Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines—2024–2025 Revision: Part I—Guidelines on Intranasal Treatments
Issued Date
2026-04-01
Resource Type
ISSN
01054538
eISSN
13989995
Scopus ID
2-s2.0-105034634931
Pubmed ID
41324154
Journal Title
Allergy European Journal of Allergy and Clinical Immunology
Volume
81
Issue
4
Start Page
954
End Page
976
Rights Holder(s)
SCOPUS
Bibliographic Citation
Allergy European Journal of Allergy and Clinical Immunology Vol.81 No.4 (2026) , 954-976
Suggested Citation
Sousa-Pinto B., Bousquet J., Vieira R.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., Palamarchuk Y., 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., Rostan M.V., Viegi G., Zhang L., Haahtela T., Cherrez-Ojeda I., Carlos Ivancevich J., 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., Braido F., Camargos P., Carreiro-Martins P., Casale T., Cecchi L., Fiocchi A., Giuliano A.F.M., Christoff G., Cirule I., de Sousa J.C., Costa E.M., Del Giacco S., Devillier P., Dokic D., Hossny E., Iinuma T., Irani C., 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., Makris M., Milenkovic B., Lee S.M., Montefort S., Moreira A., Mullol J. Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines—2024–2025 Revision: Part I—Guidelines on Intranasal Treatments. Allergy European Journal of Allergy and Clinical Immunology Vol.81 No.4 (2026) , 954-976. 976. doi:10.1111/all.70131 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116042
Title
Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines—2024–2025 Revision: Part I—Guidelines on Intranasal Treatments
Author(s)
Sousa-Pinto B.
Bousquet J.
Vieira R.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.
Palamarchuk Y.
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.
Rostan M.V.
Viegi G.
Zhang L.
Haahtela T.
Cherrez-Ojeda I.
Carlos Ivancevich J.
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.
Braido F.
Camargos P.
Carreiro-Martins P.
Casale T.
Cecchi L.
Fiocchi A.
Giuliano A.F.M.
Christoff G.
Cirule I.
de Sousa J.C.
Costa E.M.
Del Giacco S.
Devillier P.
Dokic D.
Hossny E.
Iinuma T.
Irani C.
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.
Makris M.
Milenkovic B.
Lee S.M.
Montefort S.
Moreira A.
Mullol J.
Bousquet J.
Vieira R.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.
Palamarchuk Y.
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.
Rostan M.V.
Viegi G.
Zhang L.
Haahtela T.
Cherrez-Ojeda I.
Carlos Ivancevich J.
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.
Braido F.
Camargos P.
Carreiro-Martins P.
Casale T.
Cecchi L.
Fiocchi A.
Giuliano A.F.M.
Christoff G.
Cirule I.
de Sousa J.C.
Costa E.M.
Del Giacco S.
Devillier P.
Dokic D.
Hossny E.
Iinuma T.
Irani C.
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.
Makris M.
Milenkovic B.
Lee S.M.
Montefort S.
Moreira A.
Mullol J.
Author's Affiliation
Imperial College London
Consiglio Nazionale delle Ricerche
Københavns Universitet
Université Paris-Saclay
Karolinska Institutet
Uppsala Universitet
McMaster University
Universitat de Barcelona
Universität Zürich
Charité – Universitätsmedizin Berlin
Università degli Studi di Firenze
Universidade do Porto
AP-HP Assistance Publique - Hopitaux de Paris
National and Kapodistrian University of Athens
Università degli Studi di Genova
Universidade Federal de Minas Gerais
University of South Florida, Tampa
Chiba University
University of Cincinnati College of Medicine
Hospital Clínic de Barcelona
Itä-Suomen yliopisto
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
IRCCS San Martino Polyclinic Hospital
Semmelweis Egyetem
Kuwait University
Saint Louis University School of Medicine
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Humanitas Research Hospital
Medical University of Sofia
Turun Yliopistollinen Keskussairaala
IRCCS Ospedale Pediatrico Bambino Gesù
Faculdade de Medicina da Universidade do Porto (FMUP)
Universidade da Beira Interior
Belgrade University School of Medicine
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
Institut Cochin
Hospital Regional Universitario Carlos Haya
Centre de Recherche en Épidémiologie et Santé des Populations
School of Medical Sciences, Universiti Sains Malaysia
Finnish Meteorological Institute
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)
Hôtel-Dieu de France 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
Azienda Ospedaliero Universitaria di Cagliari
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
Beijing Institute of Otorhinolaryngology
Celal Bayar Üniversitesi Tip Fakültesi
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
Bērnu klīniskā UniversItātes Slimnīca
Pantai Holdings Sdn Bhd
Hospital CUF Descobertas
Ain Shams University Children's Hospital
USL Toscana Centro
Clinica Santa Isabel
University Medical Center
