A2 Refereed review article in a scientific journal

Allergic Rhinitis and Its Impact on Asthma (ARIA)‐EAACIGuidelines—2024–2025 Revision: Part II—Guidelines on Oral and Ocular Treatments



Authors: Vieira, Rafael José; Sousa‐Pinto, Bernardo; Bousquet, Jean; Schünemann, Holger J.; Zuberbier, Torsten; Bognanni, Antonio; Togias, Alkis; Samolinski, Boleslaw; Valiulis, Arunas; Williams, Sian; Bedbrook, Anna; Czarlewski, Wienczyslawa; Torres, Maria Jose; Shamji, Mohamed H.; Morais‐Almeida, Mário; Canonica, G. Walter; de las Vecillas, Leticia; Dykewicz, Mark S.; Jacomelli, Cristina; Klimek, Ludger; Leemann, Lucas; Lourenço, Olga; Papadopoulos, Nikolaos G.; Pereira, Ana Margarida; Savouré, Marine; Toppila‐Salmi, Sanna K.; Ventura, Maria Teresa; Yepes‐Nuñez, Juan José; Cruz, Alvaro A.; Ciprandi, Giorgio; Gemicioglu, Bilun; Giovannini, Mattia; Gradauskiene, Brigita; Jartti, Tuomas; Jeseňák, Miloš; Kuna, Piotr; Kvedariene, Violeta; Larenas‐Linnemann, Désirée E.; Latiff, Amir H. A.; Mohammad, Yousser; Ohta, Ken; Mahesh, Padukudru A.; Pali‐Schöll, Isabella; Pfaar, Oliver; Regateiro, Frederico S.; Roche, Nicolas; Taborda‐Barata, Luís; Ulrik, Charlotte Suppli; Viegi, Giovanni; Zhang, Luo; Haahtela, Tari; Cherrez‐Ojeda, Ivan; Ivancevich, Juan Carlos; Khaltaev, Nikolai; Yorgancioglu, Arzu; Abdullah, Baharudin; Al‐Ahmad, Mona; Al‐Nesf, Maryam Ali; Amaral, Rita; Asllani, Julijana; Bergmann, Karl‐C.; Bernstein, Jonathan A.; Blaiss, Michael S.; Toskala, Elina; Carreiro‐Martins, Pedro; Casale, Thomas; Cecchi, Lorenzo; Fiocchi, Alessandro; Giuliano, Antonio F. M.; Christoff, George; Cirule, Ieva; de Sousa, Jaime Correia; Costa, Elisio M.; Devillier, Philippe; Hossny, Elham; Iinuma, Tomohisa; Ispayeva, Zhanat; Julge, Kaja; Kaidashev, Igor; Bennoor, Kazi S.; Kraxner, Helga; Kull, Inger; Kulus, Marek; Kupczyk, Maciej; Kurchenko, Andriy; La Grutta, Stefania; Miculinic, Neven; Tuyet, Lan Le Thi; Lee, Sang Min; Montefort, Stephen; Moreira, Andre; Mullol, Joaquim; Nadif, Rachel; Nakonechna, Alla; Neffen, Hugo E.; Niedoszytko, Marek; O'Hehir, Robyn E.; Ogulur, Ismail; Okamoto, Yoshitaka; Olze, Heidi; Palomares, Oscar; Panzner, Petr; Patella, Vincenzo; Pitsios, Constantinos; Puggioni, Francesca; Quirce, Santiago; Ramonaité, Agné; Repka‐Ramirez, Maria Susana; Roberts, Graham; Robles‐Velasco, Karla; Rottem, Menachem; Salapatas, Marianella; Sastre, Joaquin; Scichilone, Nicola; Sisul, Juan‐Carlos; Solé, Dirceu; Soto‐Martinez, Manuel E.; Sova, Milan; Tantilipikorn, Pongsakorn; Todo‐Bom, Ana; Tsaryk, Vladyslav; Tsiligianni, Ioanna; Urrutia‐Pereira, Marilyn; Valovirta, Erkka; Vasankari, Tuula; Wallace, Dana; Wang, De Yun; Worm, Margitta; Yusuf, Osman M.; Gil‐Mata, Sara; Marques‐Cruz, Manuel; Mahboub, Bassam; Romano, Antonino; Aberer Werner; Artesani, Maria Cristina; Azzolini, Elena; Barreto, Bruno; Bartra, Joan; Becker, Sven; Beghe, Bianca; Boner, Attilio; Borowiack, Ewa; Bouchard, Jacques; Brussino, Luisa; Buhl, Roland; Catamerò, Francesco; Charpin, Denis; Chavannes, Niels H.; Chełmińska, Marta; Cheng, Lei; Chkhartishvili, Ekaterine; Cho, Seong H.; Chong‐Neto, Herberto Jose; Chu, Derek K.; Cingi, Cemal; Compalati, Enrico; Albuquerque Costa, Raquel; Cvetkovski, Biljana; Cardona, Victoria; D'Amato, Gennaro; Davies, Janet M.; Di Bona, Danilo; Gonzalez Diaz, Sandra N.; Dimou, Maria V.; Doulaptsi, Maria; Ferreira‐da‐Silva, Renato; Gawlik, Radoslaw; Calvo‐Gil, Mario; Gómez, Maximiliano R.; Gotua, Maia; Grigoreas, Christos; Guzman, Maria Antonieta; House, Rachel; Hyland, Michael; Ierodiakonou, Despo; Karavelia, Aspasia; Keith, Paul; Kisiel, Marta; Kosak, Tanja Soklic; Kosnik, Mitja; Koyuncu, Ilgim Vardaloglu; Kritikos, Vicky; Litynska, Justyna; Lombardi, Carlo; Louis, Gilles; Luo, Xin; Martini, Matteo; Meço, Cem; Mesonjesi, Eris; Mihaltan, Florin; Moniuszko, Marcin; Naclerio, Robert N.; Neisinger, Sophia; Ollert, Markus; Ordak, Michal; Paoletti, Giovanni; Parmelli, Elena; Perdomo‐Flores, Edgar Arturo; Pereira, Henrique; Pérez, José Miguel Fuentes; Pham‐Thi, Nhan; Prokopakis, Emmanuel; Ribeiro‐Vaz, Inês; Rolla, Giovanni; Romantowski, Jan; Rombaux, Philippe; Rouadi, Philip W.; Ryan, Dermot; Sadowska, Ewelina; Sakurai, Daiju; Salameh, Laila; Serrano, Elie; Da Silva, Jane; Soyka, Michael B.; Specjalski, Krzysztof; Tomic‐Spiric, Vesna; Stevanovic, Katarina; Subramaniam, Abirami; Thomander, Tuuli; Tong, Wu; Vachova, Martina; van Hage, Marianne; Wagenmann, Martin; Ko, Fanny Wai San; Werminghaus, Pascal; Xepapadaki Paraskevi, Vicky; Xiang ,Yi‐Kui; Yang, Qintai; Zhang, He; Zuberbier, Jaron; Fonseca, João A.

Publication year: 2026

Journal: Allergy

ISSN: 0105-4538

eISSN: 1398-9995

DOI: https://doi.org/10.1111/all.70305

Publication's open availability at the time of reporting: Open Access

Publication channel's open availability : Partially Open Access publication channel

Web address : https://doi.org/10.1111/all.70305

Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/522872294

Self-archived copy's licence: CC BY

Self-archived copy's version: Publisher`s PDF


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.


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Funding information in the publication: 
The work of this study has been funded within the context of the Allergic Rhinitis and its Impact on Asthma (ARIA) group.


Last updated on 16/04/2026 09:31:54 AM