GuidelineAllergy2026
Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines-2024-2025 Revision: Part I-Guidelines on Intranasal Treatments.
Abstract readPractice Guideline
In one paragraph
Guideline in Allergy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 3 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Guideline
- Guideline
- Efficacy and safety of Xiangju capsules for allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials.Frontiers in pharmacology · 2026Pooled it
- Asthma and Sinonasal Diseases: Shared Clinical Comorbidities, Inflammatory Pathways and Management Strategies.Medical sciences (Basel, Switzerland) · 2026Review
- Human Factors and Device Engineering in OTC Intranasal Drug Delivery: GentleMist Technology™.Pharmaceutics · 2026Review
- Exposome-driven molecular sensitization signatures in pediatric rhinitis and asthma across Spanish regions.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Observational
- Real-world effectiveness of fluticasone propionate-azelastine nasal spray in moderate-to-severe nonallergic and perennial allergic rhinitis.The World Allergy Organization journal · 2026Article
- Recurrent Spasmodic Croup-Like Episodes With Cough-Predominant Symptoms in an Atopic School-Aged Child: The Importance of Integrated Upper- and Lower-Airway Management.Respirology case reports · 2026Article
- Intervention with Polyvalent Bacterial Lysate Modulates T Helper Cell Subsets in Polish Children with Grass Pollen-Induced Allergic Rhinitis.Biomedicines · 2026Article
- Prediction of future onset of allergic rhinitis and analysis of risk factors in children with food allergy during infancy.European journal of pediatrics · 2026Article
- The Evaluation initiative: management of rhinitis by Italian otorhinolaryngologists.Multidisciplinary respiratory medicine · 2026Article
- Allergic Rhinitis and Its Impact on Asthma (ARIA) Guidelines: Moving Towards Living Guidelines With Regionally Tailored Recommendations.Allergy, asthma & immunology research · 2026Article
- Montelukast and Bilastine Combination Therapy in Allergic Rhinitis: A Narrative Review of Evidence.Cureus · 2026Review
- Immunological effects of subcutaneous and sublingual immunotherapy in house dust mite-allergic adults: a nine-month prospective pilot study.Scientific reports · 2026Article
- Article
- Update on pediatric allergic rhinitis: narrative review based on guideline updates.Clinical and experimental pediatrics · 2026Review
- Review
- Enhanced Early Detection of Allergic Rhinitis: A Prospective Study on a Symptom-Based Predictive Model.World journal of otorhinolaryngology - head and neck surgery · 2026Article
- Exposure to Urinary and Dust Parabens: Compound-Specific Risks for Pediatric Respiratory Allergic Phenotypes.Toxics · 2026Article
- Airborne Ragweed (Life (Basel, Switzerland) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
253 authors.
Bernardo Sousa-PintoMEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Jean BousquetInstitute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-4061-4766
Rafael José VieiraMEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0003-1834-3055
Holger J SchünemannFraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.
Torsten ZuberbierInstitute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-1466-8875
Antonio BognanniDepartment of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, Ontario, Canada.ORCID https://orcid.org/0000-0003-0128-903X
Alkis TogiasDivision of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.
Boleslaw SamolinskiDepartment of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland.
Arunas ValiulisInstitute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania.
Sian WilliamsInternational Primary Care Respiratory Group IPCRG, Edinburgh, UK.
Anna BedbrookARIA (Allergic Rhinitis and Its Impact on Asthma), Montpellier, France.
Wienczyslawa CzarlewskiARIA (Allergic Rhinitis and Its Impact on Asthma), Montpellier, France.
