Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines-2024-2025 Revision: Part I-Guidelines on Intranasal Treatments

Bernardo Sousa-Pinto^{1

2}, Jean Bousquet^{3

4

5}, Rafael José Vieira^{1

2}, Holger J Schünemann^{4

6

7}, Torsten Zuberbier^{3

4

6}, Antonio Bognanni^{6

7}, Alkis Togias⁸, Boleslaw Samolinski⁹, Arunas Valiulis^{10

11}, Sian Williams¹², Anna Bedbrook⁵, Wienczyslawa Czarlewski^{5

13}, Maria Jose Torres¹⁴, Mohamed H Shamji¹⁵, Mário Morais-Almeida¹⁶, G Walter Canonica^{7

17}, Leticia de Las Vecillas¹⁸, Mark S Dykewicz¹⁹, Cristina Jacomelli²⁰, Ludger Klimek^{21

22}, Lucas Leemann²³, Olga Lourenço²⁴, Yuliia Palamarchuk²⁵, Nikolaos G Papadopoulos²⁶, Ana Margarida Pereira^{1

27

28}, Marine Savouré^{29

30

31}, Sanna K Toppila-Salmi^{32

33}, Maria Teresa Ventura^{34

35}, Juan José Yepes-Nuñez^{36

37}, Alvaro A Cruz³⁸, Giorgio Ciprandi³⁹, Bilun Gemicioglu⁴⁰, Mattia Giovannini^{41

42}, Brigita Gradauskiene⁴³, Tuomas Jartti⁴⁴, Miloš Jeseňák^{45

46

47}, Piotr Kuna⁴⁸, Violeta Kvedariene^{49

50}, Désirée E Larenas-Linnemann⁵¹, Amir Ha Latiff⁵², Yousser Mohammad^{53

54}, Ken Ohta⁵⁵, Padukudru A Mahesh⁵⁶, Isabella Pali-Schöll⁵⁷, Oliver Pfaar⁵⁸, Frederico S Regateiro^{59

60

61

62}, Nicolas Roche^{63

64

65}, Luís Taborda-Barata^{62

66}, Charlotte Suppli Ulrik^{67

68}, Marylin Valentin Rostan⁶⁹, Giovanni Viegi⁷⁰, Luo Zhang⁷¹, Tari Haahtela⁷², Ivan Cherrez-Ojeda^{73

74}, Juan Carlos Ivancevich⁷⁵, Nikolai Khaltaev⁷⁶, Arzu Yorgancioglu⁷⁷, Baharudin Abdullah⁷⁸, Mona Al-Ahmad⁷⁹, Maryam Ali Al-Nesf⁸⁰, Rita Amaral^{1

2

81

82}, Julijana Asllani⁸³, Karl-C Bergmann^{3

4}, Jonathan A Bernstein⁸⁴, Michael S Blaiss⁸⁵, Fulvio Braido^{86

87}, Paulo Camargos⁸⁸, Pedro Carreiro-Martins^{89

90}, Thomas Casale⁹¹, Lorenzo Cecchi⁹², Alessandro Fiocchi⁹³, Antonio F M Giuliano⁹⁴, George Christoff⁹⁵, Ieva Cirule⁹⁶, Jaime Correia de Sousa⁹⁷, Elisio M Costa⁹⁸, Stefano Del Giacco⁹⁹, Philippe Devillier¹⁰⁰, Dejan Dokic¹⁰¹, Elham Hossny¹⁰², Tomohisa Iinuma¹⁰³, Carla Irani¹⁰⁴, Zhanat Ispayeva¹⁰⁵, Kaja Julge¹⁰⁶, Igor Kaidashev¹⁰⁷, Kazi S Bennoor¹⁰⁸, Helga Kraxner¹⁰⁹, Inger Kull^{110

111}, Marek Kulus¹¹², Maciej Kupczyk⁴⁸, Andriy Kurchenko¹¹³, Stefania La Grutta¹¹⁴, Neven Miculinic¹¹⁵, Lan Le Thi Tuyet¹¹⁶, Michael Makris¹¹⁷, Branislava Milenkovic¹¹⁸, Sang Min Lee¹¹⁹, Stephen Montefort¹²⁰, Andre Moreira^{121

122

123}, Joaquim Mullol^{124

125}, Rachel Nadif^{65

126}, Alla Nakonechna^{127

128}, Hugo E Neffen¹²⁹, Marek Niedoszytko¹³⁰, Dieudonné Nyembue¹³¹, Robyn E O'Hehir¹³², Ismail Ogulur¹³³, Yoshitaka Okamoto^{134

135}, Heidi Olze¹³⁶, Oscar Palomares¹³⁷, Petr Panzner¹³⁸, Vincenzo Patella^{139

140

141}, Ruby Pawankar¹⁴², Constantinos Pitsios¹⁴³, Todor A Popov¹⁴⁴, Francesca Puggioni¹⁴⁵, Santiago Quirce¹⁸, Agné Ramonaité^{146

147}, Marysia Recto¹⁴⁸, Maria Susana Repka-Ramirez¹⁴⁹, Graham Roberts^{150

151

152}, Karla Robles-Velasco^{73

74

153}, Menachem Rottem^{154

155}, Marianella Salapatas¹⁵⁶, Joaquin Sastre¹⁵⁷, Nicola Scichilone¹⁵⁸, Juan-Carlos Sisul¹⁵⁹, Dirceu Solé¹⁶⁰, Manuel E Soto-Martinez¹⁶¹, Milan Sova¹⁶², Pongsakorn Tantilipikorn¹⁶³, Ana Todo-Bom¹⁶⁴, Vladyslav Tsaryk¹¹³, Ioanna Tsiligianni^{165

166}, Marilyn Urrutia-Pereira¹⁶⁷, Erkka Valovirta¹⁶⁸, Tuula Vasankari^{169

170}, Dana Wallace¹⁷¹, De Yun Wang¹⁷², Margitta Worm¹⁷³, Osman M Yusuf¹⁷⁴, Mihaela Zidarn^{175

176}, Sara Gil-Mata^{1

2}, Manuel Marques-Cruz^{1

2}, Bassam Mahboub^{177

178}, Ignacio J Ansotegui¹⁷⁹, Antonino Romano^{180

181}, Werner Aberer¹⁸², Maria Cristina Artesani⁹³, Elena Azzolini¹⁷, Bruno Barreto¹⁸³, Joan Bartra^{184

185}, Sven Becker¹⁸⁶, Bianca Beghe¹⁸⁷, Attilio Boner¹⁸⁸, Ewa Borowiack^{189

190}, Jacques Bouchard¹⁹¹, Melisande Bourgoin-Heck^{192

193

194}, Luisa Brussino^{195

196}, Roland Buhl¹⁹⁷, José Antonio Castillo-Vizuete^{198

199}, Denis Charpin²⁰⁰, Niels H Chavannes^{201

202}, Marta Chełmińska²⁰³, Lei Cheng²⁰⁴, Ekaterine Chkhartishvili²⁰⁵, Seong H Cho²⁰⁶, Herberto Jose Chong-Neto²⁰⁷, Deepa Choudhury²⁰⁸, Derek K Chu^{6

209}, Cemal Cingi²¹⁰, Enrico Compalati²¹¹, Raquel Albuquerque Costa¹, Olga Mariana Cunha²¹², Biljana Cvetkovski²¹³, Victoria Cardona-Dahl^{214

