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Pharmacologic Treatment of Seasonal Allergic Rhinitis: Synopsis of Guidance From the 2017 Joint Task Force on Practice Parameters
Annals of Internal Medicine ( IF 39.2 ) Pub Date : 2017-11-28 , DOI: 10.7326/m17-2203
Dana V Wallace 1 , Mark S Dykewicz 1 , John Oppenheimer 1 , Jay M Portnoy 1 , David M Lang 1
Affiliation  

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)



中文翻译:

季节性过敏性鼻炎的药物治疗:2017 年实践参数联合工作组指南概要

描述:

由美国过敏、哮喘和免疫学会 (AAAAI) 和美国过敏、哮喘和免疫学会 (ACAAI) 的代表组成的实践参数联合工作组成立了一个工作组,以审查证据并为医疗保健提供指导提供者对 12 岁或以上患者的季节性过敏性鼻炎进行初始药物治疗。

方法:

为了更新之前的系统评价,工作组在 2012 年 7 月 18 日至 2016 年 7 月 29 日期间检索了 MEDLINE、EMBASE 和 Cochrane 中央对照试验注册库,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。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始治疗方法的建议。AAAAI 成员、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。

建议一:

对于 12 岁或以上人群的季节性过敏性鼻炎的初始治疗,常规开具鼻内皮质类固醇的单一疗法,而不是鼻内皮质类固醇联合口服抗组胺药。(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,推荐使用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 岁或以上人群的中度至重度季节性过敏性鼻炎的治疗,临床医生可能会推荐联合使用鼻内皮质类固醇和鼻内抗组胺药进行初始治疗。(弱推荐)

更新日期:2017-11-28
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