International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Author:

Wise Sarah K.1,Damask Cecelia2,Roland Lauren T.3ORCID,Ebert Charles4,Levy Joshua M.1ORCID,Lin Sandra5,Luong Amber6ORCID,Rodriguez Kenneth7,Sedaghat Ahmad R.8ORCID,Toskala Elina9,Villwock Jennifer10ORCID,Abdullah Baharudin11ORCID,Akdis Cezmi12,Alt Jeremiah A.13ORCID,Ansotegui Ignacio J.14,Azar Antoine15,Baroody Fuad16,Benninger Michael S.17,Bernstein Jonathan18,Brook Christopher19,Campbell Raewyn20,Casale Thomas21,Chaaban Mohamad R.22ORCID,Chew Fook Tim23,Chambliss Jeffrey24,Cianferoni Antonella25,Custovic Adnan26,Davis Elizabeth Mahoney27,DelGaudio John M.1,Ellis Anne K.28,Flanagan Carrie1,Fokkens Wytske J.29,Franzese Christine30,Greenhawt Matthew31,Gill Amarbir32ORCID,Halderman Ashleigh33,Hohlfeld Jens M.34,Incorvaia Cristoforo35,Joe Stephanie A.36,Joshi Shyam37,Kuruvilla Merin Elizabeth38ORCID,Kim Jean39ORCID,Klein Adam M.1,Krouse Helene J.40,Kuan Edward C.41ORCID,Lang David42,Larenas‐Linnemann Desiree43,Laury Adrienne M.44,Lechner Matt45,Lee Stella E.46,Lee Victoria S.36ORCID,Loftus Patricia47,Marcus Sonya48ORCID,Marzouk Haidy49,Mattos Jose50ORCID,McCoul Edward51ORCID,Melen Erik52,Mims James W.53,Mullol Joaquim54,Nayak Jayakar V.55ORCID,Oppenheimer John56,Orlandi Richard R.13ORCID,Phillips Katie8,Platt Michael27,Ramanathan Murugappan39,Raymond Mallory57,Rhee Chae‐Seo58,Reitsma Sietze59,Ryan Matthew33,Sastre Joaquin60,Schlosser Rodney J.61,Schuman Theodore A.62ORCID,Shaker Marcus S.63,Sheikh Aziz64,Smith Kristine A.13ORCID,Soyka Michael B.65ORCID,Takashima Masayoshi66,Tang Monica67,Tantilipikorn Pongsakorn68ORCID,Taw Malcolm B.69,Tversky Jody15,Tyler Matthew A.70ORCID,Veling Maria C.33,Wallace Dana71,Wang De Yun72,White Andrew73,Zhang Luo74ORCID

Affiliation:

