score (TNSS) ≥5, not receiving either antihistamines within the previous week or nasal corticosteroids during the 2 previous weeks. Disease severity using both original Allergic Rhinitis and its Impact on Asthma (o-ARIA) and modified (m-ARIA) classifications, nasal symptoms, and Quality of Life (ESPRINT-15), were measured at baseline and after 4 weeks of treatment. Results: Among the recruited AR patients (n = 707, 58% women), 39.3% were intermittent and 60.7% persistent, 40.2% had asthma and 61.4% conjunctivitis. Most patients were treated with second generation antihistamines in monotherapy (63.2%) or in combination with intranasal corticosteroids (31.5%). While using o-ARIA, 96.9% of patients had 'moderate/severe' AR, the m-ARIA discriminated between 'moderate' (55.4%) and severe (41.5%) AR, at baseline. After 4 weeks of treatment, improvement was found on disease severity (P < 0.0001), TNSS (8.2 ± 1.8 vs. 3.5 ± 2.3, P < 0.0001) and Quality of Life (ESPRINT-15 global score: 3.0 ± 1.2 vs. 1.1 ± 1.0, P < 0.0001). Conclusions: Specialist-based treatment reduces AR severity, evaluated using the m-ARIA classification for the first time, in addition to the improvement of nasal symptoms and quality of life. Clinical relevance: Specialist-based treatment improves AR severity, in addition to nasal symptoms and quality of life. However, no matter the treatment option some AR patients remain severe and need further follow-up. © 2013 John Wiley & Sons Ltd. Source

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