Maria Jose TorresAllergy Unit, Málaga Regional University Hospital of Málaga, Malaga University, ARADyAL, Malaga, Spain.ORCID https://orcid.org/0000-0001-5228-471X
Mohamed H ShamjiImmunomodulation and Tolerance Group and Allergy and Clinical Immunology, Imperial College London, London, UK.ORCID https://orcid.org/0000-0003-3425-3463
Mário Morais-AlmeidaAllergy Center, CUF Descobertas Hospital, Lisbon, Portugal.ORCID https://orcid.org/0000-0003-1837-2980
G Walter CanonicaDepartment of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy.ORCID https://orcid.org/0000-0001-8467-2557
Leticia de Las VecillasDepartment of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.ORCID https://orcid.org/0000-0003-4969-5678
Mark S DykewiczSection of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA.
Cristina Jacomelli"Respiriamo Insieme" Association, Asthma & Allergy Center, Padova, Italy.
Ludger KlimekDepartment of Otolaryngology, Head & Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany.ORCID https://orcid.org/0000-0002-2455-0192
Lucas LeemannDepartment of Political Science, University of Zürich, Zürich, Switzerland.
Olga LourençoRISE-Health, Department of Medical Sciences, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.ORCID https://orcid.org/0000-0002-8401-5976
Yuliia PalamarchukFinnish Meteorological Institute (FMI), Atmospheric Composition Research, Helsinki, Finland.
Nikolaos G PapadopoulosAllergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.ORCID https://orcid.org/0000-0002-4448-3468
Ana Margarida PereiraMEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Marine SavouréBarcelona Institute for Global Health (ISGlobal), Barcelona, Spain.ORCID https://orcid.org/0000-0003-3220-8175
Sanna K Toppila-SalmiDepartment of Allergy, Skin and Allergy Hospital, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.ORCID https://orcid.org/0000-0003-0890-6686
Maria Teresa VenturaUniversity of Bari Medical School, Bari, Italy.
Juan José Yepes-NuñezSchool of Medicine, Universidad de los Andes, Bogotá, D. C., Colombia.
Alvaro A CruzFundacao ProAR and (Faculdade de Medicina da), Universidade Federal da Bahia, Salvador, Bahia, Brazil.ORCID https://orcid.org/0000-0002-7403-3871
Giorgio CiprandiCasa di Cura Villa Montallegro, Allergology Department, Genova, Italy.
Bilun GemiciogluDepartment of Pulmonary Diseases and Institute of Pulmonology and Tuberculosis, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey.
Mattia GiovanniniDepartment of Health Sciences, University of Florence, Florence, Italy.ORCID https://orcid.org/0000-0001-9568-6882
Brigita GradauskieneDepartment of Immunology and Allergology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Tuomas JarttiDepartment of Pediatrics and Adolescent Medicine, University of Turku, Turku University Hospital, Turku, Finland.ORCID https://orcid.org/0000-0003-2748-5362
Miloš JeseňákInstitute of Clinical Immunology and Medical Genetics, Department of Paediatrics and Adolescent Medicine, Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine, Martin, Slovakia.ORCID https://orcid.org/0000-0001-7976-2523
Piotr KunaDivision of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
Violeta KvedarieneInstitute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Désirée E Larenas-LinnemannCenter of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
Amir Ha LatiffAllergy & Immunology Centre, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
Yousser MohammadNational Center for Research in Chronic Respiratory Diseases, Collaborating With WHO-EMRO Tishreen University School of Medicine, Latakia, Syria.
Ken OhtaJapan Antituberculosis Association (JATA), Fukujuji Hospital, Tokyo, Japan.
Padukudru A MaheshDepartment of Respiratory Medicine, JSS Medical College, JSSAHER Mysuru, Mysore, Karnataka, India.
Isabella Pali-SchöllDepartement of Biological Sciences and Pathophysiology, University of Veterinary Medicine, Vienna, Austria.
Oliver PfaarSection of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.ORCID https://orcid.org/0000-0003-4374-9639
Frederico S RegateiroAllergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
Nicolas RochePneumologie, AP-HP Centre Université de Paris Cité, Hôpital Cochin, Paris, France.
Luís Taborda-BarataUBIAir-Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
Charlotte Suppli UlrikDepartment of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Copenhagen, Denmark.
