Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision

Jan L. Brozek , Jean Bousquet (1) , Ioana Agache (2) , Arnav Agarwal , Claus Bachert (3) , Sinthia Bosnic-Anticevich (4) , Romina Brignardello-Petersen , G. Walter Canonica (5) , Thomas Casale (6) , Niels H. Chavannes (7) , Jaime Correia De Sousa , Alvaro A. Cruz (8) , Carlos A. Cuello-Garcia , Pascal Demoly (1) , Mark Dykewicz , Itziar Etxeandia-Ikobaltzeta , Ivan D. Florez , Wytske Fokkens , Joao Fonseca (9) , Peter W. Hellings (10) , Ludger Klimek (11) , Sergio Kowalski , Piotr Kuna (12) , Kaja-Triin Laisaar , Désirée E. Larenas-Linnemann , Karin C. Lødrup Carlsen (13) , Peter J. Manning , Eli Meltzer (14) , Joaquim Mullol (15) , Antonella Muraro (16) , Robyn O'Hehir (17) , Ken Ohta , Petr Panzner (18) , Nikolaos Papadopoulos , Hae-Sim Park , Gianni Passalacqua (19) , Ruby Pawankar (20) , David Price , John J. Riva , Yetiani Roldán , Dermot Ryan (21) , Behnam Sadeghirad , Boleslaw Samolinski (22) , Peter Schmid-Grendelmeier (23) , Aziz Sheikh (24) , Alkis Togias (25) , Antonio Valero , Arunas Valiulis (26) , Erkka Valovirta (27) , Matthew Ventresca , Dana Wallace , Susan Waserman , Magnus Wickman (28, 29) , Wojtek Wiercioch , Juan José Yepes-Nuñez , Luo Zhang (30) , Yuan Zhang , Mihaela Zidarn (31) , Torsten Zuberbier (32) , Holger J. Schünemann (33)

1 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
2 Department of Allergy and Clinical Immunology
3 Ghent University Hospital
4 Woolcock Institute of Medical Research [Sydney]
5 Allergy & Respiratory Diseases Clinic - DIMI
6 USF - University of South Florida [Tampa]
7 Department of Public Health and Primary Care [leiden]
8 ProAR – Nucleo de Excelencia em Asma
9 CINTESIS - Center of Research in Health Technologies and Information Systems
10 Laboratory of clinical immunology
11 German Society for Otorhinolaryngology HNS
12 MUL - Medical University of Łódź
13 Department of Paediatrics [Oslo]
14 Allergy & Asthma Medical Group & Research Center
15 CIBERES - Centro de Investigación Biomédica en Red Enfermedades Respiratorias
16 Unipd - Università degli Studi di Padova = University of Padua
17 Department of Allergy, Immunology and Respiratory Medicine
18 Department of Allergology and Clinical Immunology
19 Allergy & Respiratory Diseases
20 Department of Pediatrics
21 Allergy and Respiratory Research Group
22 Medical University of Warsaw - Poland
23 Allergy Unit - Department of Dermatology
24 Edin. - University of Edinburgh
25 NIAID-NIH - National Institute of Allergy and Infectious Diseases [Bethesda]
26 Vilnius University Clinic of Children's Diseases
27 Department of Lung Diseases & Clinical Allergology
28 Sachs' Children's Hospital
29 National Institute of Environmental Medicine
30 TSCM - National Key State Laboratory for ThermoStructural Composites
31 Respiratory and Allergic Diseases
32 Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]
33 Departments of Clinical Epidemiology and Biostatistics and Medicine [Ontario]

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.

Mots clés: Humans; Child; Asthma; Animals; Quality of Life; Rhinitis; Allergic; Allergic rhinitis; Anti-Allergic Agents; Clinical Decision-Making; Evidence-Based Practice; Histamine H1 Antagonists; practice guideline

Domaines: Sciences du Vivant [q-bio]

Jan L. Brozek, Jean Bousquet, Ioana Agache, Arnav Agarwal, Claus Bachert, et al.. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. Journal of Allergy and Clinical Immunology, 2017, 140 (4), pp.950--958. ⟨10.1016/j.jaci.2017.03.050⟩. ⟨hal-01760836⟩