Allergic Rhinitis and Its Impact on Asthma ( ARIA )‐ EAACI Guidelines—2024–2025 Revision: Part II —Guidelines on Oral and Ocular Treatments
Year: 2026
Type: article
Abstract: BACKGROUND: Oral and ocular medications are frequently used in the treatment of allergic rhinitis (AR). As part of the update of the Allergic Rhinitis and its Impact on Asthma (ARIA)-EAACI guidelines, this manuscript presents the ARIA-EAACI 2024-2025 recommendations for oral and ocular treatments. METHODS: The ARIA-EAACI 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 judgements and recommendations, including systematic reviews, mHealth and pharmacovigilance data as well as a survey on costs. RESULTS: Eight guideline questions concerning oral treatments for AR and three questions concerning ocular treatments were addressed. These questions led to the recommendations. Overall, these questions concern the choice between different classes of medication. They also discuss the role of oral antihistamines (OAH), leukotriene receptor antagonists (LTRA), ocular antihistamines (OcAH) and ocular mast cell stabilisers. Four questions had not been previously evaluated in ARIA guidelines, while, for the other four, there was a change in the strength or directionality of the recommendations. Overall, these guidelines recommend using intranasal corticosteroids over OAH and using OAH over LTRA. Moreover, they suggest using OAH over OcAH and suggest being against adding LTRA to OAH. Finally, considerations for choosing between different individual OAHs are presented. CONCLUSION: This ARIA-EAACI 2024-2025 article supports patients, their caregivers and healthcare professionals in choosing oral and ocular treatments for AR. Decisions on treatment should consider the clinical variability of the disease, patients' values and the affordability of medications.
Source: Allergy
DOI: 10.1111/all.70305
Authors: Rafael José Vieira, Bernardo Sousa‐Pinto, Jean Bousquet, Holger J. Schünemann, Torsten Zuberbier, Antonio Bognanni, Alkis Togias, Boleslaw Samolinski, Arunas Valiulis, Sian Williams, Anna Bedbrook, Wienczyslawa Czarlewski, Maria Jose Torres, Mohamed H. Shamji, Mário Morais‐Almeida, G. Walter Canonica, Leticia de las Vecillas, Mark S. Dykewicz, Cristina Jacomelli, Ludger Klimek, Lucas Leemann, Olga Lourenço, Nikolaos G. Papadopoulos, Ana Margarida Pereira, Marine Savouré, Sanna K. Toppila‐Salmi, Maria Teresa Ventura, Juan José Yepes‐Nuñez, Alvaro A. Cruz, Giorgio Ciprandi, Bilun Gemicioglu, Mattia Giovannini, Brigita Gradauskiene, Tuomas Jartti, Miloš Jeseňák, Piotr Kuna, Violeta Kvedariene, Désirée E. Larenas‐Linnemann, Amir H. A. Latiff, Yousser Mohammad, Ken Ohta, Padukudru A. Mahesh, Isabella Pali‐Schöll, Oliver Pfaar, Frederico S. Regateiro, Nicolas Roche, Luís Taborda‐Barata, Charlotte Suppli Ulrik, Giovanni Viegi, Luo Zhang, Tari Haahtela, Ivan Cherrez‐Ojeda, Juan Carlos Ivancevich, Nikolai Khaltaev, Arzu Yorgancioglu, Baharudin Abdullah, Mona Al‐Ahmad, Maryam Ali Al‐Nesf, Rita Amaral, Julijana Asllani, Karl‐C. Bergmann, Jonathan A. Bernstein, Michael S. Blaiss, Elina Toskala, Pedro Carreiro‐Martins, Thomas Casale, Lorenzo Cecchi, Alessandro Fiocchi, Antonio F. M. Giuliano, George Christoff, Ieva Cirule, Jaime Correia de Sousa, Elisio M. Costa, Philippe Devillier, Elham Hossny, Tomohisa Iinuma, Zhanat Ispayeva, Kaja Julge, Igor Kaidashev, Kazi S. Bennoor, Helga Kraxner, Inger Kull, Marek Kulus, Maciej Kupczyk, Andriy Kurchenko, Stefania La Grutta, Neven Miculinic, Lan Le Thi Tuyet, Sang Min Lee, Stephen Montefort, Andre Moreira, Joaquim Mullol, Rachel Nadif, Alla Nakonechna, Hugo E. Neffen, Marek Niedoszytko, Robyn E. O'Hehir, Ismail Ogulur, Yoshitaka Okamoto, Heidi Olze, Oscar Palomares, Petr Panzner, Vincenzo Patella, Constantinos Pitsios, Francesca Puggioni, Santiago Quirce, Agné Ramonaité, Maria Susana Repka‐Ramirez, Graham Roberts, Karla Robles‐Velasco, Menachem Rottem, Marianella Salapatas, Joaquin Sastre, Nicola Scichilone, Juan‐Carlos Sisul, Dirceu Solé, Manuel E. Soto‐Martinez, Milan