Marylin Valentin RostanPediatrics, Allergy & Immunology, Latín American Society of Allergy, Asthma & Immunology (SLAAi), Montevideo, Uruguay.
Giovanni ViegiPulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
Luo ZhangDepartment of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China.ORCID https://orcid.org/0000-0002-0910-9884
Tari HaahtelaSkin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.ORCID https://orcid.org/0000-0003-4757-2156
Ivan Cherrez-OjedaUniversidad Espíritu Santo, Samborondón, Ecuador.ORCID https://orcid.org/0000-0002-1610-239X
Juan Carlos IvancevichServicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
Nikolai KhaltaevGlobal NCD Platform, Geneva, Switzerland.
Arzu YorganciogluDepartment of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey.ORCID https://orcid.org/0000-0002-4032-0944
Baharudin AbdullahDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Mona Al-AhmadMicrobiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait.
Maryam Ali Al-NesfAdult Allergy and Immunology Division-Hamad Medical Corporation, Doha, Qatar.ORCID https://orcid.org/0000-0001-9354-0214
Rita AmaralMEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0002-0233-830X
Julijana AsllaniDepartment of Internal Medicine, University of Medicine, Tirana, Albania.ORCID https://orcid.org/0009-0003-1493-7101
Karl-C BergmannInstitute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
Jonathan A BernsteinDivision of Immunology, Allergy and Rheumatology, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.ORCID https://orcid.org/0000-0002-3476-1196
Michael S BlaissDepartment of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
Fulvio BraidoDepartment of Internal Medicine (DIMI), University of Genoa, Genoa, Italy.
Paulo CamargosDepartment of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Pedro Carreiro-MartinsNOVA Medical School/Comprehensive Health Research Centre (CHRC), Lisbon, Portugal.
Thomas CasaleDivision of Allergy/Immunology, University of South Florida, Tampa, Florida, USA.
Lorenzo CecchiSOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.ORCID https://orcid.org/0000-0002-0658-2449
Alessandro FiocchiAllergy, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.ORCID https://orcid.org/0000-0002-2549-0523
Antonio F M GiulianoDepartment of Internal Medicine 'A. Murri' and Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy.ORCID https://orcid.org/0000-0002-9345-5156
George ChristoffFaculty of Public Health, Sofia Medical University, Sofia, Bulgaria.
Ieva CiruleLatvian Association of Allergists, University Children Hospital, Riga, Latvia.
Jaime Correia de SousaLife and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.ORCID https://orcid.org/0000-0001-6459-7908
Elisio M CostaCINTESIS@RISE, Biochemistry Lab, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto, Porto, Portugal.
Stefano Del GiaccoDepartment of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy.ORCID https://orcid.org/0000-0002-4517-1749
Philippe DevillierVIM Suresnes, UMR 0892, Pôle Des Maladies Des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France.
Dejan DokicMedical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, Republic of North Macedonia.
Elham HossnyPediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.
Tomohisa IinumaDepartment of Otorhinolaryngology, Chiba University, Chiba, Japan.ORCID https://orcid.org/0000-0002-9940-5520
Carla IraniDepartment of Internal Medicine and Infectious Diseases, St Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon.
Zhanat IspayevaDepartment of Allergology and Clinical Immunology, Kazakhstan Association of Allergology and Clinical Immunology, Kazakh National Medical University, Almaty, Kazakhstan.
Kaja JulgeInstitute of Clinical Medicine, Children's Clinic, Tartu University, Tartu, Estonia.
Igor KaidashevPoltava State Medical University, Immunology & Allergology Department, Poltava, Ukraine.
Kazi S BennoorDepartment of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh.
Helga KraxnerDepartment of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary.
Inger KullDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0001-6096-3771
Marek KulusDepartment of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland.
