SpringerLink
Log in

ARIA 2017: a Review of Major Changes and Innovations

  • Allergic Rhinitis (J Maspero, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Abstract

Background

Allergic rhinitis is a disease underestimated by patients, and underdiagnosed and thus undertreated by physicians since most of the patients present with symptoms of moderate-to-severe disease, overall diminished quality of life, impairing sleep quality and cognitive function, and a substantial impact on work productivity, school absenteeism, and costs. The relationship between treating physician and patients is crucial in all chronic diseases.

Objectives

Review the main changes and innovations of recent years in the ARIA guidelines.

Methods

The most recent publications of the ARIA (Allergic Rhinitis and its Impact on Asthma) guidelines were reviewed.

Results

ARIA 2016 strengthens the role of patients in the control and treatment of their symptoms by the use of technology, which improves physician-patient communication. The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. It confirms that inhaled corticosteroids are the most effective drugs for the management of seasonal or perennial allergic rhinitis, not surpassed by combination therapies with oral or topical antihistamines. On the other hand, no significant differences between the use of oral or topical antihistamines are evidenced. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. A step-up/step-down individualized approach to AR pharmacotherapy might hold the potential for optimal control of AR symptoms while minimizing side effects and costs. After choosing the best pharmacological therapy, compliance is a critical issue in the management of all chronic diseases. In order to improve compliance, it is important to consider patient preferences and views of patients and their caregivers, as ARIA guidelines remarks in the 2016 update.

Conclusion

ARIA guideline has evolved to a technology-based implementation strategy to help rhinitis sufferers to have an active and healthy life and to reduce health and social inequalities caused by this very common disease, irrespective of their age, sex, or socio-economic status.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Canada)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Bousquet J, Van Cauwenberge P, Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001;108(5 Suppl):S147–334.

    Article  PubMed  CAS  Google Scholar 

  2. Neffen H, Mello J Jr, Sole D, et al. Nasal allergies in the Latin American population: results from the allergies in Latin America survey. Allergy Asthma Proc. 2010;31(3):9–27.

    Article  Google Scholar 

  3. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008;63(Suppl 86):8–160.

    Article  PubMed  Google Scholar 

  4. Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126(3):466–76.

    Article  PubMed  Google Scholar 

  5. • Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines—2016 revision. J Allergy Clin Immunol. 2017;140(4):950–8. https://doi.org/10.1016/j.jaci.2017.03.050. ARIA recommendations support patients, caregivers, and health care providers in choosing the optimal treatment.

    Article  PubMed  Google Scholar 

  6. Bousquet J, Addis A, Adcock I, Hellings PW, Agache I, Agusti A, et al. Integrated care pathways for airway diseases (AIRWAYS-ICPs). Eur Respir J. 2014;44:304–23.

    Article  PubMed  CAS  Google Scholar 

  7. Bousquet J, Barbara C, Bateman E, Bel E, Bewick M, Chavannes NH, et al. AIRWAYSICPs (European innovation partnership on active and healthy ageing) from concept to implementation. Eur Respir J. 2016;47:1028–33.

    Article  PubMed  Google Scholar 

  8. Bousquet J, Farrell J, Crooks G, Hellings P, Bel EH, Bewick M, et al. Scaling up strategies of the chronic respiratory disease programme of the European innovation partnership on active and healthy ageing (action plan B3: area 5). Clin Transl Allergy. 2016;6:29.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  9. • Bousquet J, Schunemann HJ, Hellings PW, Arnavielhe S, Bachert C, Bedbrook A, et al. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis. J Allergy Clin Immunol. 2016;138:367–374.e2. A step-up/step-down individualized approach to allergic rhinitis pharmacotherapy might hold the potential for optimal control of symptoms while minimizing side effects and costs.

    Article  PubMed  Google Scholar 

  10. • Bourret R, Bousquet J, Mercier J, Camuzat T, Bedbrook A, Demoly P, et al. MASKrhinitis: a single tool for integrated care pathways in allergic rhinitis. World Hosp Health Serv. 2015;51:36–9.MASK-rhinitis will be important for establishing care pathways across the life cycle, stratify patients with severe uncontrolled rhinitis and to perform clinical trials.

    PubMed  Google Scholar 

  11. Bousquet J, Schunemann HJ, Fonseca J, Samolinski B, Bachert C, Canonica GW, et al. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation. Allergy. 2015;70:1372–92.

    Article  PubMed  CAS  Google Scholar 

  12. • Bousquet J, Hellings PW, Agache I, et al. ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle. Clin Transl Allergy. 2016;6:47. ARIA has evolved from a rigorously developed guideline to a mobile technology-based implementation strategy in order to provide an active and healthy life to rhinitis sufferers.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Meltzer EO. Pharmacotherapeutic strategies for allergic rhinitis: matching treatment to symptoms, disease progression, and associated conditions. Allergy Asthma Proc. 2013;34:301–11.

    Article  PubMed  CAS  Google Scholar 

  14. Bousquet PJ, Bachert C, Canonica GW, Casale TB, Mullol J, Klossek JM, et al. Uncontrolled allergic rhinitis during treatment and its impact on quality of life: a cluster randomized trial. (e1–5). J Allergy Clin Immunol. 2010;126:666–8.

    Article  PubMed  Google Scholar 

  15. Demoly P, Bousquet PJ, Mesbah K, Bousquet J, Devillier P. Visual analogue scale in patients treated for allergic rhinitis: an observational prospective study in primary care: asthma and rhinitis. Clin Exp Allergy. 2013;43:881–8.

    Article  PubMed  CAS  Google Scholar 

  16. Ohta K, Jean Bousquet P, Akiyama K, Adachi M, Ichinose M, Ebisawa M, et al. Visual analog scale as a predictor of GINA-defined asthma control. The SACRA study in Japan. J Asthma. 2013;50:514–21.

    Article  PubMed  Google Scholar 

  17. Caimmi D, Baiz N, Tanno LK, Demoly P, Arnavielhe S, Murray R, et al. Validation of the MASK-rhinitis visual analogue scale on smartphone screens to assess allergic rhinitis control. Clin Exp Allergy. 2017;47:1526–33. https://doi.org/10.1111/cea.13025.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina

    Hugo E. Neffen MD

  2. Immunology, Faculty of Medicine, del Salvador University, Buenos Aires, Argentina

    Juan Carlos Ivancevich MD

  3. Allergy & Immunology, Santa Isabel Clinic, Buenos Aires, Argentina

    Juan Carlos Ivancevich MD

Authors
  1. Hugo E. Neffen MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juan Carlos Ivancevich MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hugo E. Neffen MD.

Ethics declarations

Conflict of Interest

Dr. Neffen declares that he has no conflict of interest.

Dr. Ivancevich reports personal fees from Faes Farma, personal fees from Eurofarma, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Allergic Rhinitis

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Neffen, H.E., Ivancevich, J.C. ARIA 2017: a Review of Major Changes and Innovations. Curr Treat Options Allergy 5, 266–273 (2018). https://doi.org/10.1007/s40521-018-0166-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40521-018-0166-4

Keywords

Search

Navigation