Sova, Pongsakorn Tantilipikorn, Ana Todo‐Bom, Vladyslav Tsaryk, Ioanna Tsiligianni, Marilyn Urrutia‐Pereira, Erkka Valovirta, Tuula Vasankari, Dana Wallace, De Yun Wang, Margitta Worm, Osman M. Yusuf, Sara Gil‐Mata, Manuel Marques‐Cruz, Bassam Mahboub, Antonino Romano, Werner Aberer, Maria Cristina Artesani, Elena Azzolini, Bruno Barreto, Joan Bartra, Sven Becker, Bianca Beghe, Attilio Boner, Ewa Borowiack, Jacques Bouchard, Luisa Brussino, Roland Buhl, Francesco Catamerò, Denis Charpin, Niels H. Chavannes, Marta Chełmińska, Lei Cheng, Ekaterine Chkhartishvili, Seong H. Cho, Herberto Jose Chong‐Neto, Derek K. Chu, Cemal Cingi, Enrico Compalati, Raquel Albuquerque Costa, Biljana Cvetkovski, Victoria Cardona, Gennaro D'Amato, Janet M. Davies, Danilo Di Bona, Sandra N. Gonzalez Diaz, Maria V. Dimou, Maria Doulaptsi, Renato Ferreira‐da‐Silva, Radoslaw Gawlik, Mario Calvo‐Gil, Maximiliano R. Gómez, Maia Gotua, Christos Grigoreas, Maria Antonieta Guzman, Rachel House, Michael Hyland, Despo Ierodiakonou, Aspasia Karavelia, Paul Keith, Marta Kisiel, Tanja Soklic Kosak, Mitja Kosnik, Ilgim Vardaloglu Koyuncu, Vicky Kritikos, Justyna Litynska, Carlo Lombardi, Gilles Louis, Xin Luo, Matteo Martini, Cem Meço, Eris Mesonjesi, Florin Mihaltan, Marcin Moniuszko, Robert N. Naclerio, Sophia Neisinger, Markus Ollert, Michal Ordak, Giovanni Paoletti, Elena Parmelli, Edgar Arturo Perdomo‐Flores, Henrique Pereira, José Miguel Fuentes Pérez, Nhan Pham‐Thi, Emmanuel Prokopakis, Inês Ribeiro‐Vaz, Giovanni Rolla, Jan Romantowski, Philippe Rombaux, Philip W. Rouadi, Dermot Ryan, Ewelina Sadowska, Daiju Sakurai, Laila Salameh, Elie Serrano, Jane Da Silva, Michael B. Soyka, Krzysztof Specjalski, Vesna Tomic‐Spiric, Katarina Stevanovic, Abirami Subramaniam, Tuuli Thomander, Wu Tong, Martina Vachova, Marianne van Hage, Martin Wagenmann, Fanny Wai San Ko, Pascal Werminghaus, Paraskevi Vicky Xepapadaki, Yi‐Kui Xiang, Qintai Yang, He Zhang, Jaron Zuberbier, João A. Fonseca
Institutions: Universidade do Porto, Centre for Health Technology and Services Research, RISE - Health Research Network, Humboldt-Universität zu Berlin, Fraunhofer Institute for Translational Medicine and Pharmacology, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humanitas University, McMaster University, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Medical University of Warsaw, Vilnius University, Hospital Regional Universitario de Málaga, Universidad de Málaga, NIHR Imperial Biomedical Research Centre, Imperial College London, Hospital CUF Descobertas, IRCCS Humanitas Research Hospital, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research, Saint Louis University, University Medical Center of the Johannes Gutenberg University Mainz, Zentrum für Rhinologie und Allergologie, University of Zurich, University of Beira Interior, National and Kapodistrian University of Athens, CUF Porto Hospital, Universitat Pompeu Fabra, Barcelona Institute for Global Health, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, University of Helsinki, University of Eastern Finland, Helsinki University Hospital, Institute of Sciences of Food Production, University of Bari Aldo Moro, Universidad de Los Andes, Fundación Santa Fe de Bogotá, Universidade Federal da Bahia, Istanbul University-Cerrahpaşa, Istanbul University, Meyer Children's Hospital, University of Florence, Lithuanian University of Health Sciences, University of Turku, Turku University Hospital, Martin University Hospital, Comenius University Bratislava, Medical University of Lodz, Hospital Médica Sur, Pantai Hospital, Kuala Lumpur, Latakia University, Al-Sham Private University, Japan Anti Tuberculosis Association, Fukujuji Hospital, JSS Academy of Higher Education and Research, JSS Medical College and Hospital, University of Veterinary Medicine Vienna, Philipps University of Marburg, Unidade Local de Saúde de Coimbra, Centro de Inovação em Biomedicina e Biotecnologia, University of Coimbra, Inserm, Université Paris Cité, Hôpital Cochin, Centre de