Maciej KupczykDivision of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
Andriy KurchenkoDepartment of Clinical and Laboratory Immunology, Allergology and Medical Genetics, Bogomolets National Medical University, Kyiv, Ukraine.ORCID https://orcid.org/0000-0001-6858-2025
Stefania La GruttaInstitute of Translational Pharmacology (IFT)-National Research Council (CNR), Palermo, Italy.
Neven MiculinicCroatian Pulmonary Society, Clinical Center for Pulmonary Diseases, Zagreb, Croatia.
Lan Le Thi TuyetAsthma, COPD Outpatient Care Unit, University Medical Center, Hô-Chi-Minh City, Vietnam.
Michael MakrisAllergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
Branislava MilenkovicClinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbian Association for Asthma and COPD, Belgrade, Serbia.
Sang Min LeeDivision of Respiratory Disease and Allergy, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea.ORCID https://orcid.org/0000-0002-9568-2096
Stephen MontefortDepartment of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
Andre MoreiraEPIUnit-Institute of Public Health, University of Porto, and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
Joaquim MullolRhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain.
Rachel NadifInserm, Equipe D'epidémiologie Respiratoire Intégrative, CESP, Villejuif, France.ORCID https://orcid.org/0000-0003-4938-9339
Alla NakonechnaImperial College Healthcare NHS Trust, London, UK.
Hugo E NeffenCenter of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina.
Marek NiedoszytkoDepartment of Allergology, Medical University of Gdansk, Gdansk, Poland.ORCID https://orcid.org/0000-0003-1089-1911
Dieudonné NyembueENT Department, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo.
Robyn E O'HehirAllergy, Asthma and Clinical Immunology, Alfred Health and Department of Immunology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-3489-7595
Ismail OgulurSwiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
Yoshitaka OkamotoChiba Rosai Hospital, ENT Department, Chiba, Japan.
Heidi OlzeDepartment of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Oscar PalomaresDepartment of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain.ORCID https://orcid.org/0000-0003-4516-0369
Petr PanznerDepartment of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic.ORCID https://orcid.org/0000-0002-1291-450X
Vincenzo PatellaDivision of Allergy and Clinical Immunology, Department of Medicine, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy.ORCID https://orcid.org/0000-0001-5640-6446
Ruby PawankarDepartment of Pediatrics, Nippon Medical School, Tokyo, Japan.ORCID https://orcid.org/0000-0002-3091-7237
Constantinos PitsiosMedical School, University of Cyprus, Nicosia, Cyprus.
Todor A PopovClinic of Occupational Diseases, University Hospital Sveti Ivan Rilski, Sofia, Bulgaria.
Francesca PuggioniIRCCS Humanitas Research Center, Personalized Medicine Asthma & Allergy, Rozzano, Milan, Italy.
Santiago QuirceDepartment of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.
Agné RamonaitéDepartment of Pulmonology and Allergology, Klaipeda National Hospital, Klaipėda, Lithuania.
Marysia RectoDivision of Adult and Pediatric Allergy and Immunology, University of the Philippines-Philippines General Hospital, Manila, Philippines.
Maria Susana Repka-RamirezDepartment of Allergy, Clinics Hospital, National University, San Lorenzo, Paraguay.ORCID https://orcid.org/0000-0002-9570-1277
Graham RobertsFaculty of Medicine, University of Southampton, Southampton, UK.ORCID https://orcid.org/0000-0003-2252-1248
Karla Robles-VelascoUniversidad Espíritu Santo, Samborondón, Ecuador.ORCID https://orcid.org/0000-0001-7780-1015
Menachem RottemDivision of Allergy, Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel.
Marianella SalapatasAria, Asthma, Rhinitis, Immunology & Allergy Department, Athens, Greece.
Joaquin SastreAllergy Service, Fundacion Jimenez Diaz, Autonoma University of Madrid, CIBERES-ISCIII, Madrid, Spain.
Nicola ScichilonePROMISE Department, University of Palermo, Palermo, Italy.
