Allergic rhinitis
Also known as: hay fever · seasonal allergies
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Rhinitis 2020: A practice parameter update
AAAAI/ACAAI Joint Task Force on Practice Parameters · 2020 · 2020 update
The current US Joint Task Force practice parameter on rhinitis, published in the Journal of Allergy and Clinical Immunology in 2020. It addresses diagnosis and assessment of allergic and non-allergic rhinitis, choice of single-agent and combination pharmacologic therapy, and allergen immunotherapy. Hosted as a PDF on the AAAAI site.
Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines - 2024-2025 Revision: Part I - Guidelines on Intranasal Treatments
EAACI / ARIA · 2026 · ARIA-EAACI 2024-2025 revision, Part I
The intranasal-treatment component of the EAACI-endorsed 2024-2025 revision of the ARIA allergic rhinitis guidelines. Recommendations were developed with GRADE evidence-to-decision frameworks, drawing on systematic reviews together with mobile-health and pharmacovigilance data. It is published in parts: Part I covers intranasal treatments and Part II covers oral and ocular treatments. Linked via PubMed because the publisher's site blocks automated access.
- Part I addresses eleven prioritised questions on intranasal treatment; published in Allergy 2026;81(4):954-976. source
- Part II covers oral and ocular treatments and is published separately in Allergy 2026;81(6):1947-1970. source
- Uses GRADE evidence-to-decision frameworks supplemented by mobile-health and real-world data. source
US vs EU key differences
- First-line pharmacotherapy diverges: the ARIA-EAACI revision suggests a fixed intranasal antihistamine plus corticosteroid combination over either agent alone, while the US 2020 rhinitis practice parameter keeps intranasal corticosteroid monotherapy as the preferred first-line treatment. source
- The US parameter explicitly advises against routinely adding an oral antihistamine to an intranasal corticosteroid in seasonal or perennial allergic rhinitis, favouring an intranasal antihistamine when add-on therapy is needed. source
- ARIA-EAACI goes down to product-level ranking, positioning azelastine-fluticasone ahead of olopatadine-mometasone in adults; the US parameter makes no comparable head-to-head choice between branded intranasal combinations. source
- Version currency differs by about five years: the US practice parameter dates from 2020, while the ARIA-EAACI intranasal-treatment guidance was rebuilt in the 2024-2025 revision using GRADE plus mHealth and pharmacovigilance data. source
What changed recently
- EU2016 revision → ARIA-EAACI 2024-2025 revision, Part I2025-12-01
This ARIA revision rebuilds the intranasal treatment recommendations around eleven prioritised questions using the GRADE evidence-to-decision framework, drawing on mHealth and pharmacovigilance data and an expert cost survey alongside systematic reviews. It now suggests a fixed combination of intranasal antihistamine plus intranasal corticosteroid ahead of either agent alone, and intranasal corticosteroid ahead of intranasal antihistamine when a single agent is used.
source ↗curation confidence 80% - US2008 → 2020 update2020-07-01
Updating the 2008 rhinitis practice parameter, the 2020 version keeps intranasal corticosteroids as preferred monotherapy for persistent allergic rhinitis but now recognises added benefit from combining them with intranasal antihistamines in both allergic and non-allergic rhinitis. It also advises against food allergy testing in the routine rhinitis workup, highlights cough as a common symptom of both allergic and non-allergic rhinitis, and reviews the newer concept of local allergic rhinitis.
source ↗curation confidence 90%
See the full update feed for changes across every system.