Update on pediatric allergic rhinitis: narrative review based on guideline updates

Area of Science:

• Pediatric Allergy and Immunology
• Respiratory Medicine
• Public Health

Background:

• Pediatric allergic rhinitis is a prevalent chronic condition in children and adolescents.
• It is closely linked to asthma, necessitating integrated management of the unified airway.
• Current guidelines emphasize evidence-based, stepwise, and patient-centered treatment strategies.

Purpose of the Study:

• To outline current evidence-based guidelines for managing pediatric allergic rhinitis.
• To detail recommended stepwise treatment strategies.
• To highlight considerations for pediatric patient management.

Main Methods:

• Review of recent guidelines from the Allergic Rhinitis and its Impact on Asthma (ARIA) and Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI).
• Analysis of randomized trial data and real-world evidence.
• Focus on a stepwise, control-oriented, patient-centered approach.

Main Results:

• Intranasal corticosteroids (INCS) are the first-line treatment for moderate to severe pediatric allergic rhinitis.
• Combination therapy (INCS + intranasal antihistamine) is recommended for inadequate symptom control with INCS alone.
• Oral antihistamines and intranasal antihistamines are options for mild disease or rapid relief; routine addition of oral antihistamines to INCS is not recommended.

Conclusions:

• Guideline-based management of pediatric allergic rhinitis is crucial for improving quality of life.
• Early diagnosis and appropriate treatment can reduce long-term respiratory morbidity.
• Pediatric management necessitates attention to age-specific factors, adherence, safety, and caregiver education.