Juan-Carlos SisulAllergy & Asthma, Medical Director, CLINICA SISUL, FACAAI, SPAAI, Asuncion, Paraguay.
Dirceu SoléDivision of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil.
Manuel E Soto-MartinezDivision of Respiratory Medicine, Department of Pediatrics, Hospital Nacional de Niños, Universidad de Costa Rica, San Jose, Costa Rica.
Milan SovaDepartment of Respiratory Medicine and Tuberculosis, University Hospital, Brno, Czech Republic.
Pongsakorn TantilipikornDepartment of Otolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Ana Todo-BomImunoalergologia, Centro Hospitalar Universitário de Coimbra, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Vladyslav TsarykDepartment of Clinical and Laboratory Immunology, Allergology and Medical Genetics, Bogomolets National Medical University, Kyiv, Ukraine.ORCID https://orcid.org/0000-0002-5658-9737
Ioanna TsiligianniInternational Primary Care Respiratory Group IPCRG, Aberdeen, UK.
Marilyn Urrutia-PereiraFederal University of Pampa, Department of Medicine, Uruguaiana, Brazil.
Erkka ValovirtaDepartment of Lung Diseases and Clinical Immunology, University of Turku, Turku, Finland.
Tuula VasankariFiLHA, Finnish Lung Health Association, Helsinki, Finland.
Dana WallaceNova Southeastern University, College of Allopathic Medicine, Fort Lauderdale, Florida, USA.
De Yun WangDepartment of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.ORCID https://orcid.org/0000-0002-0909-2963
Margitta WormDivision of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-3449-1245
Osman M YusufThe Allergy and Asthma Institute, Allergy & Asthma Department, Islamabad, Pakistan.
Mihaela ZidarnUniversity Clinic of Respiratory and Allergic Diseases, Pulmonary & Allergy Department, Golnik, Slovenia.
Sara Gil-MataMEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Manuel Marques-CruzMEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Bassam MahboubPulmonary Department, Rashid Hospital, DUBAI Health, Dubai, UAE.
Ignacio J AnsoteguiDepartment of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain.
Antonino RomanoOasi Research Institute-IRCCS, Troina, Italy.
Werner AbererDepartment of Dermatology, Medical University of Graz, Graz, Austria.
Maria Cristina ArtesaniAllergy, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.ORCID https://orcid.org/0000-0003-2970-1591
Elena AzzoliniAsthma & Allergy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Bruno BarretoDepartment of Allergy and Immunology, Para State University Center-CESUPA, Belém, Brazil.
Joan BartraAllergy Department, Hospital Clinic and IDIBAPS. Universitat de Barcelona, Barcelona, Spain.ORCID https://orcid.org/0000-0001-7767-4730
Sven BeckerDepartment for Otorhinolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany.ORCID https://orcid.org/0000-0003-1972-3797
Bianca BegheRespiratory Medicine, University of Modena & Reggio Emilia, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.
Attilio BonerPediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy.
Ewa BorowiackEvidence Prime, Kraków, Poland.
Jacques BouchardLaval University, Quebec City, Quebec, Canada.
Melisande Bourgoin-HeckDepartment of Pediatric Allergology, Armand Trousseau University Hospital, Sorbonne University, AP-HP, Paris, France.ORCID https://orcid.org/0000-0001-6497-4830
Luisa BrussinoDepartment of Medical Sciences, University of Turin, Turin, Italy.
Roland BuhlDepartment of Pulmonary Medicine, Mainz University Hospital, Mainz, Germany.
José Antonio Castillo-VizuetePneumology Department, Hospital Universitari Dexeus, Barcelona, Spain.
Denis CharpinClinique Des Bronches, Allergie et Sommeil, Hôpital Nord, Marseille, France.
Niels H ChavannesDepartment of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.
Marta ChełmińskaDepartment of Pulmonology and Allergology, Medical University of Gdańsk, Gdańsk, Poland.