215}, Gennaro D'Amato²¹⁶, Janet Davies^{217

218}, Danilo Di Bona²¹⁹, Sandra N Gonzalez Diaz²²⁰, Maria V Dimou²⁶, Maria Doulaptsi²²¹, Renato Ferreira-da-Silva^{1

2}, Radoslaw Gawlik²²², Mario Calvo-Gil²²³, Ozlem Goksel²²⁴, Maximiliano R Gómez²²⁵, Maia Gotua²²⁶, Christos Grigoreas²²⁷, Ineta Grisle²²⁸, Maria Antonieta Guzman²²⁹, Rachel House Tan^{230

231}, Michael Hyland²³², Despo Ierodiakonou²³³, Aspasia Karavelia²³⁴, Paul Keith²³⁵, Marta Kisiel²³⁶, Tanja Soklic Kosak²³⁷, Mitja Kosnik^{238

239}, Ilgim Vardaloglu Koyuncu²⁴⁰, Vicky Kritikos^{241

242}, Justyna Litynska^{189

190}, Carlo Lombardi²⁴³, Gilles Louis^{244

245}, Matteo Martini^{246

247}, Cem Meço^{248

249

250}, Eris Mesonjesi²⁵¹, Florin Mihaltan²⁵², Marcin Moniuszko²⁵³, Robert N Naclerio²⁵⁴, Kari C Nadeau²⁵⁵, Sophia Neisinger^{3

4}, Markus Ollert^{256

257}, Michal Ordak²⁵⁸, Giovanni Paoletti^{7

145}, Hae-Sim Park²⁵⁹, Elena Parmelli^{17

260}, Edgar Arturo Perdomo-Flores²⁶¹, José Miguel Fuentes Pérez²⁶², Nhan Pham-Thi^{263

264

265}, Emmanuel Prokopakis²²¹, Inês Ribeiro-Vaz^{1

2}, Giovanni Rolla¹⁹⁵, Jan Romantowski¹³⁰, Philippe Rombaux²⁶⁶, Philip W Rouadi^{267

268}, Maia Rukhadze²⁶⁹, Dermot Ryan²⁷⁰, Ewelina Sadowska^{189

190}, Daiju Sakurai²⁷¹, Laila Salameh²⁷², Faradiba Serpa Sarquis²⁷³, Elie Serrano²⁷⁴, Jane Da Silva^{275

276}, Michael Soyka²⁷⁷, Krzysztof Specjalski¹³⁰, Vesna Tomic-Spiric^{278

279}, Katarina Stevanovic^{3

4}, Abirami Subramaniam²⁸⁰, Maria Do Ceu Teixeira^{281

282}, Tuuli Thomander^{1

283

284}, Martina Vachova^{285

286}, Marianne van Hage^{287

288

289}, Pakit Vichyanond^{290

291}, Martin Wagenmann²⁹², Fanny Wai San Ko²⁹³, Pascal Werminghaus²⁹⁴, Paraskevi Vicky Xepapadaki²⁶, Yi-Kui Xiang^{3

4

295}, Qintai Yang²⁹⁶, Daniela Rivero Yeverino²⁹⁷, Jaron Zuberbier¹³⁶, João A Fonseca^{1

