Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},


Subject: Participation in the survey ‘An observational, cross-sectional survey to evaluate the management of patients with moderate to severe Allergic Rhinitis & role of Antihistamines in Indian Setting’


Allergic rhinitis (AR)occurs when an allergen is the trigger for the nasal symptoms. NAR is when obstruction and rhinorrhoea occur in relation to nonallergic, non-infectious triggers such as change in the weather, exposure to caustic doors or cigarette smoke, barometric pressure differences, etc.1


Both are highly prevalent diseases that have a significant economic burden on society and negative impact on patient quality of life.2


The prevalence of AR has been reported from 10% to40 % worldwide. AR is primarily driven by an immunoglobulin E (IgE)-mediated type 1 hypersensitivity response, due to an allergen exposure.3


Classic AR symptoms include sneezing, rhinorrhoea, and nasal congestion/obstruction. These symptoms are non-specific, and the differential diagnosis of AR is broad.1


Vasomotor rhinitis is the most common form of nonallergic rhinitis, comprising approximately 71% of all nonallergic rhinitis conditions. It is estimated that 14 million Americans suffer from vasomotor rhinitis, with a worldwide prevalence approaching 320 million.4


For phenotype classification, various criteria may be used, including the severity of disease (mild, moderate/severe), pattern of symptoms (seasonal/perennial or intermittent/persistent), predominant symptom (runners/blockers), possible triggering factor (allergens, infectious agents, etc.) and response to treatment (controlled/uncontrolled) The typical profile of patients with LAR includes mostly young women, non-smokers with moderate/severe rhinitis, with persistent/perennial clinical behaviour, and with conjunctivitis and asthma


AR has been associated with both increased risk of asthma development and asthma severity. The exact mechanisms underlying these relationships have yet to be fully elucidated, but evidence supports a role for allergen sensitization. Compared to those with asthma alone, patients with comorbid AR and asthma have greater use of health care resources, including visits to the general practitioner, emergency department and hospitalizations.5


Asthma is a complex multifactorial disease and has a significant impact on quality of life. The patient presents with respiratory symptoms such as wheezing, shortness of breath, chest tightness, and cough, which vary over time and in severity.6,7 Globally, the estimated burden of asthma in India is 34.3 million patients, accounting for 13.09% of the global population. In India, 13.2 per thousand deaths occur due to asthma compared to the global asthma burden, India has a three times higher death rate.8,9

Yours truly,

Sun Pharmaceutical Laboratories Limited

Mr. Pritam Kulkarni

Sr GM -Sales and Marketing

Sun Pharma

References


1. Nguyen P. Management of Rhinitis: Allergic and Non-Allergic Allergy Asthma Immunol Res. 2011 July;3(3):148-156.


2. Georgia A Georgia A. Review of Rhinitis: Classification, Types, Pathophysiology. J ClinMed. 2021 Jul; 10(14): 3183


3. Sarah K Wise et al international consensus statement on allergy and rhinology: Allergic rhinitis – 2023. nt Forum Allergy Rhinol. 2023 Apr;13(4):293-859


4. Russell A. Epidemiology of Vasomotor Rhinitis.World Allergy Organization Journal 2009; volume 2:s115–118.


5. Egan, M., Bunyavanich, S. Allergic rhinitis: the “Ghost Diagnosis” in patients with asthma. asthma res and pract 1, 8 (2015)


6. GINA Report, Global Strategy for Asthma Management and Prevention (2023 update). Available at: https://ginasthma.org/wp-content/uploads/2023/07/GINA-2023-Full-report-23_07_06-WMS.pdf. Accessed on:15-03-2024


7. Habib N, Pasha MA, Tang DD. Current Understanding of Asthma Pathogenesis and Biomarkers. Cells. 2022;11(17):2764.


8. Singh S, Salvi S, Mangal DK, Singh M, Awasthi S, Mahesh PA, Kabra SK, Mohammed S, Sukumaran TU, Ghoshal AG, Barne M, Sinha S, Kochar SK, Singh N, Singh U, Patel KK, Sharma AK, Girase B, Chauhan A, Sit N, Siddaiah JB, Singh V. Prevalence, time trends and treatment practices of asthma in India: the Global Asthma Network study. ERJ Open Res. 2022;8(2):00528-2021.


9. Ganai I, Saha I, Banerjee P, Laha A, Sultana S, Sultana N, Biswas H, Moitra S, Podder S. In silico analysis of single nucleotide polymorphism (rs34377097) of TBXA2R gene and pollen induced bronchial asthma susceptibility in West Bengal population, India. Front Immunol.