Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines—2024–2025 Revision: Part II—Guidelines on Oral and Ocular Treatments
Issued Date
2026-01-01
Resource Type
ISSN
01054538
eISSN
13989995
Scopus ID
2-s2.0-105034087681
Journal Title
Allergy European Journal of Allergy and Clinical Immunology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Allergy European Journal of Allergy and Clinical Immunology (2026)
Suggested Citation
Vieira R.J., Sousa-Pinto B., Bousquet J., Schünemann H.J., Zuberbier T., Bognanni A., Togias A., Samolinski B., Valiulis A., Williams S., Bedbrook A., Czarlewski W., Torres M.J., Shamji M.H., Morais-Almeida M., Canonica G.W., Vecillas L.d.l., Dykewicz M.S., Jacomelli C., Klimek L., Leemann L., Lourenço O., Papadopoulos N.G., Pereira A.M., Savouré M., Toppila-Salmi S.K., Ventura M.T., Yepes-Nuñez J.J., Cruz A.A., Ciprandi G., Gemicioglu B., Giovannini M., Gradauskiene B., Jartti T., Jeseňák M., Kuna P., Kvedariene V., Larenas-Linnemann D.E., Latiff A.H.A., Mohammad Y., Ohta K., Mahesh P.A., Pali-Schöll I., Pfaar O., Regateiro F.S., Roche N., Taborda-Barata L., Ulrik C.S., Viegi G., Zhang L., Haahtela T., Cherrez-Ojeda I., Ivancevich J.C., Khaltaev N., Yorgancioglu A., Abdullah B., Al-Ahmad M., Al-Nesf M.A., Amaral R., Asllani J., Bergmann K.C., Bernstein J.A., Blaiss M.S., Toskala E., Carreiro-Martins P., Casale T., Cecchi L., Fiocchi A., Giuliano A.F.M., Christoff G., Cirule I., de Sousa J.C., Costa E.M., Devillier P., Hossny E., Iinuma T., Ispayeva Z., Julge K., Kaidashev I., Bennoor K.S., Kraxner H., Kull I., Kulus M., Kupczyk M., Kurchenko A., La Grutta S., Miculinic N., Tuyet L.L.T., Lee S.M., Montefort S., Moreira A., Mullol J., Nadif R., Nakonechna A., Neffen H.E., Niedoszytko M., O'Hehir R.E., Ogulur I., Okamoto Y., Olze H. Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines—2024–2025 Revision: Part II—Guidelines on Oral and Ocular Treatments. Allergy European Journal of Allergy and Clinical Immunology (2026). doi:10.1111/all.70305 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116020
Title
Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines—2024–2025 Revision: Part II—Guidelines on Oral and Ocular Treatments
Author(s)
Vieira R.J.
Sousa-Pinto B.
Bousquet J.
Schünemann H.J.
Zuberbier T.
Bognanni A.
Togias A.
Samolinski B.
Valiulis A.
Williams S.
Bedbrook A.
Czarlewski W.
Torres M.J.
Shamji M.H.
Morais-Almeida M.
Canonica G.W.
Vecillas L.d.l.
Dykewicz M.S.
Jacomelli C.
Klimek L.
Leemann L.
Lourenço O.
Papadopoulos N.G.
Pereira A.M.
Savouré M.
Toppila-Salmi S.K.
Ventura M.T.
Yepes-Nuñez J.J.
Cruz A.A.
Ciprandi G.
Gemicioglu B.
Giovannini M.
Gradauskiene B.
Jartti T.
Jeseňák M.
Kuna P.
Kvedariene V.
Larenas-Linnemann D.E.
Latiff A.H.A.
Mohammad Y.
Ohta K.
Mahesh P.A.
Pali-Schöll I.
Pfaar O.
Regateiro F.S.
Roche N.
Taborda-Barata L.
Ulrik C.S.
Viegi G.
Zhang L.
Haahtela T.
Cherrez-Ojeda I.
Ivancevich J.C.
Khaltaev N.
Yorgancioglu A.
Abdullah B.
Al-Ahmad M.
Al-Nesf M.A.
Amaral R.
Asllani J.
Bergmann K.C.
Bernstein J.A.
Blaiss M.S.
Toskala E.
Carreiro-Martins P.
Casale T.
Cecchi L.
Fiocchi A.
Giuliano A.F.M.
Christoff G.
Cirule I.
de Sousa J.C.
Costa E.M.