1. Otolaryngology‐HNS Emory University Atlanta Georgia USA

2. Otolaryngology‐HNS, Private Practice University of Central Florida Lake Mary Florida USA

3. Otolaryngology‐HNS Washington University St. Louis Missouri USA

4. Otolaryngology‐HNS University of North Carolina Chapel Hill North Carolina USA

5. Otolaryngology‐HNS University of Wisconsin Madison Wisconsin USA

6. Otolaryngology‐HNS McGovern Medical School of the University of Texas Houston Texas USA

7. Otolaryngology‐HNS University Hospitals Cleveland Medical Center Cleveland Ohio USA

8. Otolaryngology‐HNS University of Cincinnati Cincinnati Ohio USA

9. Otolaryngology‐HNS Thomas Jefferson University Philadelphia Pennsylvania USA

10. Otolaryngology‐HNS University of Kansas Kansas City Kansas USA

11. Otolaryngology‐HNS Universiti Sains Malaysia Kubang, Kerian Kelantan Malaysia

12. Immunology, Infectious Diseases Swiss Institute of Allergy and Asthma Research Davos Switzerland

13. Otolaryngology‐HNS University of Utah Salt Lake City Utah USA

14. Allergy/Immunology Hospital Quironsalud Bizkala Bilbao Spain

15. Allergy/Immunology Johns Hopkins University Baltimore Maryland USA

16. Otolaryngology‐HNS University of Chicago Chicago Illinois USA

17. Otolaryngology‐HNS Cleveland Clinic Cleveland Ohio USA

18. Allergy/Immunology University of Cincinnati Cincinnati Ohio USA

19. Otolaryngology‐HNS Harvard University Beth Israel Deaconess Medical Center Boston Massachusetts USA

20. Otolaryngology‐HNS Macquarie University Sydney NSW Australia

21. Allergy/Immunology University of South Florida College of Medicine Tampa Florida USA

22. Otolaryngology‐HNS Cleveland Clinic Case Western Reserve University Cleveland Ohio USA

23. Allergy/Immunology, Genetics National University of Singapore Singapore Singapore

24. Allergy/Immunology University of Texas Southwestern Dallas Texas USA

25. Allergy/Immunology Children's Hospital of Philadelphia Philadelphia Pennsylvania USA

26. Pediatric allergy Imperial College London London UK

27. Otolaryngology‐HNS Boston University Boston Massachusetts USA

28. Allergy/Immunology Queens University Kingston ON Canada

29. Otorhinolaryngology Amsterdam University Medical Centres Amsterdam Netherlands

30. Otolaryngology‐HNS University of Missouri Columbia Missouri USA

31. Allergy/Immunology, Pediatrics University of Colorado Children's Hospital Colorado Aurora Colorado USA

32. Otolaryngology‐HNS University of Michigan Ann Arbor Michigan USA

33. Otolaryngology‐HNS University of Texas Southwestern Dallas Texas USA

34. Respiratory Medicine Fraunhofer Institute for Toxicology and Experimental Medicine ITEM Hannover Medical School German Center for Lung Research Hannover Germany

35. Allergy Private Practice Milan Italy

36. Otolaryngology‐HNS University of Illinois Chicago Chicago Illinois USA

37. Allergy/Immunology Oregon Health and Science University Portland Oregon USA

38. Allergy/Immunology Emory University Atlanta Georgia USA

39. Otolaryngology‐HNS Johns Hopkins University Baltimore Maryland USA

40. Otorhinolaryngology Nursing University of Texas Rio Grande Valley Edinburg Texas USA

41. Otolaryngology‐HNS University of California Irvine Orange California USA

42. Allergy/Immunology Cleveland Clinic Cleveland Ohio USA

43. Allergy/Immunology, Pediatric Medica Sur Clinical Foundation and Hospital Mexico City Mexico

44. Otolaryngology‐HNS Bellevue ENT Bellevue Washington USA

45. Otolaryngology‐HNS University College London Barts Health NHS Trust London UK

46. Otolaryngology‐HNS Brigham and Women's Hospital Boston Massachusetts USA

47. Otolaryngology‐HNS University of California San Francisco San Francisco California USA

48. Otolaryngology‐HNS Stony Brook University Stony Brook New York USA

49. Otolaryngology‐HNS State University of New York Upstate Syracuse New York USA

50. Otolaryngology‐HNS University of Virginia Charlottesville Virginia USA

51. Otolaryngology‐HNS Ochsner Clinic New Orleans Louisiana USA

52. Pediatric Allergy Karolinska Institutet Stockholm Sweden

53. Otolaryngology‐HNS Wake Forest University Winston Salem North Carolina USA

54. Otorhinolaryngology Hospital Clinic Barcelona Barcelona Spain

55. Otolaryngology‐HNS Stanford University Palo Alto California USA

56. Allergy/Immunology, Rutgers State University of New Jersey Newark New Jersey USA

57. Otolaryngology‐HNS Mayo Clinic Jacksonville Florida USA

58. Rhinology/Allergy Seoul National University Hospital and College of Medicine Seoul Korea

59. Otolaryngology‐HNS University of Amsterdam Amsterdam Netherlands

60. Allergy, Fundacion Jiminez Diaz University Autonoma de Madrid Madrid Spain

61. Otolaryngology‐HNS Medical University of South Carolina Charleston South Carolina USA

62. Otolaryngology‐HNS Virginia Commonwealth University Richmond Virginia USA

63. Allergy/Immunology Dartmouth Geisel School of Medicine Lebanon New Hampshire USA

64. Primary Care University of Edinburgh Edinburgh Scotland

65. Otolaryngology‐HNS University of Zurich University Hospital of Zurich Zurich Switzerland

66. Otolaryngology‐HNS Houston Methodist Academic Institute Houston Texas USA

67. Allergy/Immunology University of California San Francisco San Francisco California USA

68. Rhinology/Allergy Mahidol University Siriraj Hospital Bangkok Thailand

69. Integrative East‐West Medicine University of California Los Angeles Westlake Village California USA

70. Otolaryngology‐HNS University of Minnesota Minneapolis Minnesota USA

71. Allergy/Immunology Nova Southeastern University Ft. Lauderdale Florida USA

72. Otolaryngology‐HNS National University of Singapore Singapore Singapore

73. Allergy/Immunology Scripps Clinic San Diego California USA

74. Otolaryngology‐HNS Beijing Tongren Hospital Beijing China

Abstract

AbstractBackgroundIn the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR‐Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR‐Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence‐based findings and recommendation from the full document.MethodsICAR‐Allergic Rhinitis 2023 employed established evidence‐based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work.ResultsICAR‐Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost.ConclusionThe ICAR‐Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.

Publisher

Wiley

Subject

Otorhinolaryngology,Immunology and Allergy

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