2}

Affiliations

¹ MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
² CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal.
³ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
⁴ Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.
⁵ ARIA (Allergic Rhinitis and Its Impact on Asthma), Montpellier, France.
⁶ Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
⁷ Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy.
⁸ Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.
⁹ Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland.
¹⁰ Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania.
¹¹ Clinic of Asthma, Allergy and Chronic Lung Diseases, Vilnius, Lithuania.
¹² International Primary Care Respiratory Group IPCRG, Edinburgh, UK.
¹³ Medical Consulting Czarlewski, Levallois, France.
¹⁴ Allergy Unit, Málaga Regional University Hospital of Málaga, Malaga University, ARADyAL, Malaga, Spain.
¹⁵ Immunomodulation and Tolerance Group and Allergy and Clinical Immunology, Imperial College London, London, UK.
¹⁶ Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
¹⁷ Asthma & Allergy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
¹⁸ Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.
¹⁹ Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA.
²⁰ "Respiriamo Insieme" Association, Asthma & Allergy Center, Padova, Italy.
²¹ Department of Otolaryngology, Head & Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany.
²² Center for Rhinology and Allergology, Allergology & Rhinology Department, Wiesbaden, Germany.
²³ Department of Political Science, University of Zürich, Zürich, Switzerland.
²⁴ RISE-Health, Department of Medical Sciences, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.
²⁵ Finnish Meteorological Institute (FMI), Atmospheric Composition Research, Helsinki, Finland.
²⁶ Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
²⁷ PaCeIT-Patient Centered Innovation and Technologies, Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
²⁸ Allergy Unit, Instituto and Hospital CUF, Porto, Portugal.
²⁹ Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.
³⁰ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
³¹ CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
³² Department of Allergy, Skin and Allergy Hospital, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
³³ Department of Otorhinolaryngology, University of Eastern Finland and the North Savo Wellbeing Services County, Kuopio, Finland.
³⁴ University of Bari Medical School, Bari, Italy.
³⁵ Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy.
³⁶ School of Medicine, Universidad de los Andes, Bogotá, D. C., Colombia.
³⁷ Pulmonology Service, Internal Medicine Section, Fundación Santa Fe de Bogotá, University Hospital, Bogotá, D. C., Colombia.
³⁸ Fundacao ProAR and (Faculdade de Medicina da), Universidade Federal da Bahia, Salvador, Bahia, Brazil.
³⁹ Casa di Cura Villa Montallegro, Allergology Department, Genova, Italy.
⁴⁰ Department of Pulmonary Diseases and Institute of Pulmonology and Tuberculosis, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey.
⁴¹ Department of Health Sciences, University of Florence, Florence, Italy.
⁴² Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy.
⁴³ Department of Immunology and Allergology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
⁴⁴ Department of Pediatrics and Adolescent Medicine, University of Turku, Turku University Hospital, Turku, Finland.
⁴⁵ Institute of Clinical Immunology and Medical Genetics, Department of Paediatrics and Adolescent Medicine, Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine, Martin, Slovakia.
⁴⁶ Comenius University, Bratislava, Slovakia.
⁴⁷ University Teaching Hospital Martin, Martin, Slovakia.
⁴⁸ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
⁴⁹ Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
⁵⁰ Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
⁵¹ Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
⁵² Allergy & Immunology Centre, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
⁵³ National Center for Research in Chronic Respiratory Diseases, Collaborating With WHO-EMRO Tishreen University School of Medicine, Latakia, Syria.
⁵⁴ Al-Sham Private University, Pharmacy Department, Damascus, Syria.
⁵⁵ Japan Antituberculosis Association (JATA), Fukujuji Hospital, Tokyo, Japan.
⁵⁶ Department of Respiratory Medicine, JSS Medical College, JSSAHER Mysuru, Mysore, Karnataka, India.
⁵⁷ Departement of Biological Sciences and Pathophysiology, University of Veterinary Medicine, Vienna, Austria.
⁵⁸ Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
⁵⁹ Allergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
⁶⁰ Center for Innovative Biomedicine and Biotechnology (CIBB), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
⁶¹ Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
⁶² UBIAir-Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
⁶³ Pneumologie, AP-HP Centre Université de Paris Cité, Hôpital Cochin, Paris, France.
⁶⁴ UMR 1016, Institut Cochin, Paris, France.
⁶⁵ Inserm, Equipe D'epidémiologie Respiratoire Intégrative, CESP, Villejuif, France.
⁶⁶ Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal.
⁶⁷ Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Copenhagen, Denmark.
⁶⁸ Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
⁶⁹ Pediatrics, Allergy & Immunology, Latín American Society of Allergy, Asthma & Immunology (SLAAi), Montevideo, Uruguay.
⁷⁰ Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
⁷¹ Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China.
⁷² Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.
⁷³ Universidad Espíritu Santo, Samborondón, Ecuador.
⁷⁴ Department of Allergology & Pulmonology, Respiralab Research Group, Guayaquil, Guayas, Ecuador.
⁷⁵ Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
⁷⁶ Global NCD Platform, Geneva, Switzerland.
⁷⁷ Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey.
⁷⁸ Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
⁷⁹ Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait.
⁸⁰ Adult Allergy and Immunology Division-Hamad Medical Corporation, Doha, Qatar.
⁸¹ Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal.
⁸² Department of Women's and Children's Health, Paediatric Research, Uppsala University, Uppsala, Sweden.
⁸³ Department of Internal Medicine, University of Medicine, Tirana, Albania.
⁸⁴ Division of Immunology, Allergy and Rheumatology, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
⁸⁵ Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
⁸⁶ Department of Internal Medicine (DIMI), University of Genoa, Genoa, Italy.
⁸⁷ Respiratory & Allergy Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
⁸⁸ Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil.
⁸⁹ NOVA Medical School/Comprehensive Health Research Centre (CHRC), Lisbon, Portugal.
⁹⁰ Serviço de Imunoalergologia, Centro Hospitalar Universitário de Lisboa Central/ULS São José, Lisbon, Portugal.
⁹¹ Division of Allergy/Immunology, University of South Florida, Tampa, Florida, USA.
⁹² SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
⁹³ Allergy, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
⁹⁴ Department of Internal Medicine 'A. Murri' and Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy.
⁹⁵ Faculty of Public Health, Sofia Medical University, Sofia, Bulgaria.
⁹⁶ Latvian Association of Allergists, University Children Hospital, Riga, Latvia.
⁹⁷ Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
⁹⁸ CINTESIS@RISE, Biochemistry Lab, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto, Porto, Portugal.
⁹⁹ Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy.
¹⁰⁰ VIM Suresnes, UMR 0892, Pôle Des Maladies Des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France.
¹⁰¹ Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, Republic of North Macedonia.
¹⁰² Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.
¹⁰³ Department of Otorhinolaryngology, Chiba University, Chiba, Japan.
¹⁰⁴ Department of Internal Medicine and Infectious Diseases, St Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon.
¹⁰⁵ Department of Allergology and Clinical Immunology, Kazakhstan Association of Allergology and Clinical Immunology, Kazakh National Medical University, Almaty, Kazakhstan.
¹⁰⁶ Institute of Clinical Medicine, Children's Clinic, Tartu University, Tartu, Estonia.
¹⁰⁷ Poltava State Medical University, Immunology & Allergology Department, Poltava, Ukraine.
¹⁰⁸ Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh.
¹⁰⁹ Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary.
¹¹⁰ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
¹¹¹ Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
¹¹² Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland.
¹¹³ Department of Clinical and Laboratory Immunology, Allergology and Medical Genetics, Bogomolets National Medical University, Kyiv, Ukraine.
¹¹⁴ Institute of Translational Pharmacology (IFT)-National Research Council (CNR), Palermo, Italy.
¹¹⁵ Croatian Pulmonary Society, Clinical Center for Pulmonary Diseases, Zagreb, Croatia.
¹¹⁶ Asthma, COPD Outpatient Care Unit, University Medical Center, Hô-Chi-Minh City, Vietnam.
¹¹⁷ Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
¹¹⁸ Clinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbian Association for Asthma and COPD, Belgrade, Serbia.
¹¹⁹ Division of Respiratory Disease and Allergy, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea.
¹²⁰ Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
¹²¹ EPIUnit-Institute of Public Health, University of Porto, and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
¹²² Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, Porto, Portugal.
¹²³ Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.
¹²⁴ Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain.
¹²⁵ Clinical & Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
¹²⁶ Université Paris-Saclay, UVSQ, Université Paris-Sud, Villejuif, France.
¹²⁷ Imperial College Healthcare NHS Trust, London, UK.
¹²⁸ University of Liverpool, Liverpool, UK.
¹²⁹ Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina.
¹³⁰ Department of Allergology, Medical University of Gdansk, Gdansk, Poland.
¹³¹ ENT Department, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo.
¹³² Allergy, Asthma and Clinical Immunology, Alfred Health and Department of Immunology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
¹³³ Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
¹³⁴ Chiba Rosai Hospital, ENT Department, Chiba, Japan.
¹³⁵ Chiba University Hospital, Department of Otolaryngology, Head and Neck Surgery, Chiba, Japan.
¹³⁶ Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
¹³⁷ Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain.
¹³⁸ Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic.
¹³⁹ Division of Allergy and Clinical Immunology, Department of Medicine, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy.
¹⁴⁰ Agency of Health ASL, Division of Allergy and Clinical Immunology, Department of Medicine, Salerno, Italy.
¹⁴¹ Postgraduate Programme in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy.
¹⁴² Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
¹⁴³ Medical School, University of Cyprus, Nicosia, Cyprus.
¹⁴⁴ Clinic of Occupational Diseases, University Hospital Sveti Ivan Rilski, Sofia, Bulgaria.
¹⁴⁵ IRCCS Humanitas Research Center, Personalized Medicine Asthma & Allergy, Rozzano, Milan, Italy.
¹⁴⁶ Department of Pulmonology and Allergology, Klaipeda National Hospital, Klaipėda, Lithuania.
¹⁴⁷ Vilnius University Medical Faculty, Vilnius, Lithuania.
¹⁴⁸ Division of Adult and Pediatric Allergy and Immunology, University of the Philippines-Philippines General Hospital, Manila, Philippines.
¹⁴⁹ Department of Allergy, Clinics Hospital, National University, San Lorenzo, Paraguay.
¹⁵⁰ Faculty of Medicine, University of Southampton, Southampton, UK.
¹⁵¹ The David Hide Asthma and Allergy Centre, St Mary's Hospital, Newport, Isle of Wight, UK.
¹⁵² NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
¹⁵³ LEADER Research Inc., Hamilton, Ontario, Canada.
¹⁵⁴ Division of Allergy, Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel.
¹⁵⁵ Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