Devillier P.
Hossny E.
Iinuma T.
Ispayeva Z.
Julge K.
Kaidashev I.
Bennoor K.S.
Kraxner H.
Kull I.
Kulus M.
Kupczyk M.
Kurchenko A.
La Grutta S.
Miculinic N.
Tuyet L.L.T.
Lee S.M.
Montefort S.
Moreira A.
Mullol J.
Nadif R.
Nakonechna A.
Neffen H.E.
Niedoszytko M.
O'Hehir R.E.
Ogulur I.
Okamoto Y.
Olze H.
Sousa-Pinto B.
Bousquet J.
Schünemann H.J.
Zuberbier T.
Bognanni A.
Togias A.
Samolinski B.
Valiulis A.
Williams S.
Bedbrook A.
Czarlewski W.
Torres M.J.
Shamji M.H.
Morais-Almeida M.
Canonica G.W.
Vecillas L.d.l.
Dykewicz M.S.
Jacomelli C.
Klimek L.
Leemann L.
Lourenço O.
Papadopoulos N.G.
Pereira A.M.
Savouré M.
Toppila-Salmi S.K.
Ventura M.T.
Yepes-Nuñez J.J.
Cruz A.A.
Ciprandi G.
Gemicioglu B.
Giovannini M.
Gradauskiene B.
Jartti T.
Jeseňák M.
Kuna P.
Kvedariene V.
Larenas-Linnemann D.E.
Latiff A.H.A.
Mohammad Y.
Ohta K.
Mahesh P.A.
Pali-Schöll I.
Pfaar O.
Regateiro F.S.
Roche N.
Taborda-Barata L.
Ulrik C.S.
Viegi G.
Zhang L.
Haahtela T.
Cherrez-Ojeda I.
Ivancevich J.C.
Khaltaev N.
Yorgancioglu A.
Abdullah B.
Al-Ahmad M.
Al-Nesf M.A.
Amaral R.
Asllani J.
Bergmann K.C.
Bernstein J.A.
Blaiss M.S.
Toskala E.
Carreiro-Martins P.
Casale T.
Cecchi L.
Fiocchi A.
Giuliano A.F.M.
Christoff G.
Cirule I.
de Sousa J.C.
Costa E.M.
Devillier P.
Hossny E.
Iinuma T.
Ispayeva Z.
Julge K.
Kaidashev I.
Bennoor K.S.
Kraxner H.
Kull I.
Kulus M.
Kupczyk M.
Kurchenko A.
La Grutta S.
Miculinic N.
Tuyet L.L.T.
Lee S.M.
Montefort S.
Moreira A.
Mullol J.
Nadif R.
Nakonechna A.
Neffen H.E.
Niedoszytko M.
O'Hehir R.E.
Ogulur I.
Okamoto Y.
Olze H.
Author's Affiliation
Consiglio Nazionale delle Ricerche
Monash University
Københavns Universitet
Université Paris-Saclay
Karolinska Institutet
Uppsala Universitet
McMaster University
Universitat de Barcelona
Universität Zürich
Charité – Universitätsmedizin Berlin
University of Liverpool
Università degli Studi di Firenze
Universidade do Porto
AP-HP Assistance Publique - Hopitaux de Paris
National and Kapodistrian University of Athens
University of South Florida, Tampa
Università degli studi di Bari Aldo Moro
Chiba University
University of Cincinnati College of Medicine
Hospital Clínic de Barcelona
Itä-Suomen yliopisto
Sidney Kimmel Medical College
Univerzita Komenského v Bratislave
Medical University of Warsaw
National Institute of Allergy and Infectious Diseases (NIAID)
Tartu Ülikool
Medical College of Georgia
Universitat Pompeu Fabra Barcelona
Universidade Federal da Bahia
Universitätsmedizin Mainz
Vilniaus Universitetas
Semmelweis Egyetem
Université de Versailles Saint-Quentin-en-Yvelines
Kuwait University
Saint Louis University School of Medicine
National Heart and Lung Institute
Gdanski Uniwersytet Medyczny
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Humanitas Research Hospital
Istanbul University-Cerrahpasa
Turun Yliopistollinen Keskussairaala
IRCCS Ospedale Pediatrico Bambino Gesù
Faculdade de Medicina da Universidade do Porto (FMUP)
Imperial College Healthcare NHS Trust
Hvidovre Hospital
L-Università ta' Malta
Veterinarmedizinische Universitat Wien
İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine
Universitätsklinikum Gießen und Marburg, Standort Marburg
Humanitas University
Hamad Medical Corporation
Centro Hospitalar e Universitário de Coimbra
The Third Affiliated Hospital, Sun Yat-sen University
Institut Cochin
Hospital Regional Universitario Carlos Haya
Centre de Recherche en Épidémiologie et Santé des Populations
School of Medical Sciences, Universiti Sains Malaysia
Universidade de Coimbra, Faculdade de Medicina
Instituto de Salud Global de Barcelona
Istituto di Fisiologia Clinica del CNR
Södersjukhuset
Lietuvos Sveikatos Mokslų Universitetas
Centro Hospitalar Universitário de São João
Instituto de Investigación Sanitaria del Hospital Universitario La Paz
Bogomolets National Medical University