recherche en Epidémiologie et Santé des Populations, Institut Cochin, University of Copenhagen, Hvidovre Hospital, Copenhagen University Hospital, Istituto di Fisiologia Clinica, Third Affiliated Hospital of Sun Yat-sen University, Universidad Espíritu Santo, Manisa Celal Bayar University, Universiti Sains Malaysia, Hospital Universiti Sains Malaysia, Kuwait University, Hamad Medical Corporation, Uppsala University, Universidade Técnica do Porto, University of Medicine Tirana, University of Cincinnati, Augusta University, Thomas Jefferson University, Unidade Local de Saúde de São José, Hospital de São José, Comprehensive Health Research Centre, Universidade Nova de Lisboa, University of South Florida, Nuovo Ospedale San Giovanni di Dio, Bambino Gesù Children's Hospital, Children's Clinical University Hospital, University of Minho, Université Paris-Saclay, Virologie et Immunologie Moléculaires, Hôpital Foch, Ain Shams University, Chiba University, Kazakh National Medical University, University of Tartu, Poltava State Medical University, National Institute of Diseases of the Chest and Hospital, Semmelweis University, Karolinska Institutet, Stockholm South General Hospital, Sachs' Children and Youth Hospital, Bogomolets National Medical University, Istituto di Farmacologia Traslazionale, National Research Council, University Medical Center HCMC, Dankook University Hospital, Dankook University, University of Malta, Hospital de São João, Institute of Public Health, University of Porto, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Université Paris-Sud, Université de Versailles Saint-Quentin-en-Yvelines, University of Liverpool, Imperial College Healthcare NHS Trust, Gdańsk Medical University, Alfred Health, Monash University, Chiba University Hospital, Chiba Rosai Hospital, Universidad Complutense de Madrid, Charles University, Azienda Sanitaria Locale Salerno, University of Naples Federico II, University of Cyprus, Republic Klaipeda Hospital, Universidad Nacional de Asunción, University Hospital Southampton NHS Foundation Trust, NIHR Southampton Biomedical Research Centre, University of Southampton, Technion – Israel Institute of Technology, Emek Medical Center, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Universidad Autónoma de Madrid, University of Palermo, Universidade Federal de São Paulo, Universidad de Costa Rica, Hospital Nacional de Niños, University Hospital Brno, Siriraj Hospital, Mahidol University, University of Crete, Universidade Federal do Pampa, Finnish Lung Health Association, Nova Southeastern University, National University of Singapore, Rashid Hospital, University of Sharjah, I.R.C.C.S. Oasi Maria SS, Medical University of Graz, Centro Universitário do Pará, University of Tübingen, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, University of Verona, Université Laval, A. O. Ordine Mauriziano di Torino, University of Turin, Hôpital Nord, Leiden University, Leiden University Medical Center, Jiangsu Province Hospital, Nanjing Medical University, David Tvildiani Medical University, Universidade Federal do Paraná, Eskişehir Osmangazi University, Lofarma (Italy), Woolcock Institute of Medical Research, Vall d'Hebron Hospital Universitari, Ospedale Antonio Cardarelli, Queensland University of Technology, Metro North Hospital and Health Service, University of Foggia, Universidad Autónoma de Nuevo León, Medical University of Silesia, Austral University of Chile, Universidad Católica de Salta, Hellenic Air Force, Hellenic Airforce General Hospital, Hospital Clínico de la Universidad de Chile, University of Chile, Macquarie University, University of Plymouth, University of Nicosia, University of Ljubljana, University Clinic of Pulmonary and Allergic Diseases Golnik, Bağcılar Eğitim ve Araştırma Hastanesi, The University of Sydney, Fondazione Poliambulanza Istituto Ospedaliero, University of Liège, Marche Polytechnic University, Azienda Ospedaliero-Universitaria delle Marche, Ankara University, Cornell University, Paracelsus Medical