¹⁵⁶ Aria, Asthma, Rhinitis, Immunology & Allergy Department, Athens, Greece.
¹⁵⁷ Allergy Service, Fundacion Jimenez Diaz, Autonoma University of Madrid, CIBERES-ISCIII, Madrid, Spain.
¹⁵⁸ PROMISE Department, University of Palermo, Palermo, Italy.
¹⁵⁹ Allergy & Asthma, Medical Director, CLINICA SISUL, FACAAI, SPAAI, Asuncion, Paraguay.
¹⁶⁰ Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil.
¹⁶¹ Division of Respiratory Medicine, Department of Pediatrics, Hospital Nacional de Niños, Universidad de Costa Rica, San Jose, Costa Rica.
¹⁶² Department of Respiratory Medicine and Tuberculosis, University Hospital, Brno, Czech Republic.
¹⁶³ Department of Otolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
¹⁶⁴ Imunoalergologia, Centro Hospitalar Universitário de Coimbra, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
¹⁶⁵ International Primary Care Respiratory Group IPCRG, Aberdeen, UK.
¹⁶⁶ Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
¹⁶⁷ Federal University of Pampa, Department of Medicine, Uruguaiana, Brazil.
¹⁶⁸ Department of Lung Diseases and Clinical Immunology, University of Turku, Turku, Finland.
¹⁶⁹ FiLHA, Finnish Lung Health Association, Helsinki, Finland.
¹⁷⁰ Department of Clinical Medicine, Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.
¹⁷¹ Nova Southeastern University, College of Allopathic Medicine, Fort Lauderdale, Florida, USA.
¹⁷² Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.
¹⁷³ Division of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany.
¹⁷⁴ The Allergy and Asthma Institute, Allergy & Asthma Department, Islamabad, Pakistan.
¹⁷⁵ University Clinic of Respiratory and Allergic Diseases, Pulmonary & Allergy Department, Golnik, Slovenia.
¹⁷⁶ Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
¹⁷⁷ Pulmonary Department, Rashid Hospital, DUBAI Health, Dubai, UAE.
¹⁷⁸ Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE.
¹⁷⁹ Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain.
¹⁸⁰ Oasi Research Institute-IRCCS, Troina, Italy.
¹⁸¹ BIOS S.P.A. Società Benefit, Rome, Italy.
¹⁸² Department of Dermatology, Medical University of Graz, Graz, Austria.
¹⁸³ Department of Allergy and Immunology, Para State University Center-CESUPA, Belém, Brazil.
¹⁸⁴ Allergy Department, Hospital Clinic and IDIBAPS. Universitat de Barcelona, Barcelona, Spain.
¹⁸⁵ RICORS de Enfermedades Inflamatorias (ISCIII), Madrid, Spain.
¹⁸⁶ Department for Otorhinolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany.
¹⁸⁷ Respiratory Medicine, University of Modena & Reggio Emilia, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.
¹⁸⁸ Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy.
¹⁸⁹ Evidence Prime, Kraków, Poland.
¹⁹⁰ Evidence Prime, Hamilton, Ontario, Canada.
¹⁹¹ Laval University, Quebec City, Quebec, Canada.
¹⁹² Department of Pediatric Allergology, Armand Trousseau University Hospital, Sorbonne University, AP-HP, Paris, France.
¹⁹³ French National Reference Center for Angioedema (CREAK), Saint-Antoine University Hospital, Paris, France.
¹⁹⁴ CRESS, Inserm, INRAE, HERA Team, Paris Cité University, Paris, France.
¹⁹⁵ Department of Medical Sciences, University of Turin, Turin, Italy.
¹⁹⁶ Allergy and Clinical Immunology Unit, Mauriziano Hospital, Torino, Italy.
¹⁹⁷ Department of Pulmonary Medicine, Mainz University Hospital, Mainz, Germany.
¹⁹⁸ Pneumology Department, Hospital Universitari Dexeus, Barcelona, Spain.
¹⁹⁹ CIBER of Respiratory Diseases, Group of Rhinitis, Rhinosinusitis and Nasal Polyps, Area of Asthma, SEPAR, Barcelona, Spain.
²⁰⁰ Clinique Des Bronches, Allergie et Sommeil, Hôpital Nord, Marseille, France.
²⁰¹ Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.
²⁰² National eHealth Living Lab, Leiden, the Netherlands.
²⁰³ Department of Pulmonology and Allergology, Medical University of Gdańsk, Gdańsk, Poland.
²⁰⁴ Department of Allergology and Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
²⁰⁵ Allergist, David Tvildiani Medical University, Tbilisi, Georgia.
²⁰⁶ University of South Florida, College of Médicine, Division of Allergy-Immunology, Department of Internal Medicine, Tampa, Florida, USA.
²⁰⁷ Associate Professor of Pediatrics, Division of Allergy and Immunology, Federal University of Parana, Curitiba, Brazil.
²⁰⁸ Paediatric Allergy Clinic, Department of Dermatology, Amersham Hospital, NHS Hospital Trust, Amersham, UK.
²⁰⁹ Evidence in Allergy Group, McMaster University and the Research Institute of St. Joe's Hamilton, Hamilton, Canada.
²¹⁰ Eskisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir, Turkey.
²¹¹ Scientific & Medical Department, Lofarma S.p.A, Milan, Italy.
²¹² LAQV@REQUIMTE, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.
²¹³ Woolcock Institute of Medical Research, Sydney, Australia.
²¹⁴ Allergy Section, Department of Internal Medicine, Hospital Vall D'hebron, Barcelona, Spain.
²¹⁵ ARADyAL Research Network, Barcelona, Spain.
²¹⁶ Division of Respiratory and Allergic Diseases, High Specialty Hospital 'A Cardarelli', and Respiratory Allergy School of Specialization in Respiratory Diseases, Federico II University of Naples, Naples, Italy.
²¹⁷ Centre for Immunology and Infection Control, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
²¹⁸ Office of Research, Metro North Hospital and Health Service, Brisbane, Australia.
²¹⁹ University of Foggia, Department of Medical and Surgical Science, Foggia, Italy.
²²⁰ Allergy and Clinical Immunology Centro Regional, Hospital Universitario, Universidad Autónoma de Nuevo Leon, Monterrey, Mexico.
²²¹ Department of Otorhinolaryngology, Head and Neck Surgery, University of Crete, School of Medicine, Heraklion, Crete, Greece.
²²² Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia in Katowice, Katowice, Poland.
²²³ Pediatrics Department, Universidad Austral de Chile, Valvidia, Chile.
²²⁴ Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Laboratory of Occupational and Environmental Respiratory Diseases, Faculty of Medicine, Ege University, EgeSAM (Ege University Translational Pulmonary Research Center), Bornova, Izmir, Türkiye.
²²⁵ Faculty of Health Sciences, Catholic University of Salta, Salta, Argentina.
²²⁶ Center of Allergy and Immunology, and Georgian Academy of Allergy, Asthma, and Clinical Immunology, Tbilisi, Georgia.
²²⁷ Former President of the Hellenic Society of Allergology and Clinical Immunology, Department of Allergy and Clinical Immunology, Air Force General Hospital, Athens, Greece.
²²⁸ Riga East University Hospital, Riga, Latvia.
²²⁹ Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile.
²³⁰ Quality Use of Research Medicines Group, Woolcock Institute of Medical Research, Macquarie Park, New South Wales, Australia.
²³¹ Macquarie University, Macquarie Park, New South Wales, Australia.
²³² Faculty of Health, University of Plymouth, Plymouth, UK.
²³³ Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.
²³⁴ Otolaryngology Department, General Hospital of Kalamata, Kalamata City, Greece.
²³⁵ Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
²³⁶ Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
²³⁷ ORL SOKLIC KOSAK, Ljubljana, Slovenia.
²³⁸ University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
²³⁹ Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
²⁴⁰ Bagcilar Research and Training Hospital, Department of Chest Diseases, Istanbul, Turkey.
²⁴¹ Clinical Management Group, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia.
²⁴² Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
²⁴³ Departmental Unit of Allergology, Clinical Immunology & Pneumology, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.
²⁴⁴ Department of Public Health, University of Liège, Liège, Belgium.
²⁴⁵ Department of Pneumology, GIGA I3 Research Group, University of Liège, Liège, Belgium.
²⁴⁶ Allergy Unit, Department of Internal Medicine, University Hospital AOU Delle Marche, Ancona, Italy.
²⁴⁷ Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
²⁴⁸ Department of Otorhinolaryngology, Head and Neck Surgery, Ankara University Medical School, Ankara, Turkey.
²⁴⁹ Department of Otorhinolaryngology Head and Neck Surgery, Salzburg Paracelsus Medical University, Salzburg, Austria.
²⁵⁰ Department of Otolaryngology, Head and Neck Surgery, Cornell University, Weill Cornell Medical College, New York, New York, USA.
²⁵¹ Allergy & Clinical Immunology Department, University Hospital Center "Mother Teresa", Tirana, Albania.
²⁵² UMF-University of Medicine and Pharmacy 'Carol Davila', Pneumology Department, National Institute of Pneumology 'Marius Nasta', Bucharest, Romania.
²⁵³ Department of Allergology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.
²⁵⁴ Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
²⁵⁵ Department of Environmental Health, Harvard TH Chan School of Public Health and Department of Medicine, Division of Allergy and Inflammation, Beth Israel Deaconess Hospital, Boston, Massachusetts, USA.
²⁵⁶ Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
²⁵⁷ Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark.
²⁵⁸ Department of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland.
²⁵⁹ Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea.
²⁶⁰ Clinical Epidemiology and Research Center, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
²⁶¹ Otorhinolaryngology and Neck Surgery Unit, San Juan de Dios National Hospital, San Miguel, El Salvador.
²⁶² Allergist, Private Practice, Mexico City, Mexico.
²⁶³ Ecole Polytechnique de Palaiseau, Palaiseau, France.
²⁶⁴ IRBA (Institut de Recherche Bio-Médicale Des Armées), Bretigny sur Orge, France.
²⁶⁵ Université Paris Cité, Paris, France.
²⁶⁶ Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
²⁶⁷ Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon.
²⁶⁸ Department of Otorhinolaryngology-Head and Neck Surgery, Dar Al Shifa Hospital, Salmiya, Kuwait.
²⁶⁹ Center Allergy & Immunology/Geomedi Teaching University, Faculty of Medicine, Tbilisi, Georgia.
²⁷⁰ Usher Institute, University of Edinburgh, Edinburgh, UK.
²⁷¹ Department of Otorhinolaryngology, Yamanashi University, Yamanashi, Japan.
²⁷² Mohammed Bin Rashid University (MBRU), Dubai Health, Dubai, UAE.
²⁷³ Asthma Reference Center-School of Medicine of Santa Casa de Misericórdia of Vitória, Espírito Santo, Brazil.
²⁷⁴ Department of Otorhinolaryngology and Head & Neck Surgery, CHU Rangueil-Larrey, Toulouse, France.
²⁷⁵ Allergy Service, University Hospital Professor Polydoro Ernani de São Thiago (HU-UFSC/EBSERH), Florianopolis, Brazil.
²⁷⁶ Department of Internal Medicine, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil.
²⁷⁷ Otolaryngology-HNS, University of Zurich, University Hospital of Zurich, Zurich, Switzerland.
²⁷⁸ Clinic of Allergology and Immunology, University Clinical Center of Serbia, Belgrade, Serbia.
²⁷⁹ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
²⁸⁰ Department of Respiratory Medicine, Medical Professorial Unit, Tallaght University Hospital & Trinity College, Dublin, Ireland.
²⁸¹ Dr Agostinho Neto University Hospital, Praia, Cabo Verde.
²⁸² Immunology, Cabo Verde University, Faculty of Medicine, Praia, Cabo Verde.
²⁸³ The Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
²⁸⁴ Faculty of Medicine, University of Porto, Porto, Portugal.
²⁸⁵ Department of Immunology and Allergology, University Hospital and Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
²⁸⁶ Charles University, Prague, Czech Republic.
²⁸⁷ Department of Medicine Solna, Division of Immunology and Respiratory Medicine, Karolinska Institutet, Stockholm, Sweden.
²⁸⁸ Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.
²⁸⁹ Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
²⁹⁰ Samitivej Allergy Institute, Bangkok, Thailand.
²⁹¹ Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University, Faculty of Medicine, Bangkok, Thailand.
²⁹² Department of Otorhinolaryngology, Heinrich Heine University Düsseldorf, Medical Faculty and University Hospital Düsseldorf, Düsseldorf, Germany.
²⁹³ The Chinese University of Hong Kong, Department of Medicine and Therapeutics, Hong Kong, China.
²⁹⁴ ENT and Allergology, Düsseldorf, Germany.
²⁹⁵ Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
²⁹⁶ The Third Affiliated Hospital of sun Yat-Sen University, Guangzhou, China.
²⁹⁷ Servicio de Alergia e Inmunología clínica, Hospital Universitario de Puebla, Puebla, México.

