Article

Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 Revision

Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada.
The Journal of allergy and clinical immunology (Impact Factor: 11.25). 09/2010; 126(3):466-76. DOI: 10.1016/j.jaci.2010.06.047
Source: PubMed

ABSTRACT Allergic rhinitis represents a global health problem affecting 10% to 20% of the population. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines have been widely used to treat the approximately 500 million affected patients globally.
To develop explicit, unambiguous, and transparent clinical recommendations systematically for treatment of allergic rhinitis on the basis of current best evidence.
The authors updated ARIA clinical recommendations in collaboration with Global Allergy and Asthma European Network following the approach suggested by the Grading of Recommendations Assessment, Development and Evaluation working group.
This article presents recommendations about the prevention of allergic diseases, the use of oral and topical medications, allergen specific immunotherapy, and complementary treatments in patients with allergic rhinitis as well as patients with both allergic rhinitis and asthma. The guideline panel developed evidence profiles for each recommendation and considered health benefits and harms, burden, patient preferences, and resource use, when appropriate, to formulate recommendations for patients, clinicians, and other health care professionals.
These are the most recent and currently the most systematically and transparently developed recommendations about the treatment of allergic rhinitis in adults and children. Patients, clinicians, and policy makers are encouraged to use these recommendations in their daily practice and to support their decisions.

Full-text

Available from: Ken Ohta, Jun 20, 2014
6 Followers
 · 
404 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Allergic rhino-conjunctivitis (ARC) and allergic rhinitis are inflammatory diseases that develop through immunoglobulin E in the rhino-ocular mucosa due to allergy. The main symptoms are runny nose, nasal congestion, sneezing, itchy nose, and conjunctivitis. This study was designed to evaluate plasma 25-hydroxyvitamin D levels in patients with ARC. This study was planned as a prospective and cross sectional study. This study was performed in a tertiary referral center. This observational study involved 42 patients with ARC and 35 consecutive, age- and sex-matched healthy subjects. Patients in both groups underwent skin-prick test. Plasma 25-hydroxyvitamin D levels of all subjects were quantified with electrochemiluminescence technique. Results were compared between the groups and p < 0.05 was considered as statistically significant. Group one included 42 ARC patients (15 male, 27 female, ages between 12 and 43, average age 25.7 ± 8.6); group two included 35 healthy people (15 male, 20 female, ages between 12 and 44, average age 26.9 ± 9.1). Plasma 25-hydroxyvitamin D levels of the subjects with ARC group (7.33 ± 3.61 ng/mL, standard error mean: 0.55, range 3.17-13.68 ng/mL) were significantly lower than the control group (13.37 ± 5.42 ng/mL, standard error mean: 0.91, range 6.84-25.92 ng/mL) (p = 0.010, Independent-Samples test). We found lower plasma vitamin D levels in patients with ARC when compared with the control group.
    American journal of rhinology & allergy 04/2015; 29(2). DOI:10.2500/ajra.2015.29.4164 · 2.18 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Allergic rhinitis is a symptomatic allergic disease of the nose that affects 10 to 20% of the global population. Chinese otolaryngologists use one acupuncture needle to stimulate the sphenopalatine ganglion because of its potential advantages for treating moderate-severe persistent allergic rhinitis compared with traditional Chinese acupuncture (verum acupuncture); however, little evidence is available to support the wide clinical use thus far. Therefore, we propose a protocol for a parallel, multicenter, assessor-blinded, randomized controlled trial to evaluate sphenopalatine ganglion stimulation with one acupuncture needle compared to verum acupuncture for treatment of moderate-severe persistent allergic rhinitis. Methods In the trial, 96 patients previously diagnosed with moderate-severe persistent allergic rhinitis and meeting all inclusion criteria will be allocated to one of two equal therapeutic groups by using a computer-generated randomization list. The interventional group will receive sphenopalatine ganglion stimulation with one acupuncture needle for 4 weeks (once or twice weekly, total four to eight sessions); attending physicians will decide whether the second session is required in a week by examining signs and symptoms. The control group will receive individualized verum acupuncture for 4 weeks (twice weekly, total eight sessions). Follow-up evaluations will be performed 1 month later. The primary outcome measure is the change in the total nasal symptom score from the baseline to week 4. The secondary outcome measures include onset time and duration of effectiveness in every session, change in number of days with moderate-severe persistent allergic rhinitis from the baseline to week 8, change in total immunoglobulin E level and eosinophil count in venous blood from the baseline to week 4, change in Rhinoconjunctivitis Quality of Life Questionnaire score from the baseline to week 4, and clinical waiting time. Discussion The trial should provide evidence for the benefits of sphenopalatine ganglion stimulation with one acupuncture needle for treating moderate-severe persistent allergic rhinitis, including better change in total nasal symptom score, faster onset time, longer duration of effectiveness, and shorter treatment time. Trial registration Current Controlled Trials: ISRCTN21980724 (registered on 27 March 2014). Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-0707-0) contains supplementary material, which is available to authorized users.
    Trials 12/2015; 16(1). DOI:10.1186/s13063-015-0707-0 · 2.12 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Allergen immunotherapy (AIT) is a guidelines-approved, disease-modifying treatment option for respiratory allergies, including allergic rhinitis (AR) induced by pollen. The various AIT regimens employed to date in pollen-induced AR can be classified as continuous (i.e. year-round) or discontinuous (i.e. pre-seasonal alone, co-seasonal alone or pre- and co-seasonal). Pre-and co-seasonal regimens are typically used for sublingual allergen immunotherapy (SLIT) and have economic and compliance advantages over perennial (year-round) regimens. However, these advantages must not come at the expensive of poor efficacy or safety. The results of recent double-blind, placebo-controlled, randomized clinical trials show that pre- and co-seasonal SLIT is safe and effective in patients with AR induced by grass pollen (treated with a tablet formulation) or by birch pollen (treated with a liquid formulation). Progress in SLIT has been made in defining the optimal dose of major allergen, the administration frequency (daily), the duration of pre-seasonal treatment (four months) and the number of treatment seasons (at least three). Post-marketing, "real-life" trials of pre- and co-seasonal birch or grass pollen SLIT regimens have confirmed the efficacy and safety observed in the clinical trials. In the treatment of pollen-induced AR, pre- and co-seasonal SLIT regimens appear to be at least as effective and safe as perennial SLIT regimens, and are associated with lower costs and good compliance. Good compliance may mean that pre- and co-seasonal SLIT regimens are inherently more effective and safer than perennial SLIT regimens. When considering the pre- and co-seasonal discontinuous regimen in particular, a 300 IR five-grass-pollen formulation is the only SLIT tablet with a clinical development programme having provided evidence of short-term, sustained and post-treatment efficacy.
    12/2015; 5(1). DOI:10.1186/s13601-015-0061-z