Allergic Rhinitis and its Impact on Asthma (ARIA) Guidelines – 2016 Revision

Publication date: Available online 8 June 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Jan L. Brożek, Jean Bousquet, Ioana Agache, Arnav Agarwal, Claus Bachert, Sinthia Bosnic-Anticevich, Romina Brignardello-Petersen, G. Walter Canonica, Thomas Casale, Niels H. Chavannes, Jaime Correia de Sousa, Alvaro A. Cruz, Carlos A. Cuello-Garcia, Pascal Demoly, Mark Dykewicz, Itziar Etxeandia-Ikobaltzeta, Ivan D. Florez, Wytske Fokkens, Joao Fonseca, Peter W. Hellings, Ludger Klimek, Sergio Kowalski, Piotr Kuna, Kaja-Triin Laisaar, Désirée E. Larenas-Linnemann, Karin C. Lødrup Carlsen, Peter J. Manning, Eli Meltzer, Joaquim Mullol, Antonella Muraro, Robyn O'Hehir, Ken Ohta, Petr Panzner, Nikolaos Papadopoulos, Hae-Sim Park, Gianni Passalacqua, Ruby Pawankar, David Price, John J. Riva, Yetiani Roldán, Dermot Ryan, Behnam Sadeghirad, Boleslaw Samolinski, Peter Schmid-Grendelmeier, Aziz Sheikh, Alkis Togias, Antonio Valero, Arunas Valiulis, Erkka Valovirta, Matthew Ventresca, Dana Wallace, Susan Waserman, Magnus Wickman, Wojtek Wiercioch, Juan José Yepes-Nuñez, Luo Zhang, Yuan Zhang, Mihaela Zidarn, Torsten Zuberbier, Holger J. Schünemann
BackgroundAllergic rhinitis affects 10 to 40% of the population. It reduces quality of life, school and work performance, and is a frequent reason for office visits in general practice. Medical costs are large but avoidable costs associated with lost work productivity are even larger than those incurred by asthma. New evidence has accumulated since the last revision of the Allergic Rhinitis and its Impact on Asthma – ARIA guidelines in 2010 prompting its update.ObjectiveTo provide a targeted update of the ARIA guidelines.MethodsThe ARIA guideline panel identified new clinical questions and selected questions requiring an update. We performed systematic reviews of health effects and the evidence about patient values and preferences, and resource requirements (up to June 2016). We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence-to-decision frameworks to develop recommendations.ResultsThe 2016 revision of the ARIA guidelines provides updated and new recommendations about the pharmacological treatment of allergic rhinitis. It specifically addresses the relative merits of using oral H1-antihistamines, intranasal H1-antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists either alone or their combination. The ARIA guideline panel provides specific recommendations for the choice of treatment, the rationale for the choice, and discusses specific considerations that clinicians and patients may want to review in order to choose the management most appropriate for an individual patient.ConclusionsAppropriate treatment of allergic rhinitis may improve patients' quality of life, school and work productivity. ARIA recommendations support patients, their caregivers, and health care providers in choosing the optimal treatment.



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