Lei ChengDepartment of Allergology and Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
Ekaterine ChkhartishviliAllergist, David Tvildiani Medical University, Tbilisi, Georgia.
Seong H ChoUniversity of South Florida, College of Médicine, Division of Allergy-Immunology, Department of Internal Medicine, Tampa, Florida, USA.ORCID https://orcid.org/0000-0003-0933-953X
Herberto Jose Chong-NetoAssociate Professor of Pediatrics, Division of Allergy and Immunology, Federal University of Parana, Curitiba, Brazil.
Deepa ChoudhuryPaediatric Allergy Clinic, Department of Dermatology, Amersham Hospital, NHS Hospital Trust, Amersham, UK.
Derek K ChuDepartment of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Cemal CingiEskisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir, Turkey.ORCID https://orcid.org/0000-0003-3934-5092
Enrico CompalatiScientific & Medical Department, Lofarma S.p.A, Milan, Italy.
Raquel Albuquerque CostaMEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Olga Mariana CunhaLAQV@REQUIMTE, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.ORCID https://orcid.org/0009-0007-6144-8203
Biljana CvetkovskiWoolcock Institute of Medical Research, Sydney, Australia.
Victoria Cardona-DahlAllergy Section, Department of Internal Medicine, Hospital Vall D'hebron, Barcelona, Spain.
Gennaro D'AmatoDivision of Respiratory and Allergic Diseases, High Specialty Hospital 'A Cardarelli', and Respiratory Allergy School of Specialization in Respiratory Diseases, Federico II University of Naples, Naples, Italy.ORCID https://orcid.org/0000-0002-0503-9428
Janet DaviesCentre for Immunology and Infection Control, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
Danilo Di BonaUniversity of Foggia, Department of Medical and Surgical Science, Foggia, Italy.
Sandra N Gonzalez DiazAllergy and Clinical Immunology Centro Regional, Hospital Universitario, Universidad Autónoma de Nuevo Leon, Monterrey, Mexico.ORCID https://orcid.org/0000-0002-3612-0042
Maria V DimouAllergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
Maria DoulaptsiDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Crete, School of Medicine, Heraklion, Crete, Greece.ORCID https://orcid.org/0000-0001-9011-0315
Renato Ferreira-da-SilvaMEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Radoslaw GawlikDepartment of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia in Katowice, Katowice, Poland.
Mario Calvo-GilPediatrics Department, Universidad Austral de Chile, Valvidia, Chile.
Ozlem GokselDepartment of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Laboratory of Occupational and Environmental Respiratory Diseases, Faculty of Medicine, Ege University, EgeSAM (Ege University Translational Pulmonary Research Center), Bornova, Izmir, Türkiye.ORCID https://orcid.org/0000-0003-1121-9967
Maximiliano R GómezFaculty of Health Sciences, Catholic University of Salta, Salta, Argentina.
Maia GotuaCenter of Allergy and Immunology, and Georgian Academy of Allergy, Asthma, and Clinical Immunology, Tbilisi, Georgia.
Christos GrigoreasFormer President of the Hellenic Society of Allergology and Clinical Immunology, Department of Allergy and Clinical Immunology, Air Force General Hospital, Athens, Greece.
Ineta GrisleRiga East University Hospital, Riga, Latvia.
Maria Antonieta GuzmanImmunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile.
Rachel House TanQuality Use of Research Medicines Group, Woolcock Institute of Medical Research, Macquarie Park, New South Wales, Australia.
Michael HylandFaculty of Health, University of Plymouth, Plymouth, UK.
Despo IerodiakonouDepartment of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.
Aspasia KaraveliaOtolaryngology Department, General Hospital of Kalamata, Kalamata City, Greece.
