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 H-1-antihistamines, intranasal H-1-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.
基金:
ARIA Initiative; AlmirallAlmirall; Meda; MerckMerck & Company; MSD; NovartisNovartis; Sanofi-AventisSanofi-Aventis; TakedaTakeda Pharmaceutical Company Ltd; TevaTeva Pharmaceutical Industries; Uriach; ChiesiChiesi Pharmaceuticals Inc; GlaxoSmithKlineGlaxoSmithKline; MenariniMenarini Group; AstraZenecaAstraZeneca; Boehringer IngelheimBoehringer Ingelheim; Eurofarma; MEDA Pharma; Hypermarcas-Ache; ALK-Abello; Stallergenes Greer; Thermo Fisher Scientific; Ysslab; MacGRADE Centre; MEDA/Mylan; MAPI S.A.S.-RWE; Allakos; Sanofi; A. MenariniMenarini Group; FAES Farma (Lab. Vitoria); Allergopharma; Bionorica; Lofarma; Biomay; HALHorticulture Australia Limited; LETI; Roxall; Bencard; Adamed; BayerBayer AG; Berlin Chemie; Faes; HAL Allergy; Lekam; Polharma; PfizerPfizer; SandozNovartis; UCBUCB Pharma SA; Grunenthal; Siegfried; Armstrong; Greer; Mylan; Kyorin; AstellasAstellas Pharmaceuticals; Shire; Stallergenes; NESTECEuropean CommissionEuropean Commission Joint Research Centre; AbbVieAbbVie; Omega Pharma; DanoneDanone Nutricia; Japanese Ministry of EducationMinistry of Education, Culture, Sports, Science and Technology, Japan (MEXT); Aerocrine; AKL Research and Development; British Lung Foundation; Mundipharma; Napp; Respiratory Effectiveness Group; Teva PharmaceuticalsTeva Pharmaceutical Industries; Theravance; UK National Health Service; Zentiva; Cipla; Skyepharma; National Science CenterNational Science Centre, Poland; Ministry of Health; Polfarma; European Academy of Allergy and Clinical Immunology; Pfizer CanadaPfizer; CSL Behring; Pediapharm; Aralez; Bayer Health CareBayer AGBayer Healthcare Pharmaceuticals; Henkel; Kryolan; L'OrealL'Oreal Group; Medical Research CouncilUK Research & Innovation (UKRI)Medical Research Council UK (MRC)European Commission [G1000758, G1000758B] Funding Source: researchfish; Asthma UK [MRC-AsthmaUKCentre, MRC-Asthma UK Centre, AUK-AC-2012-01] Funding Source: researchfish
第一作者机构:[1]McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada[2]McMaster Univ, Dept Med, Div Clin Immunol & Allergy, Hamilton, ON, Canada[*1]McMaster University, Department of Clinical Epidemiology and Biostatistics, Hamilton, Ontario L8S 4K1, Canada.
通讯作者:
通讯机构:[1]McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada[2]McMaster Univ, Dept Med, Div Clin Immunol & Allergy, Hamilton, ON, Canada[*1]McMaster University, Department of Clinical Epidemiology and Biostatistics, Hamilton, Ontario L8S 4K1, Canada.
推荐引用方式(GB/T 7714):
Brozek Jan L.,Bousquet Jean,Agache Ioana,et al.Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision[J].JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY.2017,140(4):950-958.doi:10.1016/j.jaci.2017.03.050.
APA:
Brozek, Jan L.,Bousquet, Jean,Agache, Ioana,Agarwal, Arnav,Bachert, Claus...&Schunemann, Holger J..(2017).Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision.JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY,140,(4)
MLA:
Brozek, Jan L.,et al."Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision".JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 140..4(2017):950-958