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2023

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NEXT-GENERATION ALLERGIC RHINITIS AND ITS IMPACT ON ASTHMA (ARIA) GUIDELINES FOR ALLERGIC RHINITIS BASED ON GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION (GRADE) AND REAL-WORLD EVIDENCE.

Bousquet J1Schünemann HJ2Togias A3Bachert C4Erhola M5Hellings PW6Klimek L7Pfaar O8Wallace D9Ansotegui I10Agache I11Bedbrook A12Bergmann KC13Bewick M14Bonniaud P15Bosnic-Anticevich S16Bossé I17Bouchard J18Boulet LP19Brozek J2Brusselle G20Calderon MA21Canonica WG22Caraballo L23Cardona V24Casale T25Cecchi L26Chu DK2Costa EM27Cruz AA28Czarlewski W29D'Amato G30Devillier P31Dykewicz M32Ebisawa M33Fauquert JL34Fokkens WJ35Fonseca JA36Fontaine JF37Gemicioglu B38van Wijk RG39Haahtela T40Halken S41Ierodiakonou D42Iinuma T43Ivancevich JC44Jutel M45Kaidashev I46Khaitov M47Kalayci O48Kleine Tebbe J49Kowalski ML50Kuna P51Kvedariene V52La Grutta S53Larenas-Linnemann D54Lau S55Laune D56Le L57Lieberman P58Lodrup Carlsen KC59Lourenço O60Marien G61Carreiro-Martins P62Melén E63Menditto E64Neffen H65Mercier G66Mosgues R67Mullol J68Muraro A69Namazova L70Novellino E71O'Hehir R72Okamoto Y43Ohta K73Park HS74Panzner P75Passalacqua G76Pham-Thi N77Price D78Roberts G79Roche N80Rolland C81Rosario N82Ryan D83Samolinski B84Sanchez-Borges M85Scadding GK86Shamji MH87Sheikh A88Bom AT89Toppila-Salmi S90Tsiligianni I42Valentin-Rostan M91Valiulis A92Valovirta E93Ventura MT94Walker S95Waserman S96Yorgancioglu A97Zuberbier T13

