Prevalence of rhinitis in patients with urticaria
From a total of 39 studies collectively comprising 6,662,860 patients with urticaria, the overall pooled prevalence of rhinitis was 31.3% (Fig. 3; 95% CI, 24.2%–38.4%).6,11-14,16-19,22,23,40-67 The overall pooled prevalence of rhinitis in 7,055,142 reference individuals without urticaria was 19.8% (95% CI, 17.0%–22.6%; 9 studies).14,16,17,23,42,45,50,56,61,66 Moreover, in patients with urticaria, the pooled prevalence of AR was 31.3% (95% CI 18.5%–44.1%; 31 studies)6,11-14,16-19,22,40-44,46-52,54,56,58,59,61,62,65,66.
When comparing the prevalence of rhinitis in adult patients with urticaria (7 studies;6,44,46,54,58,63,64 2354 adults with urticaria) with that in children and adolescents (14 studies;11-14,23,46,49,50,52,55-57,59,66 1,305,798 children and adolescents with urticaria), the overall random-effect of prevalence of rhinitis indicated no significant difference between children and adolescents with urticaria (30.6%; 95% CI, 13.8%–47.5%) and adults with urticaria (30.0%; 95% CI, 19.3%–40.7%). Categorizing by geographical region, the prevalence of rhinitis was 26.6% (95% CI, 18.8%–33.6%) in European, 30.6% (95% CI, 20.6%–40.5%) in Asian, 35.9% (95% CI, 12.9%–58.9%) in North American, and 35.3% (95% CI, 16.2%–54.5%) in South American patients with urticaria.
In total, 13 studies had a sample size of >1000 individuals,14,17,40-42,47,50,52,56,57,61,62,67indicating a higher prevalence of rhinitis (32.5%; 95% CI, 20.8%–44.3%) than the 25 additional studies6,11-13,16,18,19,22,23,43,44,46,48,49,51,53-55,58-60,63-66with a sample size of <1000 individuals (28.9%; 95% CI, 23.9%–36.8%). A total of 11 studies13,40,47,52,53,56,59,61,62,64,66 were cross-sectional, 10 were cohort studies,6,14,17,23,41-43,49,50,63 and 1711,12,16,18,19,22,44-46,48,51,54,55,57,58,60,65,67were clinical trials. The pooled prevalence of urticaria was the highest among cross-sectional studies (37.9%; 95% CI, 8.5%–67.3%), followed by clinical trials (pooled prevalence, 31.2%; 95% CI, 25.3%–37.0%) and cohort studies (pooled prevalence, 25.0%; 95% CI, 15.5%–34.5%). When restricting the analysis of articles with a clinical diagnosis of both rhinitis and urticaria, the pooled prevalence was 37.4% (16 studies16,17,40-42,45,47,49,50,56,58,61-64,66; 95% CI, 19.0%–55.7%). Only two studies6,14 defined rhinitis and urticaria using a self-reported questionnaire completed by patients, and the pooled prevalence of rhinitis was 12.2% in patients with urticaria (95% CI, −2%–26.4%). The pooled prevalence was 27.4% (95% CI, 18.4%–36.3%) in 21 studies,11-13,18,19,22,23,43,44,46,48,51-55,57,59,60,65,67in which rhinitis and/or urticaria were not specifically defined.