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

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

doi:10.1016/j.jaci.2017.03.050

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

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 HellingsLudger 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

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Abstract

Background

Allergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and 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.

Objective

We sought to provide a targeted update of the ARIA guidelines.

Methods

The ARIA guideline panel identified new clinical questions and selected questions requiring an update. We performed systematic reviews of health effects and the evidence about patients' 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.

Results

The 2016 revision of the ARIA guidelines provides both updated and new recommendations about the pharmacologic treatment of AR. Specifically, it addresses the relative merits of using oral H1-antihistamines, intranasal H1-antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists either alone or in combination. The ARIA guideline panel provides specific recommendations for the choice of treatment and the rationale for the choice and discusses specific considerations that clinicians and patients might want to review to choose the management most appropriate for an individual patient.

Conclusions

Appropriate treatment of AR might improve patients' quality of life and school and work productivity. ARIA recommendations support patients, their caregivers, and health care providers in choosing the optimal treatment.

Original language	English
Pages (from-to)	950-958
Number of pages	9
Journal	Journal of Allergy and Clinical Immunology
Volume	140
Issue number	4
Early online date	8 Jun 2017
DOIs	https://doi.org/10.1016/j.jaci.2017.03.050
Publication status	Published - Oct 2017

Keywords

Journal Article
allergic rhinitis
practice guideline

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Brożek, J. L., Bousquet, J., Agache, I., Agarwal, A., Bachert, C., Bosnic-Anticevich, S., Brignardello-Petersen, R., Canonica, G. W., Casale, T., Chavannes, N. H., Correia de Sousa, J., Cruz, A. A., Cuello-Garcia, C. A., Demoly, P., Dykewicz, M., Etxeandia-Ikobaltzeta, I., Florez, I. D., Fokkens, W., Fonseca, J., ... Schünemann, H. J. (2017). Allergic Rhinitis and its Impact on Asthma (ARIA) Guidelines - 2016 Revision. Journal of Allergy and Clinical Immunology, 140(4), 950-958. https://doi.org/10.1016/j.jaci.2017.03.050

Brożek, JL, Bousquet, J, Agache, I, Agarwal, A, Bachert, C, Bosnic-Anticevich, S, Brignardello-Petersen, R, Canonica, GW, Casale, T, Chavannes, NH, Correia de Sousa, J, Cruz, AA, Cuello-Garcia, CA, Demoly, P, Dykewicz, M, Etxeandia-Ikobaltzeta, I, Florez, ID, Fokkens, W, Fonseca, J, Hellings, PW, Klimek, L, Kowalski, S, Kuna, P, Laisaar, K-T, Larenas-Linnemann, DE, Lødrup Carlsen, KC, Manning, PJ, Meltzer, E, Mullol, J, Muraro, A, O'Hehir, R, Ohta, K, Panzner, P, Papadopoulos, N, Park, H-S, Passalacqua, G, Pawankar, R, Price, D, Riva, JJ, Roldán, Y, Ryan, D, Sadeghirad, B, Samolinski, B, Schmid-Grendelmeier, P, Sheikh, A, Togias, A, Valero, A, Valiulis, A, Valovirta, E, Ventresca, M, Wallace, D, Waserman, S, Wickman, M, Wiercioch, W, Yepes-Nuñez, JJ, Zhang, L, Zhang, Y, Zidarn, M, Zuberbier, T & Schünemann, HJ 2017, 'Allergic Rhinitis and its Impact on Asthma (ARIA) Guidelines - 2016 Revision', Journal of Allergy and Clinical Immunology, vol. 140, no. 4, pp. 950-958. https://doi.org/10.1016/j.jaci.2017.03.050

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title = "Allergic Rhinitis and its Impact on Asthma (ARIA) Guidelines - 2016 Revision",

abstract = "BackgroundAllergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and 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.ObjectiveWe sought to 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 patients' 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 both updated and new recommendations about the pharmacologic treatment of AR. Specifically, it addresses the relative merits of using oral H1-antihistamines, intranasal H1-antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists either alone or in combination. The ARIA guideline panel provides specific recommendations for the choice of treatment and the rationale for the choice and discusses specific considerations that clinicians and patients might want to review to choose the management most appropriate for an individual patient.ConclusionsAppropriate treatment of AR might improve patients' quality of life and school and work productivity. ARIA recommendations support patients, their caregivers, and health care providers in choosing the optimal treatment.",

