International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis

Sarah K. Wise*, Sandra Y Lin, Elina Toskala, Richard R. Orlandi, Cezmi A Akdis, Jeremiah A. Alt, Antoine Azar, Fuad M. Baroody, Claus Bachert, Walter G Canonica, Thomas Chacko, Cemal Cingi, Giorgio Ciprandi, Jacquelynne Corey, Linda S. Cox, Peter Socrates Creticos, Adnan Custovic, Cecelia Damask, Adam DeConde, John M. DelGaudioCharles S. Ebert, Jean Anderson Eloy, Carrie E. Flanagan, Wytske J Fokkens, Christine Franzese, Jan Gosepath, Ashleigh Halderman, Robert G. Hamilton, Hans Juergen Hoffman, Jens M. Hohlfeld, Steven M. Houser, Peter H. Hwang, Cristoforo Incorvaia, Deborah L. Jarvis, Ayesha N. Khalid, Maritta Kilpelaeinen, Todd. T. Kingdom, Helene Krouse, Desiree Larenas-Linnemann, Adrienne M. Laury, Stella E. Lee, Joshua M. Levy, Amber U. Luong, Bradley F. Marple, Edward D. McCoul, K. Christopher McMains, Erik Melen, James W. Mims, Gianna Moscato, Joaquim Mullol, Harold S. Nelson, Monica Patadia, Ruby Pawankar, Oliver Pfaar, Michael P. Platt, William Reisacher, Carmen Rondon, Luke Rudmik, Matthew Ryan, Joaquin Sastre, Rodney J. Schlosser, Russell A. Settipane, Hemant P. Sharma, Aziz Sheikh, Timothy L. Smith, Pongsakorn Tantilipikorn, Jody R. Tversky, Maria C. Veling, De Yun Wang, Marit Westman, Magnus Wickman, Mark Zacharek, Anand Andiappan, Philipp Badorrek, Christopher D. Brook, Paloma Campo, Mohamad R. Chaaban, Anna Charles-Jones, Esther Cheng, Nipun Chhabra, Daniel J Cox, Pedram Daraei, Aaron M. Drucker, Kai Fruth, Canting Guo, Matthias Kopp, Patricia A. Loftus, Mauricio Lopez-Chacon, Michael J. Marino, Jose Mattos, Nuray Bayar Muluk, Chew Lip Ng, Bright I. Nwaru, Gianni Pala, Jono Paulin, Michael Pfisterer, Andrew J. Rosko, Chloe Lan Russo, Theodore Asher Schuman, Christine Segboer, Michela Silvestri, Kristine A. Smith, Michael B. Soyka, Jeanie Sozansky Lujan, Andrew J. Thomas, Arja Viinanen, Thomas J. Willson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Critical examination of the quality and validity of available allergic rhinitis (AR) literature is necessary to improve understanding and to appropriately translate this knowledge to clinical care of the AR patient. To evaluate the existing AR literature, international multidisciplinary experts with an interest in AR have produced the International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR).

Methods: Using previously described methodology, specific topics were developed relating to AR. Each topic was assigned a literature review, evidence-based review (EBR), or evidence-based review with recommendations (EBRR) format as dictated by available evidence and purpose within the ICAR:AR document. Following iterative reviews of each topic, the ICAR:AR document was synthesized and reviewed by all authors for consensus.

Results: The ICAR:AR document addresses over 100 individual topics related to AR, including diagnosis, pathophysiology, epidemiology, disease burden, risk factors for the development of AR, allergy testing modalities, treatment, and other conditions/comorbidities associated with AR.

Conclusion: This critical review of the AR literature has identified several strengths; providers can be confident that treatment decisions are supported by rigorous studies. However, there are also substantial gaps in the AR literature. These knowledge gaps should be viewed as opportunities for improvement, as often the things that we teach and the medicine that we practice are not based on the best quality evidence. This document aims to highlight the strengths and weaknesses of the AR literature to identify areas for future AR research and improved understanding. (C) 2018 ARS-AAOA, LLC.

Original languageEnglish
Pages (from-to)108-352
Number of pages245
JournalInternational Forum of Allergy and Rhinology
Volume8
Issue number2
Early online date13 Feb 2018
DOIs
Publication statusE-pub ahead of print - 13 Feb 2018

Keywords

  • allergen extract
  • allergy
  • allergen immunotherapy
  • allergic rhinitis
  • antihistamine
  • asthma
  • atopic dermatitis
  • avoidance
  • biologic
  • cockroach
  • conjunctivitis
  • consensus
  • corticosteroid
  • cough
  • cromolyn
  • decongestant
  • eosinophilic esophagitis
  • environment
  • epicutaneous immunotherapy
  • epidemiology
  • evidence-based medicine
  • food allergy
  • genetics
  • house dust mite
  • IgE
  • immunoglobulin E
  • immunotherapy
  • inhalant allergy
  • leukotriene
  • microbiome
  • occupational rhinitis
  • omalizumab
  • pathophysiology
  • perennial
  • pet dander
  • pollen
  • probiotic
  • quality of life
  • rhinitis
  • rhinosinusitis
  • risk factor
  • saline
  • seasonal
  • sensitization
  • sinusitis
  • sleep
  • socioeconomic
  • specific IgE
  • subcutaneous immunotherapy
  • sublingual immunotherapy
  • systematic review
  • total IgE
  • transcutaneous immunotherapy
  • validated survey
  • QUALITY-OF-LIFE
  • HOUSE-DUST-MITE
  • AZELASTINE NASAL SPRAY
  • PLACEBO-CONTROLLED TRIAL
  • OBSTRUCTIVE SLEEP-APNEA
  • SKIN-PRICK TEST
  • RANDOMIZED-DOUBLE-BLIND
  • ENVIRONMENTAL EXPOSURE UNIT
  • GRASS-POLLEN IMMUNOTHERAPY
  • JAPANESE CEDAR POLLINOSIS

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