Pharmacologic Treatment of Seasonal Allergic Rhinitis: Synopsis of Guidance From the 2017 Joint Task Force on Practice Parameters
Pharmacologic Treatment of Seasonal Allergic Rhinitis: Synopsis of Guidance From the 2017 Joint Task Force on Practice Parameters
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DOI：
10.7326/m17-2203
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发表时间：
2017-12-19
影响因子：
39.2
通讯作者：
Lang, David M.
中科院分区：
文献类型：
--
作者：
Wallace, Dana V.;Dykewicz, Mark S.;Lang, David M.
描述：由美国过敏、哮喘和免疫学学会 (AAAAI) 和美国过敏、哮喘和免疫学学院 (ACAAI) 的代表组成的实践参数联合工作组成立了一个工作组，负责审查证据并为医疗保健提供者提供关于 12 岁或以上患者季节性过敏性鼻炎初始药物治疗的指导。方法：为了更新之前的系统评价，工作组检索了 MEDLINE、EMBASE 和 Cochrane Central 2012年7月18日至2016年7月29日的对照试验登记册，以确定针对季节性过敏性鼻炎的单一或联合药物疗法的疗效和不良反应的研究。该工作组与联合工作组一起审查了证据，并通过使用建议分级评估、制定和评估方法制定了有关初步治疗方法的建议。 AAAAI、ACAAI 和公众对文件草案提供了反馈，联合工作组在最终确定指南之前对其进行了审查。建议 1：对于 12 岁或以上人群季节性过敏性鼻炎的初始治疗，常规采用鼻内皮质类固醇单一疗法，而不是鼻内皮质类固醇与口服抗组胺药联合用药。 （强烈推荐）建议2：对于15岁或以上人群的季节性过敏性鼻炎的初始治疗，推荐鼻内皮质类固醇而不是白三烯受体拮抗剂。 （强烈推荐）建议3：对于12岁或以上人群的中重度季节性过敏性鼻炎的治疗，临床医生可能会推荐鼻内皮质类固醇和鼻内抗组胺药联合用于初始治疗。 （弱推荐）
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)