Pharmacologic Treatment of Seasonal Allergic Rhinitis: Synopsis of Guidance From the 2017 Joint Task Force on Practice Parameters.

Creator(s)

Dana V. Wallace
Mark S. Dykewicz
John Oppenheimer
Jay M. Portnoy, Children's Mercy HospitalFollow
David M. Lang

Document Type

Article

Publication Date

12-19-2017

Identifier

DOI: 10.7326/M17-2203

Abstract

Description: The Joint Task Force on Practice Parameters, which comprises representatives of the American Academy of Allergy, Asthma and Immunology (AAAAI) and the American College of Allergy, Asthma and Immunology (ACAAI), formed a workgroup to review evidence and provide guidance to health care providers on the initial pharmacologic treatment of seasonal allergic rhinitis in patients aged 12 years or older.

Methods: To update a prior systematic review, the workgroup searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from 18 July 2012 to 29 July 2016 to identify studies that addressed efficacy and adverse effects of single or combination pharmacotherapy for seasonal allergic rhinitis. In conjunction with the Joint Task Force, the workgroup reviewed the evidence and developed recommendations about initial treatment approaches by using the Grading of Recommendations Assessment, Development and Evaluation approach. Members of the AAAAI, the ACAAI, and the general public provided feedback on the draft document, which the Joint Task Force reviewed before finalizing the guideline.

Recommendation 1: For initial treatment of seasonal allergic rhinitis in persons aged 12 years or older, routinely prescribe monotherapy with an intranasal corticosteroid rather than an intranasal corticosteroid in combination with an oral antihistamine. (Strong recommendation).

Recommendation 2: For initial treatment of seasonal allergic rhinitis in persons aged 15 years or older, recommend an intranasal corticosteroid over a leukotriene receptor antagonist. (Strong recommendation).

Recommendation 3: For treatment of moderate to severe seasonal allergic rhinitis in persons aged 12 years or older, the clinician may recommend the combination of an intranasal corticosteroid and an intranasal antihistamine for initial treatment. (Weak recommendation).

Journal Title

Annals of internal medicine

Volume

167

Issue

12

First Page

876

Last Page

881

MeSH Keywords

Administration, Intranasal; Administration, Oral; Adolescent; Adrenal Cortex Hormones; Age Factors; Drug Therapy, Combination; Histamine Antagonists; Humans; Leukotriene Antagonists; Rhinitis, Allergic, Seasonal; Severity of Illness Index

Keywords

Intranasal Administration; Oral Administration; Adrenal Cortex Hormones; Age Factors; Combination Drug Therapy; Histamine Antagonists; Leukotriene Antagonists; Rhinitis, Allergic, Seasonal; Severity of Illness Index

Comments

Erratum in

• Correction: Pharmacologic Treatment of Seasonal Allergic Rhinitis. [No authors listed]Ann Intern Med. 2018 May 15;168(10):756. doi: 10.7326/L18-0190.PMID: 29800447 No abstract available.

Recommended Citation

Wallace DV, Dykewicz MS, Oppenheimer J, Portnoy JM, Lang DM. Pharmacologic Treatment of Seasonal Allergic Rhinitis: Synopsis of Guidance From the 2017 Joint Task Force on Practice Parameters [published correction appears in Ann Intern Med. 2018 May 15;168(10):756]. Ann Intern Med. 2017;167(12):876-881. doi:10.7326/M17-2203