Paul KeithDivision of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.ORCID https://orcid.org/0000-0002-5644-1855
Marta KisielOccupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Tanja Soklic KosakORL SOKLIC KOSAK, Ljubljana, Slovenia.ORCID https://orcid.org/0000-0002-9326-7606
Mitja KosnikUniversity Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.ORCID https://orcid.org/0000-0002-4701-7374
Ilgim Vardaloglu KoyuncuBagcilar Research and Training Hospital, Department of Chest Diseases, Istanbul, Turkey.
Vicky KritikosClinical Management Group, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0003-3955-0002
Justyna LitynskaEvidence Prime, Kraków, Poland.
Carlo LombardiDepartmental Unit of Allergology, Clinical Immunology & Pneumology, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.
Gilles LouisDepartment of Public Health, University of Liège, Liège, Belgium.
Matteo MartiniAllergy Unit, Department of Internal Medicine, University Hospital AOU Delle Marche, Ancona, Italy.ORCID https://orcid.org/0000-0001-9873-9695
Cem MeçoDepartment of Otorhinolaryngology, Head and Neck Surgery, Ankara University Medical School, Ankara, Turkey.
Eris MesonjesiAllergy & Clinical Immunology Department, University Hospital Center "Mother Teresa", Tirana, Albania.
Florin MihaltanUMF-University of Medicine and Pharmacy 'Carol Davila', Pneumology Department, National Institute of Pneumology 'Marius Nasta', Bucharest, Romania.
Marcin MoniuszkoDepartment of Allergology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.
Robert N NaclerioDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Kari C NadeauDepartment of Environmental Health, Harvard TH Chan School of Public Health and Department of Medicine, Division of Allergy and Inflammation, Beth Israel Deaconess Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-2146-2955
Sophia NeisingerInstitute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
Markus OllertDepartment of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.ORCID https://orcid.org/0000-0002-8055-0103
Michal OrdakDepartment of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland.ORCID https://orcid.org/0000-0001-5652-4397
Giovanni PaolettiDepartment of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy.ORCID https://orcid.org/0000-0003-3953-9225
Hae-Sim ParkDepartment of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea.ORCID https://orcid.org/0000-0003-2614-0303
Elena ParmelliAsthma & Allergy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Edgar Arturo Perdomo-FloresOtorhinolaryngology and Neck Surgery Unit, San Juan de Dios National Hospital, San Miguel, El Salvador.
José Miguel Fuentes PérezAllergist, Private Practice, Mexico City, Mexico.ORCID https://orcid.org/0000-0002-5378-3956
Nhan Pham-ThiEcole Polytechnique de Palaiseau, Palaiseau, France.
Emmanuel ProkopakisDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Crete, School of Medicine, Heraklion, Crete, Greece.
Inês Ribeiro-VazMEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Giovanni RollaDepartment of Medical Sciences, University of Turin, Turin, Italy.
Jan RomantowskiDepartment of Allergology, Medical University of Gdansk, Gdansk, Poland.
Philippe RombauxDepartment of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Philip W RouadiDepartment of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon.ORCID https://orcid.org/0000-0002-5365-9568
Maia RukhadzeCenter Allergy & Immunology/Geomedi Teaching University, Faculty of Medicine, Tbilisi, Georgia.
Dermot RyanUsher Institute, University of Edinburgh, Edinburgh, UK.ORCID https://orcid.org/0000-0002-4115-7376
Ewelina SadowskaEvidence Prime, Kraków, Poland.ORCID https://orcid.org/0000-0001-8585-4109
Daiju SakuraiDepartment of Otorhinolaryngology, Yamanashi University, Yamanashi, Japan.
Laila SalamehMohammed Bin Rashid University (MBRU), Dubai Health, Dubai, UAE.
Faradiba Serpa SarquisAsthma Reference Center-School of Medicine of Santa Casa de Misericórdia of Vitória, Espírito Santo, Brazil.
Elie SerranoDepartment of Otorhinolaryngology and Head & Neck Surgery, CHU Rangueil-Larrey, Toulouse, France.