PMID: 41324154
DOI: 10.1111/all.70131

Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines-2024-2025 Revision: Part I-Guidelines on Intranasal Treatments

Bernardo Sousa-Pinto et al. Allergy. 2025.

. 2025 Dec 1.

doi: 10.1111/all.70131. Online ahead of print.

Authors

Affiliations

¹ MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
² CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal.
³ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
⁴ Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.
⁵ ARIA (Allergic Rhinitis and Its Impact on Asthma), Montpellier, France.
⁶ Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
⁷ Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy.
⁸ Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.
⁹ Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland.
¹⁰ Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania.
¹¹ Clinic of Asthma, Allergy and Chronic Lung Diseases, Vilnius, Lithuania.
¹² International Primary Care Respiratory Group IPCRG, Edinburgh, UK.
¹³ Medical Consulting Czarlewski, Levallois, France.
¹⁴ Allergy Unit, Málaga Regional University Hospital of Málaga, Malaga University, ARADyAL, Malaga, Spain.
¹⁵ Immunomodulation and Tolerance Group and Allergy and Clinical Immunology, Imperial College London, London, UK.
¹⁶ Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
¹⁷ Asthma & Allergy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
¹⁸ Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.
¹⁹ Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA.
²⁰ "Respiriamo Insieme" Association, Asthma & Allergy Center, Padova, Italy.
²¹ Department of Otolaryngology, Head & Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany.
²² Center for Rhinology and Allergology, Allergology & Rhinology Department, Wiesbaden, Germany.
²³ Department of Political Science, University of Zürich, Zürich, Switzerland.
²⁴ RISE-Health, Department of Medical Sciences, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.
²⁵ Finnish Meteorological Institute (FMI), Atmospheric Composition Research, Helsinki, Finland.
²⁶ Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
²⁷ PaCeIT-Patient Centered Innovation and Technologies, Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
²⁸ Allergy Unit, Instituto and Hospital CUF, Porto, Portugal.
²⁹ Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.
³⁰ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
³¹ CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
³² Department of Allergy, Skin and Allergy Hospital, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
³³ Department of Otorhinolaryngology, University of Eastern Finland and the North Savo Wellbeing Services County, Kuopio, Finland.
³⁴ University of Bari Medical School, Bari, Italy.
³⁵ Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy.
³⁶ School of Medicine, Universidad de los Andes, Bogotá, D. C., Colombia.
³⁷ Pulmonology Service, Internal Medicine Section, Fundación Santa Fe de Bogotá, University Hospital, Bogotá, D. C., Colombia.
³⁸ Fundacao ProAR and (Faculdade de Medicina da), Universidade Federal da Bahia, Salvador, Bahia, Brazil.
³⁹ Casa di Cura Villa Montallegro, Allergology Department, Genova, Italy.
⁴⁰ Department of Pulmonary Diseases and Institute of Pulmonology and Tuberculosis, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey.
⁴¹ Department of Health Sciences, University of Florence, Florence, Italy.
⁴² Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy.
⁴³ Department of Immunology and Allergology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
⁴⁴ Department of Pediatrics and Adolescent Medicine, University of Turku, Turku University Hospital, Turku, Finland.
⁴⁵ Institute of Clinical Immunology and Medical Genetics, Department of Paediatrics and Adolescent Medicine, Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine, Martin, Slovakia.
⁴⁶ Comenius University, Bratislava, Slovakia.
⁴⁷ University Teaching Hospital Martin, Martin, Slovakia.
⁴⁸ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
⁴⁹ Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
⁵⁰ Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
⁵¹ Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
⁵² Allergy & Immunology Centre, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
⁵³ National Center for Research in Chronic Respiratory Diseases, Collaborating With WHO-EMRO Tishreen University School of Medicine, Latakia, Syria.
⁵⁴ Al-Sham Private University, Pharmacy Department, Damascus, Syria.
⁵⁵ Japan Antituberculosis Association (JATA), Fukujuji Hospital, Tokyo, Japan.
⁵⁶ Department of Respiratory Medicine, JSS Medical College, JSSAHER Mysuru, Mysore, Karnataka, India.
⁵⁷ Departement of Biological Sciences and Pathophysiology, University of Veterinary Medicine, Vienna, Austria.
⁵⁸ Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
⁵⁹ Allergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
⁶⁰ Center for Innovative Biomedicine and Biotechnology (CIBB), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
⁶¹ Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
⁶² UBIAir-Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
⁶³ Pneumologie, AP-HP Centre Université de Paris Cité, Hôpital Cochin, Paris, France.
⁶⁴ UMR 1016, Institut Cochin, Paris, France.
⁶⁵ Inserm, Equipe D'epidémiologie Respiratoire Intégrative, CESP, Villejuif, France.
⁶⁶ Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal.
⁶⁷ Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Copenhagen, Denmark.
⁶⁸ Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
⁶⁹ Pediatrics, Allergy & Immunology, Latín American Society of Allergy, Asthma & Immunology (SLAAi), Montevideo, Uruguay.
⁷⁰ Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
⁷¹ Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China.
⁷² Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.
⁷³ Universidad Espíritu Santo, Samborondón, Ecuador.
⁷⁴ Department of Allergology & Pulmonology, Respiralab Research Group, Guayaquil, Guayas, Ecuador.
⁷⁵ Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
⁷⁶ Global NCD Platform, Geneva, Switzerland.
⁷⁷ Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey.
⁷⁸ Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
⁷⁹ Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait.
⁸⁰ Adult Allergy and Immunology Division-Hamad Medical Corporation, Doha, Qatar.
⁸¹ Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal.
⁸² Department of Women's and Children's Health, Paediatric Research, Uppsala University, Uppsala, Sweden.
⁸³ Department of Internal Medicine, University of Medicine, Tirana, Albania.
⁸⁴ Division of Immunology, Allergy and Rheumatology, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
⁸⁵ Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
⁸⁶ Department of Internal Medicine (DIMI), University of Genoa, Genoa, Italy.
⁸⁷ Respiratory & Allergy Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
⁸⁸ Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil.
⁸⁹ NOVA Medical School/Comprehensive Health Research Centre (CHRC), Lisbon, Portugal.
⁹⁰ Serviço de Imunoalergologia, Centro Hospitalar Universitário de Lisboa Central/ULS São José, Lisbon, Portugal.
⁹¹ Division of Allergy/Immunology, University of South Florida, Tampa, Florida, USA.
⁹² SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
⁹³ Allergy, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
⁹⁴ Department of Internal Medicine 'A. Murri' and Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy.
⁹⁵ Faculty of Public Health, Sofia Medical University, Sofia, Bulgaria.
⁹⁶ Latvian Association of Allergists, University Children Hospital, Riga, Latvia.
⁹⁷ Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
⁹⁸ CINTESIS@RISE, Biochemistry Lab, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto, Porto, Portugal.
⁹⁹ Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy.
¹⁰⁰ VIM Suresnes, UMR 0892, Pôle Des Maladies Des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France.
¹⁰¹ Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, Republic of North Macedonia.
¹⁰² Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.
¹⁰³ Department of Otorhinolaryngology, Chiba University, Chiba, Japan.