University, Weill Cornell Medicine, Mother Teresa Hospital, Carol Davila University of Medicine and Pharmacy, Institutul de Pneumoftiziologie "Marius Nasta", Medical University of Białystok, Johns Hopkins University, Vrije Universiteit Brussel, Luxembourg Institute of Health, Universitair Ziekenhuis Brussel, École Polytechnique, Cliniques Universitaires Saint-Luc, University of Edinburgh, University of Yamanashi, Mohammed Bin Rashid University of Medicine and Health Sciences, Hôpital Rangueil, Hôpital Larrey, Universidade Federal de Santa Catarina, Polydoro Ernani de São Thiago University Hospital, University Hospital Zurich, University of Belgrade, Univerzitetski Klinički Centar Srbije, Trinity College Dublin, Tallaght University Hospital, University Hospital Plzen, Karolinska University Hospital, Düsseldorf University Hospital, Heinrich Heine University Düsseldorf, Chinese University of Hong Kong, Tongji University, Shanghai Skin Disease Hospital
Language: English
Subfield: Immunology and Allergy
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,300
Funders: Advanced Research and Invention Agency, Università degli Studi di Napoli Federico II, Univerzita Komenského v Bratislave, Ankara Universitesi, Universidade da Beira Interior, Itä-Suomen Yliopisto, Helsingin Yliopisto, Hamad Medical Corporation, Université Laval, Johns Hopkins University, University of Cincinnati, Thomas Jefferson University, University of South Florida, Philipps-Universität Marburg, McMaster University, Nova Southeastern University, Saint Louis University, Augusta University, Universidad de Especialidades Espíritu Santo, Universitat Pompeu Fabra, JSS Academy of Higher Education and Research, Tishreen University, Ospedale Pediatrico Bambino Gesù, National Institute for Health and Care Research, Imperial College London, National Heart and Lung Institute, National University of Singapore, Institut National de la Santé et de la Recherche Médicale, Universiteit Leiden, Queensland University of Technology, Semmelweis Egyetem, Eberhard Karls Universität Tübingen, Ain Shams University, Sun Yat-sen University, Gentofte Hospital, Heinrich-Heine-Universität Düsseldorf, Karolinska Institutet, Warszawski Uniwersytet Medyczny, Tongji University, Vrije Universiteit Brussel, University of Crete, Università degli Studi di Firenze, Kuwait University, Universiti Sains Malaysia, Chinese University of Hong Kong, National and Kapodistrian University of Athens, Turun Yliopisto, Uniwersytet Łódzki, Universidade de Coimbra, Universitat de Barcelona, Eskişehir Osmangazi Üniversitesi, Humboldt-Universität zu Berlin, Uniwersytet Warszawski, Universität Zürich, Università degli Studi di Torino, Universidade do Porto, Uppsala Universitet, Università degli Studi di Verona, Universidade Federal de Santa Catarina, Instituto Politécnico do Porto, Université Paris-Saclay, Nanjing Medical University, Freie Universität Berlin, Filha, Chiba University, Universidade do Minho, Karl-Franzens-Universität Graz, Veterinärmedizinische Universität Wien, Humanitas University, Universidad Austral de Chile, Medizinische Universität Graz, Śląski Uniwersytet Medyczny w Katowicach, Turun Yliopistollinen Keskussairaala, Paracelsus Medizinische Privatuniversität, Uniwersytet Śląski w Katowicach, Lietuvos Sveikatos Mokslų Universitetas, Centro de Investigação em Tecnologias e Serviços de Saúde, Humanitas Research Hospital, Mohammed Bin Rashid University of Medicine and Health Sciences, Université de Paris, National Institutes of Health, Directorate for Biological Sciences, Weill Cornell Medical College, College of Medicine, University of Cincinnati, Metro North Hospital and Health Service, Instituto de Salud Carlos III, Istituto di Scienze delle Produzioni Alimentari, Consiglio Nazionale delle Ricerche, NIHR Imperial Biomedical Research Centre, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, National Institute of Allergy and Infectious Diseases, NIH Clinical Center, Cliniques Universitaires Saint-Luc
OpenAlex ID: W7140171272