Executive summary: Japanese guidelines for allergic rhinitis 2020

Area of Science:

• Immunology
• Otolaryngology
• Clinical Medicine

Background:

• The Japanese Society of Allergology first published the Practical Guideline for the Management of Allergic Rhinitis in 1993.
• The 9th edition, published in 2020, represents a significant update incorporating the latest scientific evidence.

Purpose of the Study:

• To provide an updated, evidence-based guideline for the management of allergic rhinitis in Japan.
• To incorporate recent advancements in understanding disease mechanisms, diagnosis, and treatment options.

Main Methods:

• Systematic review of the latest scientific literature.
• Inclusion of new immunological insights, such as the role of regulatory T cells and type 2 innate lymphoid cells.
• Development of practical diagnostic and treatment strategies.

Main Results:

• Updated epidemiology of allergic rhinitis in Japan.
• Detailed mechanisms of allergic rhinitis, including onset and sensitization phases.
• Introduction of new pharmacotherapies (e.g., anti-IgE mAb), drug delivery systems for antihistamines, and sublingual immunotherapy options (dual immunotherapy).
• Revised classification for surgical interventions and specific treatment considerations for older adults.

Conclusions:

• The guideline provides a comprehensive, evidence-based approach to allergic rhinitis management.
• It emphasizes a step-by-step treatment strategy, integrating new therapeutic modalities.
• The updated guideline aims to improve patient outcomes through current best practices.