¹⁰⁴ Department of Internal Medicine and Infectious Diseases, St Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon.
¹⁰⁵ Department of Allergology and Clinical Immunology, Kazakhstan Association of Allergology and Clinical Immunology, Kazakh National Medical University, Almaty, Kazakhstan.
¹⁰⁶ Institute of Clinical Medicine, Children's Clinic, Tartu University, Tartu, Estonia.
¹⁰⁷ Poltava State Medical University, Immunology & Allergology Department, Poltava, Ukraine.
¹⁰⁸ Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh.
¹⁰⁹ Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary.
¹¹⁰ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
¹¹¹ Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
¹¹² Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland.
¹¹³ Department of Clinical and Laboratory Immunology, Allergology and Medical Genetics, Bogomolets National Medical University, Kyiv, Ukraine.
¹¹⁴ Institute of Translational Pharmacology (IFT)-National Research Council (CNR), Palermo, Italy.
¹¹⁵ Croatian Pulmonary Society, Clinical Center for Pulmonary Diseases, Zagreb, Croatia.
¹¹⁶ Asthma, COPD Outpatient Care Unit, University Medical Center, Hô-Chi-Minh City, Vietnam.
¹¹⁷ Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
¹¹⁸ Clinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbian Association for Asthma and COPD, Belgrade, Serbia.
¹¹⁹ Division of Respiratory Disease and Allergy, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea.
¹²⁰ Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
¹²¹ EPIUnit-Institute of Public Health, University of Porto, and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
¹²² Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, Porto, Portugal.
¹²³ Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.
¹²⁴ Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain.
¹²⁵ Clinical & Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
¹²⁶ Université Paris-Saclay, UVSQ, Université Paris-Sud, Villejuif, France.
¹²⁷ Imperial College Healthcare NHS Trust, London, UK.
¹²⁸ University of Liverpool, Liverpool, UK.
¹²⁹ Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina.
¹³⁰ Department of Allergology, Medical University of Gdansk, Gdansk, Poland.
¹³¹ ENT Department, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo.
¹³² Allergy, Asthma and Clinical Immunology, Alfred Health and Department of Immunology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
¹³³ Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
¹³⁴ Chiba Rosai Hospital, ENT Department, Chiba, Japan.
¹³⁵ Chiba University Hospital, Department of Otolaryngology, Head and Neck Surgery, Chiba, Japan.
¹³⁶ Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
¹³⁷ Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain.
¹³⁸ Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic.
¹³⁹ Division of Allergy and Clinical Immunology, Department of Medicine, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy.
¹⁴⁰ Agency of Health ASL, Division of Allergy and Clinical Immunology, Department of Medicine, Salerno, Italy.
¹⁴¹ Postgraduate Programme in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy.
¹⁴² Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
¹⁴³ Medical School, University of Cyprus, Nicosia, Cyprus.
¹⁴⁴ Clinic of Occupational Diseases, University Hospital Sveti Ivan Rilski, Sofia, Bulgaria.
¹⁴⁵ IRCCS Humanitas Research Center, Personalized Medicine Asthma & Allergy, Rozzano, Milan, Italy.
¹⁴⁶ Department of Pulmonology and Allergology, Klaipeda National Hospital, Klaipėda, Lithuania.
¹⁴⁷ Vilnius University Medical Faculty, Vilnius, Lithuania.
¹⁴⁸ Division of Adult and Pediatric Allergy and Immunology, University of the Philippines-Philippines General Hospital, Manila, Philippines.
¹⁴⁹ Department of Allergy, Clinics Hospital, National University, San Lorenzo, Paraguay.
¹⁵⁰ Faculty of Medicine, University of Southampton, Southampton, UK.
¹⁵¹ The David Hide Asthma and Allergy Centre, St Mary's Hospital, Newport, Isle of Wight, UK.
¹⁵² NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
¹⁵³ LEADER Research Inc., Hamilton, Ontario, Canada.
¹⁵⁴ Division of Allergy, Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel.
¹⁵⁵ Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
¹⁵⁶ Aria, Asthma, Rhinitis, Immunology & Allergy Department, Athens, Greece.
¹⁵⁷ Allergy Service, Fundacion Jimenez Diaz, Autonoma University of Madrid, CIBERES-ISCIII, Madrid, Spain.
¹⁵⁸ PROMISE Department, University of Palermo, Palermo, Italy.
¹⁵⁹ Allergy & Asthma, Medical Director, CLINICA SISUL, FACAAI, SPAAI, Asuncion, Paraguay.
¹⁶⁰ Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil.
¹⁶¹ Division of Respiratory Medicine, Department of Pediatrics, Hospital Nacional de Niños, Universidad de Costa Rica, San Jose, Costa Rica.
¹⁶² Department of Respiratory Medicine and Tuberculosis, University Hospital, Brno, Czech Republic.
¹⁶³ Department of Otolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
¹⁶⁴ Imunoalergologia, Centro Hospitalar Universitário de Coimbra, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
¹⁶⁵ International Primary Care Respiratory Group IPCRG, Aberdeen, UK.
¹⁶⁶ Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
¹⁶⁷ Federal University of Pampa, Department of Medicine, Uruguaiana, Brazil.
¹⁶⁸ Department of Lung Diseases and Clinical Immunology, University of Turku, Turku, Finland.
¹⁶⁹ FiLHA, Finnish Lung Health Association, Helsinki, Finland.
¹⁷⁰ Department of Clinical Medicine, Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.
¹⁷¹ Nova Southeastern University, College of Allopathic Medicine, Fort Lauderdale, Florida, USA.
¹⁷² Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.
¹⁷³ Division of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany.
¹⁷⁴ The Allergy and Asthma Institute, Allergy & Asthma Department, Islamabad, Pakistan.
¹⁷⁵ University Clinic of Respiratory and Allergic Diseases, Pulmonary & Allergy Department, Golnik, Slovenia.
¹⁷⁶ Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
¹⁷⁷ Pulmonary Department, Rashid Hospital, DUBAI Health, Dubai, UAE.
¹⁷⁸ Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE.
¹⁷⁹ Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain.
¹⁸⁰ Oasi Research Institute-IRCCS, Troina, Italy.
¹⁸¹ BIOS S.P.A. Società Benefit, Rome, Italy.
¹⁸² Department of Dermatology, Medical University of Graz, Graz, Austria.
¹⁸³ Department of Allergy and Immunology, Para State University Center-CESUPA, Belém, Brazil.
¹⁸⁴ Allergy Department, Hospital Clinic and IDIBAPS. Universitat de Barcelona, Barcelona, Spain.
¹⁸⁵ RICORS de Enfermedades Inflamatorias (ISCIII), Madrid, Spain.
¹⁸⁶ Department for Otorhinolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany.
¹⁸⁷ Respiratory Medicine, University of Modena & Reggio Emilia, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.
¹⁸⁸ Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy.
¹⁸⁹ Evidence Prime, Kraków, Poland.
¹⁹⁰ Evidence Prime, Hamilton, Ontario, Canada.
¹⁹¹ Laval University, Quebec City, Quebec, Canada.
¹⁹² Department of Pediatric Allergology, Armand Trousseau University Hospital, Sorbonne University, AP-HP, Paris, France.
¹⁹³ French National Reference Center for Angioedema (CREAK), Saint-Antoine University Hospital, Paris, France.
¹⁹⁴ CRESS, Inserm, INRAE, HERA Team, Paris Cité University, Paris, France.
¹⁹⁵ Department of Medical Sciences, University of Turin, Turin, Italy.
¹⁹⁶ Allergy and Clinical Immunology Unit, Mauriziano Hospital, Torino, Italy.
¹⁹⁷ Department of Pulmonary Medicine, Mainz University Hospital, Mainz, Germany.
¹⁹⁸ Pneumology Department, Hospital Universitari Dexeus, Barcelona, Spain.
¹⁹⁹ CIBER of Respiratory Diseases, Group of Rhinitis, Rhinosinusitis and Nasal Polyps, Area of Asthma, SEPAR, Barcelona, Spain.
²⁰⁰ Clinique Des Bronches, Allergie et Sommeil, Hôpital Nord, Marseille, France.
²⁰¹ Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.
²⁰² National eHealth Living Lab, Leiden, the Netherlands.
²⁰³ Department of Pulmonology and Allergology, Medical University of Gdańsk, Gdańsk, Poland.
²⁰⁴ Department of Allergology and Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
²⁰⁵ Allergist, David Tvildiani Medical University, Tbilisi, Georgia.