Jane Da SilvaAllergy Service, University Hospital Professor Polydoro Ernani de São Thiago (HU-UFSC/EBSERH), Florianopolis, Brazil.
Michael SoykaOtolaryngology-HNS, University of Zurich, University Hospital of Zurich, Zurich, Switzerland.ORCID https://orcid.org/0000-0003-4179-4989
Krzysztof SpecjalskiDepartment of Allergology, Medical University of Gdansk, Gdansk, Poland.
Vesna Tomic-SpiricClinic of Allergology and Immunology, University Clinical Center of Serbia, Belgrade, Serbia.
Katarina StevanovicInstitute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0003-3930-9761
Abirami SubramaniamDepartment of Respiratory Medicine, Medical Professorial Unit, Tallaght University Hospital & Trinity College, Dublin, Ireland.ORCID https://orcid.org/0000-0001-6715-3915
Maria Do Ceu TeixeiraDr Agostinho Neto University Hospital, Praia, Cabo Verde.
Tuuli ThomanderMEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Martina VachovaDepartment of Immunology and Allergology, University Hospital and Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
Marianne van HageDepartment of Medicine Solna, Division of Immunology and Respiratory Medicine, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0003-3091-1596
Pakit VichyanondSamitivej Allergy Institute, Bangkok, Thailand.
Martin WagenmannDepartment of Otorhinolaryngology, Heinrich Heine University Düsseldorf, Medical Faculty and University Hospital Düsseldorf, Düsseldorf, Germany.ORCID https://orcid.org/0000-0002-9734-0241
Fanny Wai San KoThe Chinese University of Hong Kong, Department of Medicine and Therapeutics, Hong Kong, China.
Pascal WerminghausENT and Allergology, Düsseldorf, Germany.
Paraskevi Vicky XepapadakiAllergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
Yi-Kui XiangInstitute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0003-3432-6837
Qintai YangThe Third Affiliated Hospital of sun Yat-Sen University, Guangzhou, China.
Daniela Rivero YeverinoServicio de Alergia e Inmunología clínica, Hospital Universitario de Puebla, Puebla, México.
Jaron ZuberbierDepartment of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
João A FonsecaMEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Funding
ARIA (Allergic Rhinitis and its Impact on Asthma), Montpellier, France
Abstract
backgroundAllergic rhinitis (AR) impacts quality of life, work and school productivity. Over the last years, an important body of evidence resulting from mHealth data has led to a better understanding of AR. Such advances have motivated an EAACI-endorsed update of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines (ARIA 2024-2025). This manuscript presents the ARIA 2024-2025 recommendations for intranasal treatments, one of the mainstays for AR management.
methodsThe ARIA 2024-2025 guideline panel issued recommendations following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) evidence-to-decision framework. Several sources of evidence were used to inform panel judgments and recommendations, including systematic reviews, evaluation of mHealth and pharmacovigilance data, as well as a survey of experts on costs.
resultsEleven guideline questions concerning intranasal treatments for AR were prioritized, leading to recommendations. Overall, these questions concern the choice between different classes of intranasal medications-most notably, intranasal corticosteroids (INCS), antihistamines (INAH), fixed combinations of INAH+INCS and decongestants-or between different individual medications within each class. Four questions had not been evaluated in previous ARIA guidelines, while for the other three there was a change in the strength or directionality of recommendations. Overall, recommendations point to the suggested use of INAH+INCS over INAH or INCS and INCS over INAH.
conclusionThis ARIA 2024-2025 article supports patients, their caregivers, and healthcare professionals in choosing an intranasal treatment. However, decisions on AR treatment should consider the clinical variability of the disease, patients' values, and the affordability of medications.
Indexed as
Anti-Allergic AgentsAsthmaRhinitis, AllergicAdministration, IntranasalDisease ManagementHumansPractice Guidelines as TopicQuality of LifeAnti-Allergic Agentsallergic rhinitisguidelinesintranasal antihistaminesintranasal corticosteroids
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