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Practice Guideline
. 2025 Aug;52(4):426-441.
doi: 10.1016/j.anl.2025.05.005. Epub 2025 Jun 21.

Practical guideline for the management of allergic rhinitis in Japan 2024

Mitsuhiro Okano  1 , Kimihiro Okubo  2 , Minoru Gotoh  2 , Mikiya Asako  3 , Nobuo Ohta  4 , Atsushi Kamijo  5 , Kayoko Kawashima  6 , Masafumi Sakashita  7 , Daiju Sakurai  8 , Tetsuya Terada  9 , Yuji Nakamaru  10 , Takechiyo Yamada  11 , Shuji Yonekura  12 , Aiko Oka  13 , Marie Yamada  13 , Tomokazu Yoshizaki  14
Affiliations
Practice Guideline

Practical guideline for the management of allergic rhinitis in Japan 2024

Mitsuhiro Okano et al. Auris Nasus Larynx. 2025 Aug.

Abstract

The Practical Guideline for the Management of Allergic Rhinitis in Japan was first published in 1993. After the COVID-19 pandemic, the current 10th edition was published in 2024. The most recent collection of evidence from the literature, such as the sustained post-treatment effect of sublingual immunotherapy on Japanese cedar pollinosis, was added to the revised guideline, which incorporates evidence-based medicine. In this revised guideline, a diagram illustrating the pathogenesis of allergic rhinitis and the mechanisms of action of various pharmacological treatments has been added. Also included is a diagram that shows the mechanism of action of allergen immunotherapy and a more detailed description of the oral allergy syndrome. The clinical question and answer section was also revised along with the introduction of new questions, such as: Does anti-IgE antibody treatment effectively reduce the symptoms of severe seasonal allergic rhinitis? Also updated was the evidence-based step-by-step strategy for treatment.

Keywords: Allergic rhinitis; Guideline; Mechanism of action of pharmacotherapy; Pollinosis; Sublingual immunotherapy.

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Conflict of interest statement

Declaration of competing interest MO received honoraria from Taiho Pharmaceutical, Mitsubishi Tanabe Pharma, Novartis Pharma, Kyorin Pharma, Meiji Seika Pharma, and Sanofi. KO received honoraria from Torii Pharmaceutical, Taiho Pharmaceutical, Mitsubishi Tanabe Pharma, Kyorin Pharma, and Novartis, and received a manuscript fee from Torii Pharmaceutical and Mitsubishi Tanabe Pharma. MG received honoraria from Taiho Pharmaceutical, Novartis Pharma, Torii Pharmaceutical, Kyorin Pharma, and Meiji Seika Pharma. MA received honoraria from Sanofi, GSK, Kyorin Pharma, and Taiho Pharmaceutical. NO received honoraria from Mitsubishi Tanabe Pharma, Kyorin Pharma, and Sanofi. AK received honoraria from Novartis Pharma and Sanofi. KK received honoraria from Mitsubishi Tanabe Pharma, Meiji Seika Pharma, and Sanofi. MS received honoraria from Kyorin Pharma, Meiji Seika Pharma, and Sanofi. DS received honoraria from Taiho Pharmaceutical. TT received honoraria from Mitsubishi Tanabe Pharma, Kyorin Pharma, and Sanofi. YN received honoraria from Sanofi. TY received honoraria from Taiho Pharmaceutical, Mitsubishi Tanabe Pharma, Novartis Pharma, Kyorin Pharma, Meiji Seika Pharma, and Sanofi. The other authors have no conflict of interest.

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