²⁰⁶ University of South Florida, College of Médicine, Division of Allergy-Immunology, Department of Internal Medicine, Tampa, Florida, USA.
²⁰⁷ Associate Professor of Pediatrics, Division of Allergy and Immunology, Federal University of Parana, Curitiba, Brazil.
²⁰⁸ Paediatric Allergy Clinic, Department of Dermatology, Amersham Hospital, NHS Hospital Trust, Amersham, UK.
²⁰⁹ Evidence in Allergy Group, McMaster University and the Research Institute of St. Joe's Hamilton, Hamilton, Canada.
²¹⁰ Eskisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir, Turkey.
²¹¹ Scientific & Medical Department, Lofarma S.p.A, Milan, Italy.
²¹² LAQV@REQUIMTE, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.
²¹³ Woolcock Institute of Medical Research, Sydney, Australia.
²¹⁴ Allergy Section, Department of Internal Medicine, Hospital Vall D'hebron, Barcelona, Spain.
²¹⁵ ARADyAL Research Network, Barcelona, Spain.
²¹⁶ Division of Respiratory and Allergic Diseases, High Specialty Hospital 'A Cardarelli', and Respiratory Allergy School of Specialization in Respiratory Diseases, Federico II University of Naples, Naples, Italy.
²¹⁷ Centre for Immunology and Infection Control, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
²¹⁸ Office of Research, Metro North Hospital and Health Service, Brisbane, Australia.
²¹⁹ University of Foggia, Department of Medical and Surgical Science, Foggia, Italy.
²²⁰ Allergy and Clinical Immunology Centro Regional, Hospital Universitario, Universidad Autónoma de Nuevo Leon, Monterrey, Mexico.
²²¹ Department of Otorhinolaryngology, Head and Neck Surgery, University of Crete, School of Medicine, Heraklion, Crete, Greece.
²²² Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia in Katowice, Katowice, Poland.
²²³ Pediatrics Department, Universidad Austral de Chile, Valvidia, Chile.
²²⁴ Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Laboratory of Occupational and Environmental Respiratory Diseases, Faculty of Medicine, Ege University, EgeSAM (Ege University Translational Pulmonary Research Center), Bornova, Izmir, Türkiye.
²²⁵ Faculty of Health Sciences, Catholic University of Salta, Salta, Argentina.
²²⁶ Center of Allergy and Immunology, and Georgian Academy of Allergy, Asthma, and Clinical Immunology, Tbilisi, Georgia.
²²⁷ Former President of the Hellenic Society of Allergology and Clinical Immunology, Department of Allergy and Clinical Immunology, Air Force General Hospital, Athens, Greece.
²²⁸ Riga East University Hospital, Riga, Latvia.
²²⁹ Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile.
²³⁰ Quality Use of Research Medicines Group, Woolcock Institute of Medical Research, Macquarie Park, New South Wales, Australia.
²³¹ Macquarie University, Macquarie Park, New South Wales, Australia.
²³² Faculty of Health, University of Plymouth, Plymouth, UK.
²³³ Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.
²³⁴ Otolaryngology Department, General Hospital of Kalamata, Kalamata City, Greece.
²³⁵ Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
²³⁶ Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
²³⁷ ORL SOKLIC KOSAK, Ljubljana, Slovenia.
²³⁸ University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
²³⁹ Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
²⁴⁰ Bagcilar Research and Training Hospital, Department of Chest Diseases, Istanbul, Turkey.
²⁴¹ Clinical Management Group, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia.
²⁴² Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
²⁴³ Departmental Unit of Allergology, Clinical Immunology & Pneumology, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.
²⁴⁴ Department of Public Health, University of Liège, Liège, Belgium.
²⁴⁵ Department of Pneumology, GIGA I3 Research Group, University of Liège, Liège, Belgium.
²⁴⁶ Allergy Unit, Department of Internal Medicine, University Hospital AOU Delle Marche, Ancona, Italy.
²⁴⁷ Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
²⁴⁸ Department of Otorhinolaryngology, Head and Neck Surgery, Ankara University Medical School, Ankara, Turkey.
²⁴⁹ Department of Otorhinolaryngology Head and Neck Surgery, Salzburg Paracelsus Medical University, Salzburg, Austria.
²⁵⁰ Department of Otolaryngology, Head and Neck Surgery, Cornell University, Weill Cornell Medical College, New York, New York, USA.
²⁵¹ Allergy & Clinical Immunology Department, University Hospital Center "Mother Teresa", Tirana, Albania.
²⁵² UMF-University of Medicine and Pharmacy 'Carol Davila', Pneumology Department, National Institute of Pneumology 'Marius Nasta', Bucharest, Romania.
²⁵³ Department of Allergology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.
²⁵⁴ Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
²⁵⁵ Department of Environmental Health, Harvard TH Chan School of Public Health and Department of Medicine, Division of Allergy and Inflammation, Beth Israel Deaconess Hospital, Boston, Massachusetts, USA.
²⁵⁶ Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
²⁵⁷ Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark.
²⁵⁸ Department of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland.
²⁵⁹ Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea.
²⁶⁰ Clinical Epidemiology and Research Center, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
²⁶¹ Otorhinolaryngology and Neck Surgery Unit, San Juan de Dios National Hospital, San Miguel, El Salvador.
²⁶² Allergist, Private Practice, Mexico City, Mexico.
²⁶³ Ecole Polytechnique de Palaiseau, Palaiseau, France.
²⁶⁴ IRBA (Institut de Recherche Bio-Médicale Des Armées), Bretigny sur Orge, France.
²⁶⁵ Université Paris Cité, Paris, France.
²⁶⁶ Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
²⁶⁷ Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon.
²⁶⁸ Department of Otorhinolaryngology-Head and Neck Surgery, Dar Al Shifa Hospital, Salmiya, Kuwait.
²⁶⁹ Center Allergy & Immunology/Geomedi Teaching University, Faculty of Medicine, Tbilisi, Georgia.
²⁷⁰ Usher Institute, University of Edinburgh, Edinburgh, UK.
²⁷¹ Department of Otorhinolaryngology, Yamanashi University, Yamanashi, Japan.
²⁷² Mohammed Bin Rashid University (MBRU), Dubai Health, Dubai, UAE.
²⁷³ Asthma Reference Center-School of Medicine of Santa Casa de Misericórdia of Vitória, Espírito Santo, Brazil.
²⁷⁴ Department of Otorhinolaryngology and Head & Neck Surgery, CHU Rangueil-Larrey, Toulouse, France.
²⁷⁵ Allergy Service, University Hospital Professor Polydoro Ernani de São Thiago (HU-UFSC/EBSERH), Florianopolis, Brazil.
²⁷⁶ Department of Internal Medicine, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil.
²⁷⁷ Otolaryngology-HNS, University of Zurich, University Hospital of Zurich, Zurich, Switzerland.
²⁷⁸ Clinic of Allergology and Immunology, University Clinical Center of Serbia, Belgrade, Serbia.
²⁷⁹ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
²⁸⁰ Department of Respiratory Medicine, Medical Professorial Unit, Tallaght University Hospital & Trinity College, Dublin, Ireland.
²⁸¹ Dr Agostinho Neto University Hospital, Praia, Cabo Verde.
²⁸² Immunology, Cabo Verde University, Faculty of Medicine, Praia, Cabo Verde.
²⁸³ The Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
²⁸⁴ Faculty of Medicine, University of Porto, Porto, Portugal.
²⁸⁵ Department of Immunology and Allergology, University Hospital and Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
²⁸⁶ Charles University, Prague, Czech Republic.
²⁸⁷ Department of Medicine Solna, Division of Immunology and Respiratory Medicine, Karolinska Institutet, Stockholm, Sweden.
²⁸⁸ Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.
²⁸⁹ Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
²⁹⁰ Samitivej Allergy Institute, Bangkok, Thailand.
²⁹¹ Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University, Faculty of Medicine, Bangkok, Thailand.
²⁹² Department of Otorhinolaryngology, Heinrich Heine University Düsseldorf, Medical Faculty and University Hospital Düsseldorf, Düsseldorf, Germany.
²⁹³ The Chinese University of Hong Kong, Department of Medicine and Therapeutics, Hong Kong, China.
²⁹⁴ ENT and Allergology, Düsseldorf, Germany.
²⁹⁵ Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
²⁹⁶ The Third Affiliated Hospital of sun Yat-Sen University, Guangzhou, China.
²⁹⁷ Servicio de Alergia e Inmunología clínica, Hospital Universitario de Puebla, Puebla, México.

