Predictors of clinical outcome in pediatrics allergic rhinitis: Korean Allergic Rhinitis Cohort study (KoARCo)

Allergic rhinitis is a disease with a high prevalence in children and adolescent. The authors investigated predictors related to the clinical outcome in children with allergic rhinitis by comparing the improved and unimproved group to provide clinical guidance in real-life. This prospective multicenter observational cohort study was conducted in children and adolescents with allergic rhinitis included in the Korean Allergic Rhinitis Cohort study (KoARCo) from October 2019 to December 2020. Questionnaire surveys, nasal fluid sampling and blood tests were performed at the first and third visits. Clinical improvement was determined by comparing the VAS score between two visits, and the patients were divided into two groups by improved and unimproved groups. The variables of two groups were analyzed non-parametrically. There were 91 patients in improved group (82%) and 19 patients in unimproved group. VAS score was significantly higher in improved group (28 quartiles) than unimproved group (23 quartile) at the first visit. There was also significant difference in prevalence of wheezing history in improved group than unimproved group. (53.2% vs. 15.4%) (p=0.015). Even though not statistically significant, improved group showed higher serum total IgE than unimproved group (417 IU/mL vs 253.5 IU/mL). There was no statistically significant difference in nasal cytokines/chemokines, gender, parental history, and history of atopic dermatitis. In the treatment of pediatric allergic rhinitis, the improved group showed significantly higher VAS score and prevalence of wheezing history. This study suggests that clinician could predict clinical improvement in pediatric allergic rhinitis patient with severe symptoms and history of wheezing.