Dana V. Wallace, MD; Mark S. Dykewicz, MD; John Oppenheimer, MD; Jay M. Portnoy, MD; David M. Lang, MD
Financial Support: The group received no financial support in the development of this article other than administrative support from the AAAAI and the ACAAI.
Disclosures: Dr. Wallace reports personal fees from Meda Pharmaceuticals and Mylan outside the submitted work. Dr. Dykewicz reports personal fees from Allergan and Merck outside the submitted work. Dr. Oppenheimer served on adjudication committees for Quintiles, PRA, and Icon and served as a consultant for GlaxoSmithKline, Teva, and DBV Technologies. Dr. Lang reports a grant from Genentech/Novartis and personal fees from Genentech/Novartis, Hycor, GlaxoSmithKline, AstraZeneca, and Merck outside the submitted work and currently serves on the Board of Directors of the American Academy of Allergy, Asthma and Immunology. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2203.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Requests for Single Reprints: Natalie Aumann, American Academy of Allergy, Asthma and Immunology, 555 East Wells Street, Suite 1100, Milwaukee, WI 53202-3823; e-mail, email@example.com.
Current Author Addresses: Dr. Wallace: 1240 SW 14th Avenue, Fort Lauderdale, FL 33312.
Dr. Dykewicz: Saint Louis University Allergy & Immunology, 1402 South Grand Boulevard, M157, St. Louis, MO 63104-1004.
Dr. Oppenheimer: UMDNJ–Rutgers, c/o Pulmonary and Allergy Associates, 1 Springfield Avenue, Summit, NJ 07901.
Dr. Portnoy: Section of Allergy, Asthma & Immunology, The Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, 2401 Gillham Road, Kansas City, MO 64108.
Dr. Lang: Cleveland Clinic, Respiratory Institute, Department of Allergy & Clinical Immunology, 9500 Euclid Avenue - A90, Cleveland, OH 44195.
Author Contributions: Conception and design: M.S. Dykewicz, J.M. Portnoy, D.M. Lang.
Analysis and interpretation of the data: D.V. Wallace, M.S. Dykewicz, J. Oppenheimer, J.M. Portnoy, D.M. Lang.
Drafting of the article: D.V. Wallace, M.S. Dykewicz, J. Oppenheimer, D.M. Lang.
Critical revision of the article for important intellectual content: D.V. Wallace, M.S. Dykewicz, J. Oppenheimer, J.M. Portnoy, D.M. Lang.
Final approval of the article: D.V. Wallace, M.S. Dykewicz, J. Oppenheimer, J.M. Portnoy, D.M. Lang.
Administrative, technical, or logistic support: D.V. Wallace, J. Oppenheimer, J.M. Portnoy, D.M. Lang.
Collection and assembly of data: D.V. Wallace, M.S. Dykewicz, J. Oppenheimer.
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.
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.
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)
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)
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)
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Wallace DV, Dykewicz MS, Oppenheimer J, et al. Pharmacologic Treatment of Seasonal Allergic Rhinitis: Synopsis of Guidance From the 2017 Joint Task Force on Practice Parameters. Ann Intern Med. 2017;167:876–881. [Epub ahead of print 28 November 2017]. doi: 10.7326/M17-2203
Download citation file:
Published: Ann Intern Med. 2017;167(12):876-881.
Published at www.annals.org on 28 November 2017
Endocrine and Metabolism, Guidelines.
Copyright © 2019 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use