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Int Forum Allergy Rhinol. 2018 Feb;8(2):108-352. doi: 10.1002/alr.22073.

International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis.

Author information

1
Otolaryngology, Emory University, USA.
2
Otolaryngology, Johns Hopkins University, USA.
3
Otolaryngology, Temple University, USA.
4
Otolaryngology, University of Utah, USA.
5
Allergy/Asthma, Swiss Institute of Allergy and Asthma Research, Switzerland.
6
Allergy/Immunology, Johns Hopkins University, USA.
7
Otolaryngology, University of Chicago, USA.
8
Otolaryngology, University of Ghent, Belgium.
9
Respiratory Diseases, Humanitas University, Italy.
10
Allergy/Immunology, Private Practice, USA.
11
Otolaryngology, Eskisehir Osmangazi University, Turkey.
12
Allergy/Immunology, Ospedale Policlinico San Martino, Italy.
13
Pediatric Allergy, Imperial College London, UK.
14
Otolaryngology, Private Practice, USA.
15
Otolaryngology, University of California San Diego, USA.
16
Otolaryngology, University of North Carolina, USA.
17
Otolaryngology, Rutgers New Jersey Medical School, USA.
18
Otolaryngology, University of Amsterdam, Netherlands.
19
Otolaryngology, University of Missouri, USA.
20
Otorhinolaryngology, Helios Kliniken Wiesbaden, Germany.
21
Otolaryngology, University of Texas Southwestern, USA.
22
Respiratory Diseases, University of Aarhus, Denmark.
23
Respiratory Medicine, Hannover Medical School, Airway Research Fraunhofer Institute for Toxicology and Experimental Medicine, German Center for Lung Research, Germany.
24
Otolaryngology, Case Western Reserve University, USA.
25
Otolaryngology, Stanford University, USA.
26
Allergy/Immunology, ASST Pini/CTO Milan, Italy.
27
Public Health, Imperial College London, UK.
28
Otolaryngology, Harvard Medical School, USA.
29
Pulmonary/Allergy, Turku University Hospital, Finland.
30
Otolaryngology, University of Colorado, USA.
31
Nursing, University of Texas Rio Grande Valley, USA.
32
Pediatric Allergy, Hospital Medica Sur, Mexico.
33
Otolaryngology, San Antonio Military Medical Center, USA.
34
Otolaryngology, University of Pittsburgh, USA.
35
Otolaryngology, McGovern Medical School at the University of Texas Health Science Center Houston, USA.
36
Otolaryngology, Ochsner Clinic Foundation, USA.
37
Otolaryngology, Uniformed Services University of Health Sciences, USA.
38
Pediatric Allergy, Karolinska Institutet, Sweden.
39
Otolaryngology, Wake Forest University, USA.
40
Allergy/Immunology, University of Pavia, Italy.
41
Otolaryngology, Universitat de Barcelona, Hospital Clinic, IDIBAPS, Spain.
42
Allergy/Immunology, National Jewish Health, USA.
43
Otolaryngology, Loyola University, USA.
44
Pediatrics, Nippon Medical School, Japan.
45
Rhinology/Allergy, Medical Faculty Mannheim, Heidelberg University,  Center for Rhinology and Allergology, Wiesbaden, Germany.
46
Otolaryngology, Boston University, USA.
47
Otolaryngology, Weill Cornell Medical College, USA.
48
Allergy, Regional University Hospital of Málaga, Spain.
49
Otolaryngology, University of Calgary, Canada.
50
Allergology, Hospital Universitario Fundacion Jiminez Diaz, Spain.
51
Otolaryngology, Medical University of South Carolina, USA.
52
Allergy/Immunology, Alpert Medical School of Brown University, USA.
53
Allergy/Immunology, Children's National Health System, George Washington University School of Medicine, USA.
54
Allergy/Asthma, University of Edinburgh, UK.
55
Otolaryngology, Oregon Health and Science University, USA.
56
Rhinology/Allergy, Mahidol University, Thailand.
57
Otolaryngology, National University of Singapore, Singapore.
58
Otolaryngology, Karolinska Institutet, Sweden.
59
Environmental Medicine, Karolinska Institutet, Sweden.
60
Otolaryngology, University of Michigan, USA.

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.

KEYWORDS:

IgE; allergen extract; allergen immunotherapy; allergic rhinitis; allergy; antihistamine; asthma; atopic dermatitis; avoidance; biologic; cockroach; conjunctivitis; consensus; corticosteroid; cough; cromolyn; decongestant; environment; eosinophilic esophagitis; epicutaneous immunotherapy; epidemiology; evidence-based medicine; food allergy; genetics; house dust mite; 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

PMID:
29438602
DOI:
10.1002/alr.22073
[Indexed for MEDLINE]
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