Scuola di Medicina
Escola de Medicina da Universidade do Minho
Central Lisbon University Hospital Center, EPE (CHULC)
Chiba University Hospital
Universidad Espíritu Santo
Jesseniuss Faculty of Medicine
Dankook University, College of Medicine
JSS Medical College & Hospital, Mysuru
Istituto di Scienze delle Produzioni Alimentari
Fundacion Santa Fe de Bogota
Comprehensive Health Research Centre
Centre for Innovative Biomedicine and Biotechnology
Asfendiyarov Kazakh National Medical University
Poltava State Medical University
Latakia University
Fundacion Clinica Medica Sur
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
Escola Superior de Saúde do Politécnico do Porto
Martinska Fakultna Nemocnica
Celal Bayar Üniversitesi Tip Fakültesi
'San Giovanni di Dio' Hospital
Skin and Allergy Hospital
Fukujuji Hospital
Faculty of Health Sciences
Universiteti i Mjekësisë, Tiranë
Uniwersytecki Szpital Kliniczny Nr 1 im. Norberta Barlickiego w Lodz
Universidad de Los Andes, Facultad de Medicina
Chiba Rosai Hospital
Bērnu klīniskā UniversItātes Slimnīca
NIHR Imperial Biomedical Research Centre
Pantai Holdings Sdn Bhd
Ain Shams University Children's Hospital
Meyer Children's Hospital IRCCS
Clinica Santa Isabel
Al-Sham Private University
University Medical Center
National Institute of Diseases of the Chest and Hospital
Hospital CUF Descobertas
Respiralab Research Group
Croatian Pulmonary Society
Instituto and Hospital CUF
Casa di Cura Villa Montallegro
Cova da Beira Hospital
Immunology and Respiratory Diseases
International Primary Care Respiratory Group
ARIA (Allergic Rhinitis and Its Impact on Asthma)
Center for Rhinology and Allergology
Clinic of Asthma
“Respiriamo Insieme” Association
Global NCD Platform
Bulgarian Alliance for Clinical and Translational Allergy
Monash University
Københavns Universitet
Université Paris-Saclay
Karolinska Institutet
Uppsala Universitet
McMaster University
Universitat de Barcelona
Universität Zürich
Charité – Universitätsmedizin Berlin
University of Liverpool
Università degli Studi di Firenze
Universidade do Porto
AP-HP Assistance Publique - Hopitaux de Paris
National and Kapodistrian University of Athens
University of South Florida, Tampa
Università degli studi di Bari Aldo Moro
Chiba University
University of Cincinnati College of Medicine
Hospital Clínic de Barcelona
Itä-Suomen yliopisto
Sidney Kimmel Medical College
Univerzita Komenského v Bratislave
Medical University of Warsaw
National Institute of Allergy and Infectious Diseases (NIAID)
Tartu Ülikool
Medical College of Georgia
Universitat Pompeu Fabra Barcelona
Universidade Federal da Bahia
Universitätsmedizin Mainz
Vilniaus Universitetas
Semmelweis Egyetem
Université de Versailles Saint-Quentin-en-Yvelines
Kuwait University
Saint Louis University School of Medicine
National Heart and Lung Institute
Gdanski Uniwersytet Medyczny
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Humanitas Research Hospital
Istanbul University-Cerrahpasa
Turun Yliopistollinen Keskussairaala
IRCCS Ospedale Pediatrico Bambino Gesù
Faculdade de Medicina da Universidade do Porto (FMUP)
Imperial College Healthcare NHS Trust
Hvidovre Hospital
L-Università ta' Malta
Veterinarmedizinische Universitat Wien
İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine
Universitätsklinikum Gießen und Marburg, Standort Marburg
Humanitas University
Hamad Medical Corporation
Centro Hospitalar e Universitário de Coimbra
The Third Affiliated Hospital, Sun Yat-sen University
Institut Cochin
Hospital Regional Universitario Carlos Haya
Centre de Recherche en Épidémiologie et Santé des Populations
School of Medical Sciences, Universiti Sains Malaysia
Universidade de Coimbra, Faculdade de Medicina
Instituto de Salud Global de Barcelona
Istituto di Fisiologia Clinica del CNR
Södersjukhuset
Lietuvos Sveikatos Mokslų Universitetas
