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Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines-2024-2025 Revision: Part I-Guidelines on
Bernardo Sousa-Pinto1,2, Jean Bousquet3,4,5, Rafael José Vieira1,2
1MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Allergy
|December 1, 2025
Summary
New guidelines recommend intranasal corticosteroid and antihistamine combinations for allergic rhinitis (AR) treatment. These updated ARIA 2024-2025 recommendations aim to improve patient quality of life and productivity by guiding intranasal therapy choices.
Area of Science:
- Allergy and Immunology
- Pharmacology
- Evidence-Based Medicine
Background:
- Allergic rhinitis (AR) significantly impacts daily life and productivity.
- Mobile health (mHealth) data has enhanced the understanding of AR.
- These advancements led to an EAACI-endorsed update of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines for 2024-2025.
Purpose of the Study:
- To present the ARIA 2024-2025 guideline recommendations for intranasal treatments in AR.
- To provide evidence-based guidance for healthcare professionals and patients on selecting appropriate intranasal therapies.
Main Methods:
- Recommendations were developed using the GRADE evidence-to-decision framework.
- Evidence sources included systematic reviews, mHealth data, pharmacovigilance, and expert cost surveys.
- Eleven prioritized guideline questions focused on intranasal treatment choices for AR.
Main Results:
- Recommendations favor fixed intranasal antihistamine (INAH) + intranasal corticosteroid (INCS) combinations over INAH or INCS alone.
- Intranasal corticosteroids (INCS) are recommended over intranasal antihistamines (INAH).
- Four questions were new, and three saw changes in recommendation strength or direction.
Conclusions:
- The ARIA 2024-2025 guidelines aid in selecting intranasal treatments for AR.
- Treatment decisions must balance clinical variability, patient preferences, and medication costs.
- These recommendations support patients, caregivers, and healthcare providers in managing AR effectively.
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