PMID: 41324154
DOI: 10.1111/all.70131

Abstract

Background: Allergic rhinitis (AR) impacts quality of life, work and school productivity. Over the last years, an important body of evidence resulting from mHealth data has led to a better understanding of AR. Such advances have motivated an EAACI-endorsed update of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines (ARIA 2024-2025). This manuscript presents the ARIA 2024-2025 recommendations for intranasal treatments, one of the mainstays for AR management.

Methods: The ARIA 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 judgments and recommendations, including systematic reviews, evaluation of mHealth and pharmacovigilance data, as well as a survey of experts on costs.

Results: Eleven guideline questions concerning intranasal treatments for AR were prioritized, leading to recommendations. Overall, these questions concern the choice between different classes of intranasal medications-most notably, intranasal corticosteroids (INCS), antihistamines (INAH), fixed combinations of INAH+INCS and decongestants-or between different individual medications within each class. Four questions had not been evaluated in previous ARIA guidelines, while for the other three there was a change in the strength or directionality of recommendations. Overall, recommendations point to the suggested use of INAH+INCS over INAH or INCS and INCS over INAH.

Conclusion: This ARIA 2024-2025 article supports patients, their caregivers, and healthcare professionals in choosing an intranasal treatment. However, decisions on AR treatment should consider the clinical variability of the disease, patients' values, and the affordability of medications.

Keywords: allergic rhinitis; guidelines; intranasal antihistamines; intranasal corticosteroids.

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References

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Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines-2024-2025 Revision: Part I-Guidelines on Intranasal Treatments

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Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines-2024-2025 Revision: Part I-Guidelines on Intranasal Treatments

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Abstract

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