Centro Hospitalar Universitário de São João
Instituto de Investigación Sanitaria del Hospital Universitario La Paz
Bogomolets National Medical University
Scuola di Medicina
Escola de Medicina da Universidade do Minho
Central Lisbon University Hospital Center, EPE (CHULC)
Chiba University Hospital
Universidad Espíritu Santo
Jesseniuss Faculty of Medicine
Dankook University, College of Medicine
JSS Medical College & Hospital, Mysuru
Istituto di Scienze delle Produzioni Alimentari
Fundacion Santa Fe de Bogota
Comprehensive Health Research Centre
Centre for Innovative Biomedicine and Biotechnology
Asfendiyarov Kazakh National Medical University
Poltava State Medical University
Latakia University
Fundacion Clinica Medica Sur
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
Escola Superior de Saúde do Politécnico do Porto
Martinska Fakultna Nemocnica
Celal Bayar Üniversitesi Tip Fakültesi
'San Giovanni di Dio' Hospital
Skin and Allergy Hospital
Fukujuji Hospital
Faculty of Health Sciences
Universiteti i Mjekësisë, Tiranë
Uniwersytecki Szpital Kliniczny Nr 1 im. Norberta Barlickiego w Lodz
Universidad de Los Andes, Facultad de Medicina
Chiba Rosai Hospital
Bērnu klīniskā UniversItātes Slimnīca
NIHR Imperial Biomedical Research Centre
Pantai Holdings Sdn Bhd
Ain Shams University Children's Hospital
Meyer Children's Hospital IRCCS
Clinica Santa Isabel
Al-Sham Private University
University Medical Center
National Institute of Diseases of the Chest and Hospital
Hospital CUF Descobertas
Respiralab Research Group
Croatian Pulmonary Society
Instituto and Hospital CUF
Casa di Cura Villa Montallegro
Cova da Beira Hospital
Immunology and Respiratory Diseases
International Primary Care Respiratory Group
ARIA (Allergic Rhinitis and Its Impact on Asthma)
Center for Rhinology and Allergology
Clinic of Asthma
“Respiriamo Insieme” Association
Global NCD Platform
Bulgarian Alliance for Clinical and Translational Allergy
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Oral and ocular medications are frequently used in the treatment of allergic rhinitis (AR). As part of the update of the Allergic Rhinitis and its Impact on Asthma (ARIA)-EAACI guidelines, this manuscript presents the ARIA-EAACI 2024–2025 recommendations for oral and ocular treatments. Methods: The ARIA-EAACI 2024–2025 guideline panel issued recommendations following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) evidence-to-decision framework. Several sources of evidence were used to inform panel judgements and recommendations, including systematic reviews, mHealth and pharmacovigilance data as well as a survey on costs. Results: Eight guideline questions concerning oral treatments for AR and three questions concerning ocular treatments were addressed. These questions led to the recommendations. Overall, these questions concern the choice between different classes of medication. They also discuss the role of oral antihistamines (OAH), leukotriene receptor antagonists (LTRA), ocular antihistamines (OcAH) and ocular mast cell stabilisers. Four questions had not been previously evaluated in ARIA guidelines, while, for the other four, there was a change in the strength or directionality of the recommendations. Overall, these guidelines recommend using intranasal corticosteroids over OAH and using OAH over LTRA. Moreover, they suggest using OAH over OcAH and suggest being against adding LTRA to OAH. Finally, considerations for choosing between different individual OAHs are presented. Conclusion: This ARIA-EAACI 2024–2025 article supports patients, their caregivers and healthcare professionals in choosing oral and ocular treatments for AR. Decisions on treatment should consider the clinical variability of the disease, patients' values and the affordability of medications.