1 - MACVIA-France, Fondation Partenariale FMC VIA-LR, Montpellier, France; VIMA, INSERM U 1168, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, Villejuif, France, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, Euforea, Brussels, Belgium and Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany. Electronic address: Este endereço de email está protegido contra piratas. Necessita ativar o JavaScript para o visualizar..
2 - Department of Health Research Methods, Evidence, and Impact, Division of Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada.
3 - Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.
4 - Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium.
5 - National Institute for Health and Welfare, Helsinki, Finland.
6 - Department of Otorhinolaryngology, University Hospitals Leuven, and Academic Medical Center, University of Amsterdam, The Netherlands, and Euforea, Brussels, Belgium.
7 - Center for Rhinology and Allergology, Wiesbaden, Germany.
8 - Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
9 - Nova Southeastern University, Fort Lauderdale, Fla.
10 - Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia, Erandio, Spain.
11 - Faculty of Medicine, Transylvania University, Brasov, Romania.
12 - MACVIA-France, Fondation Partenariale FMC VIA-LR, Montpellier, France.
13 - Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, member of GA(2)LEN, Berlin, Germany.
14 - iQ4U Consultants, London, United Kingdom.
15 - CHU Dijon, Dijon, France.
16 - Woolcock Institute of Medical Research, University of Sydney and Woolcock Emphysema Centre and Sydney Local Health District, Glebe, Australia.
17 - Allergist, La Rochelle, France.
18 - Laval University, Quebec City, Quebec, Canada.
19 - Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
20 - Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
21 - Imperial College London-National Heart and Lung Institute, Royal Brompton Hospital NHS, London, United Kingdom.
22 - Personalized Medicine Clinic Asthma & Allergy, Humanitas University, Humanitas Research Hospital, Rozzano, Milan, Italy.
23 - Institute for Immunological Research, University of Cartagena, Campus de Zaragocilla, Edificio Biblioteca Primer Piso, and the Foundation for the Development of Medical and Biological Sciences (Fundemeb), Cartagena, Colombia.
24 - Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL research network, Barcelona, Spain.
25 - The Division of Allergy/Immunology, University of South Florida, Tampa, Fla.
26 - SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
27 - UCIBIO, REQUIMTE, Faculty of Pharmacy, and Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork), University of Porto, Porto, Portugal.
28 - ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, and the WHO GARD Planning Group, Bahia, Brazil.
29 - Medical Consulting Czarlewski, Levallois, France.
30 - Division of Respiratory and Allergic Diseases, Hospital "A Cardarelli", University of Naples Federico II, Naples, Italy.
31 - UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France; Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
32 - Section of Allergy and Immunology, Saint Louis University School of Medicine, St Louis, Mo.
33 - Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.
34 - Unité de pneumo-allergologie de l'enfant, pôle pédiatrique Pr-Labbé, CHU de Clermont-Ferrand-Estaing, Clermont-Ferrand, France.
35 - Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands.
36 - CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto, and Medida, Porto, Portugal.
37 - Allergist, Reims, France.
38 - Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
39 - Department of Internal Medicine, section of Allergology, Erasmus MC, Rotterdam, The Netherlands.
40 - Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.
41 - Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
42 - Department of Social Medicine, Faculty of Medicine, University of Crete and International Primary Care Respiratory Group, Crete, Greece.
43 - Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.
44 - Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
45 - Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland.
46 - Ukrainina Medical Stomatological Academy, Poltava, Ukraine.
47 - National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular immunology, Moscow, Russia.
48 - Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey.
49 - Allergy & Asthma Center Westend, Outpatient & Clinical Research Center, Berlin, Germany.
50 - Department of Immunology and Allergy, Healthy Ageing Research Center, Medical University of Lodz, Lodz, Poland.
51 - Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
52 - Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University and Institute of Clinical medicine, Clinic of Chest diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
53 - Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council (CNR), Palermo, Italy.
54 - Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, Mexico City, Mexico.
55 - Department of Paediatric Pneumology, Immunology and Intensive Care, Charité Universitätsmedizin, Berlin, Germany.
56 - KYomed INNOV, Montpellier, France.
57 - University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
58 - Departments of Internal Medicine and Pediatrics (Divisions of Allergy and Immunology), University of Tennessee College of Medicine, Germantown, Tenn.
59 - Oslo University Hospital, Department of Paediatrics, Oslo, and University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.
60 - Faculty of Health Sciences and CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
61 - Euforea, Brussels, Belgium.
62 - Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisbon, and Nova Medical School, CEDOC, Integrated Pathophysiological Mechanisms Research Group, Lisbon, Portugal.
63 - Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
64 - CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy.
65 - Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, and the Center for Allergy and Immunology, Santa Fe, Argentina.
66 - Unité Médico-Economie, Département de l'Information Médicale, University Hospital, Montpellier, France.
67 - Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, and Clinical Research International, Hamburg, Germany.
68 - Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
69 - Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy.
70 - Scientific Centre of Children's Health under the MoH, Moscow, and Russian National Research Medical University named Pirogov, Moscow, Russia.
71 - Department of Pharmacy of University of Naples Federico II, Naples, Italy.
72 - Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, and the Department of Immunology, Monash University, Melbourne, Australia.
73 - National Hospital Organization, Tokyo National Hospital, Tokyo, Japan.
74 - Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea.
75 - Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic.
76 - Allergy and Respiratory Diseases, Ospedale Policlino San Martino-University of Genoa, Genoa, Italy.
77 - Allergy Department, Pasteur Institute, Paris, France.
78 - Observational and Pragmatic Research Institute, Singapore.
79 - David Hide Centre, St Mary's Hospital, Isle of Wight, and University of Southampton, Southampton, United Kingdom.
80 - Pneumologie et Soins Intensifs Respiratoires, Hôpitaux Universitaires Paris, and Hôpital Cochin, Paris, France.
81 - Association Asthme et Allergie, Paris, France.
82 - Hospital de Clinicas, University of Parana, Parana, Brazil.
83 - Allergy and Respiratory Research Group, University of Edinburgh, Edinburgh, United Kingdom.
84 - Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.
85 - Allergy and Clinical Immunology Department, Centro Medico-Docente La Trinidad, Caracas, Venezuela.
86 - Royal National TNE Hospital, University College London, London, United Kingdom.
87 - Immunomodulation and Tolerance Group and Allergy and Clinical Immunology, Imperial College London, London, United Kingdom.
88 - Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom.
89 - Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
90 - Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
91 - Allergist, Montevideo, Uruguay.
92 - Vilnius University Institute of Clinical Medicine, Clinic of Children's Diseases, and Institute of Health Sciences, Department of Public Health, Vilnius, Mexico, and the European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium.
93 - Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo Allergy Clinic, Turku, Finland.
94 - University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy.
95 - Asthma UK, London, United Kingdom.
96 - Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada.
97 - Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey.

J Allergy Clin Immunol. doi: 10.1016/j.jaci.2019.06.049. 2019 Oct 15. Review. PubMed PMID: 31627910.

Resumo: The selection of pharmacotherapy for patients with allergic rhinitis aims to control the disease and depends on many factors. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines have considerably improved the treatment of allergic rhinitis. However, there is an increasing trend toward use of real-world evidence to inform clinical practice, especially because randomized controlled trials are often limited with regard to the applicability of results. The Contre les Maladies Chroniques pour un Vieillissement Actif (MACVIA) algorithm has proposed an allergic rhinitis treatment by a consensus group. This simple algorithm can be used to step up or step down allergic rhinitis treatment. Next-generation guidelines for the pharmacologic treatment of allergic rhinitis were developed by using existing GRADE-based guidelines for the disease, real-world evidence provided by mobile technology, and additive studies (allergen chamber studies) to refine the MACVIA algorithm.

Palavras Chave: Allergic Rhinitis and Its Impact on Asthma; Allergic rhinitis; Development and Evaluation; Grading of Recommendations Assessment; guidelines; real-world evidence