keywords = "Journal Article, allergic rhinitis, practice guideline",

author = "Bro{\.z}ek, {Jan L} and Jean Bousquet and Ioana Agache and Arnav Agarwal and Claus Bachert and Sinthia Bosnic-Anticevich and Romina Brignardello-Petersen and Canonica, {G Walter} and Thomas Casale and Chavannes, {Niels H} and {Correia de Sousa}, Jaime and Cruz, {Alvaro A} and Cuello-Garcia, {Carlos A} and Pascal Demoly and Mark Dykewicz and Itziar Etxeandia-Ikobaltzeta and Florez, {Ivan D} and Wytske Fokkens and Joao Fonseca and Hellings, {Peter W} and Ludger Klimek and Sergio Kowalski and Piotr Kuna and Kaja-Triin Laisaar and Larenas-Linnemann, {D{\'e}sir{\'e}e E} and {L{\o}drup Carlsen}, {Karin C} and Manning, {Peter J} and Eli Meltzer and Joaquim Mullol and Antonella Muraro and Robyn O'Hehir and Ken Ohta and Petr Panzner and Nikolaos Papadopoulos and Hae-Sim Park and Gianni Passalacqua and Ruby Pawankar and David Price and Riva, {John J} and Yetiani Rold{\'a}n and Dermot Ryan and Behnam Sadeghirad and Boleslaw Samolinski and Peter Schmid-Grendelmeier and Aziz Sheikh and Alkis Togias and Antonio Valero and Arunas Valiulis and Erkka Valovirta and Matthew Ventresca and Dana Wallace and Susan Waserman and Magnus Wickman and Wojtek Wiercioch and Yepes-Nu{\~n}ez, {Juan Jos{\'e}} and Luo Zhang and Yuan Zhang and Mihaela Zidarn and Torsten Zuberbier and Sch{\"u}nemann, {Holger J}",

note = "Copyright {\textcopyright} 2017. Published by Elsevier Inc.",

year = "2017",

month = oct,

doi = "10.1016/j.jaci.2017.03.050",

language = "English",

volume = "140",

pages = "950--958",

journal = "Journal of Allergy and Clinical Immunology",

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TY - JOUR

T1 - Allergic Rhinitis and its Impact on Asthma (ARIA) Guidelines - 2016 Revision

AU - Brożek, Jan L

AU - Bousquet, Jean

AU - Agache, Ioana

AU - Agarwal, Arnav

AU - Bachert, Claus

AU - Bosnic-Anticevich, Sinthia

AU - Brignardello-Petersen, Romina

AU - Canonica, G Walter

AU - Casale, Thomas

AU - Chavannes, Niels H

AU - Correia de Sousa, Jaime

AU - Cruz, Alvaro A

AU - Cuello-Garcia, Carlos A

AU - Demoly, Pascal

AU - Dykewicz, Mark

AU - Etxeandia-Ikobaltzeta, Itziar

AU - Florez, Ivan D

AU - Fokkens, Wytske

AU - Fonseca, Joao

AU - Hellings, Peter W

AU - Klimek, Ludger

AU - Kowalski, Sergio

AU - Kuna, Piotr

AU - Laisaar, Kaja-Triin

AU - Larenas-Linnemann, Désirée E

AU - Lødrup Carlsen, Karin C

AU - Manning, Peter J

AU - Meltzer, Eli

AU - Mullol, Joaquim

AU - Muraro, Antonella

AU - O'Hehir, Robyn

AU - Ohta, Ken

AU - Panzner, Petr

AU - Papadopoulos, Nikolaos

AU - Park, Hae-Sim

AU - Passalacqua, Gianni

AU - Pawankar, Ruby

AU - Price, David

AU - Riva, John J

AU - Roldán, Yetiani

AU - Ryan, Dermot

AU - Sadeghirad, Behnam

AU - Samolinski, Boleslaw

AU - Schmid-Grendelmeier, Peter

AU - Sheikh, Aziz

AU - Togias, Alkis

AU - Valero, Antonio

AU - Valiulis, Arunas

AU - Valovirta, Erkka

AU - Ventresca, Matthew

AU - Wallace, Dana

AU - Waserman, Susan

AU - Wickman, Magnus

AU - Wiercioch, Wojtek

AU - Yepes-Nuñez, Juan José

AU - Zhang, Luo

AU - Zhang, Yuan

AU - Zidarn, Mihaela

AU - Zuberbier, Torsten

AU - Schünemann, Holger J

PY - 2017/10

Y1 - 2017/10

N2 - BackgroundAllergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and 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.ObjectiveWe sought to 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 patients' 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 both updated and new recommendations about the pharmacologic treatment of AR. Specifically, it addresses the relative merits of using oral H1-antihistamines, intranasal H1-antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists either alone or in combination. The ARIA guideline panel provides specific recommendations for the choice of treatment and the rationale for the choice and discusses specific considerations that clinicians and patients might want to review to choose the management most appropriate for an individual patient.ConclusionsAppropriate treatment of AR might improve patients' quality of life and school and work productivity. ARIA recommendations support patients, their caregivers, and health care providers in choosing the optimal treatment.

AB - BackgroundAllergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and 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.ObjectiveWe sought to 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 patients' 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 both updated and new recommendations about the pharmacologic treatment of AR. Specifically, it addresses the relative merits of using oral H1-antihistamines, intranasal H1-antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists either alone or in combination. The ARIA guideline panel provides specific recommendations for the choice of treatment and the rationale for the choice and discusses specific considerations that clinicians and patients might want to review to choose the management most appropriate for an individual patient.ConclusionsAppropriate treatment of AR might improve patients' quality of life and school and work productivity. ARIA recommendations support patients, their caregivers, and health care providers in choosing the optimal treatment.

KW - Journal Article

KW - allergic rhinitis

KW - practice guideline

U2 - 10.1016/j.jaci.2017.03.050

DO - 10.1016/j.jaci.2017.03.050

M3 - Article

C2 - 28602936

SN - 0091-6749

VL - 140

SP - 950

EP - 958

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

IS - 4

ER -

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

Abstract

Keywords

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