Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision
Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision
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DOI：
10.1016/j.jaci.2017.03.050
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发表时间：
2017-10-01
影响因子：
14.2
通讯作者：
Schunemann, Holger J.
中科院分区：
文献类型：
--
作者：
Brozek, Jan L.;Bousquet, Jean;Schunemann, Holger J.
背景：过敏性鼻炎（AR）影响10%至40%的人口。它降低了生活质量和学习和工作表现，是一般做法中经常去办公室的原因。医疗费用很大，但与工作效率损失相关的可避免成本甚至比哮喘引起的成本更大。自从2010年过敏性鼻炎及其对哮喘的影响（ARIA）指南的最后一次修订以来，新的证据已经积累，促使其update.Objective：我们试图提供ARIA guidelines.Methods的有针对性的更新：ARIA指南小组确定了新的临床问题和需要更新的选定问题。我们对健康影响以及患者价值观、偏好和资源需求的证据进行了系统评价（截至2016年6月）。我们遵循分级建议评估，开发和评估（GRADE）证据到决策框架来制定recommends.Results：2016年修订的ARIA指南提供了关于AR药物治疗的更新和新建议。具体而言，它解决了使用口服H-1-抗组胺药，鼻内H-1-抗组胺药，鼻内皮质类固醇，和白三烯受体拮抗剂单独或组合的相对优点。ARIA指南小组提供了具体的建议，治疗的选择和选择的理由，并讨论了具体的考虑因素，临床医生和患者可能要审查，以选择最适合于个别patient.Conclusions的管理：适当的治疗AR可能会提高患者的生活质量和学校和工作效率。ARIA的建议支持患者，他们的照顾者和卫生保健提供者选择最佳治疗。
Background: Allergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and school and work performance and is a frequent reason for office visits in general practice. Medical costs are large, but avoidable costs associated with lost work productivity are even larger than those incurred by asthma. New evidence has accumulated since the last revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in 2010, prompting its update.Objective: We sought to provide a targeted update of the ARIA guidelines.Methods: The ARIA guideline panel identified new clinical questions and selected questions requiring an update. We performed systematic reviews of health effects and the evidence about patients' values and preferences and resource requirements (up to June 2016). We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence-to-decision frameworks to develop recommendations.Results: The 2016 revision of the ARIA guidelines provides both updated and new recommendations about the pharmacologic treatment of AR. Specifically, it addresses the relative merits of using oral H-1-antihistamines, intranasal H-1-antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists either alone or in combination. The ARIA guideline panel provides specific recommendations for the choice of treatment and the rationale for the choice and discusses specific considerations that clinicians and patients might want to review to choose the management most appropriate for an individual patient.Conclusions: Appropriate treatment of AR might improve patients' quality of life and school and work productivity. ARIA recommendations support patients, their caregivers, and health care providers in choosing the optimal treatment.