National Institute of Diseases of the Chest and Hospital
Center for Rhinology and Allergology
Medical Consulting Czarlewski
University Teaching Hospital in Martin
Croatian Pulmonary Society
Instituto and Hospital CUF
Cova da Beira University Hospital Centre
Al-Sham Private University
International Primary Care Respiratory Group
Respiralab Research Group
ARIA (Allergic Rhinitis and Its Impact on Asthma)
University Clinic of Pulmology and Allergy
Clinic of Asthma
Meyer Children's Hospital IRCCS
Latín American Society of Allergy
Global NCD Platform
“Respiriamo Insieme” Association
Allergology Department
Consiglio Nazionale delle Ricerche
Københavns Universitet
Université Paris-Saclay
Karolinska Institutet
Uppsala Universitet
McMaster University
Universitat de Barcelona
Universität Zürich
Charité – Universitätsmedizin Berlin
Università degli Studi di Firenze
Universidade do Porto
AP-HP Assistance Publique - Hopitaux de Paris
National and Kapodistrian University of Athens
Università degli Studi di Genova
Universidade Federal de Minas Gerais
University of South Florida, Tampa
Chiba University
University of Cincinnati College of Medicine
Hospital Clínic de Barcelona
Itä-Suomen yliopisto
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
IRCCS San Martino Polyclinic Hospital
Semmelweis Egyetem
Kuwait University
Saint Louis University School of Medicine
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Humanitas Research Hospital
Medical University of Sofia
Turun Yliopistollinen Keskussairaala
IRCCS Ospedale Pediatrico Bambino Gesù
Faculdade de Medicina da Universidade do Porto (FMUP)
Universidade da Beira Interior
Belgrade University School of Medicine
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
Institut Cochin
Hospital Regional Universitario Carlos Haya
Centre de Recherche en Épidémiologie et Santé des Populations
School of Medical Sciences, Universiti Sains Malaysia
Finnish Meteorological Institute
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)
Hôtel-Dieu de France 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
Azienda Ospedaliero Universitaria di Cagliari
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
Beijing Institute of Otorhinolaryngology
Celal Bayar Üniversitesi Tip Fakültesi
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
Bērnu klīniskā UniversItātes Slimnīca
Pantai Holdings Sdn Bhd
Hospital CUF Descobertas
Ain Shams University Children's Hospital
USL Toscana Centro
Clinica Santa Isabel
University Medical Center
National Institute of Diseases of the Chest and Hospital
Center for Rhinology and Allergology
Medical Consulting Czarlewski
University Teaching Hospital in Martin
Croatian Pulmonary Society
Instituto and Hospital CUF
Cova da Beira University Hospital Centre
Al-Sham Private University
International Primary Care Respiratory Group
Respiralab Research Group
ARIA (Allergic Rhinitis and Its Impact on Asthma)
University Clinic of Pulmology and Allergy
Clinic of Asthma
Meyer Children's Hospital IRCCS
Latín American Society of Allergy
Global NCD Platform
“Respiriamo Insieme” Association
Allergology Department
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Allergic rhinitis (AR) impacts quality of life, work and school productivity. Over the last years, an important body of evidence resulting from mHealth data has led to a better understanding of AR. Such advances have motivated an EAACI-endorsed update of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines (ARIA 2024–2025). This manuscript presents the ARIA 2024–2025 recommendations for intranasal treatments, one of the mainstays for AR management. Methods: The ARIA 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 judgments and recommendations, including systematic reviews, evaluation of mHealth and pharmacovigilance data, as well as a survey of experts on costs. Results: Eleven guideline questions concerning intranasal treatments for AR were prioritized, leading to recommendations. Overall, these questions concern the choice between different classes of intranasal medications—most notably, intranasal corticosteroids (INCS), antihistamines (INAH), fixed combinations of INAH+INCS and decongestants—or between different individual medications within each class. Four questions had not been evaluated in previous ARIA guidelines, while for the other three there was a change in the strength or directionality of recommendations. Overall, recommendations point to the suggested use of INAH+INCS over INAH or INCS and INCS over INAH. Conclusion: This ARIA 2024–2025 article supports patients, their caregivers, and healthcare professionals in choosing an intranasal treatment. However, decisions on AR treatment should consider the clinical variability of the disease, patients' values, and the affordability of medications.