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International consensus statement on allergy and rhinology: Allergic rhinitis - 2023

Wise SK 1 , Damask C 2 , Roland LT 3 , Ebert C 4 , Levy JM 1 , Lin S 5 Show all authors , Luong A 6 , Rodriguez K 7 , Sedaghat AR 8 , Toskala E 9 , Villwock J 10 , Abdullah B 11 , Akdis C 12 , Alt JA 13 , Ansotegui IJ 14 , Azar A 15 , Baroody F 16 , Benninger MS 17 , Bernstein J 18 , Brook C 19 , Campbell R 20 , Casale T 21 , Chaaban MR 22 , Chew FT 23 , Chambliss J 24 , Cianferoni A 25 , Custovic A 26 , Davis EM 27 , DelGaudio JM 1 , Ellis AK 28 , Flanagan C 1 , Fokkens WJ 29 , Franzese C 30 , Greenhawt M 31 , Gill A 32 , Halderman A 33 , Hohlfeld JM 34 , Incorvaia C 35 , Joe SA 36 , Joshi S 37 , Kuruvilla ME 38 , Kim J 39 , Klein AM 1 , Krouse HJ 40 , Kuan EC 41 , Lang D 42 , Larenas-Linnemann D 43 , Laury AM 44 , Lechner M 45 , Lee SE 46 , Lee VS 36 , Loftus P 47 , Marcus S 48 , Marzouk H 49 , Mattos J 50 , McCoul E 51 , Melen E 52 , Mims JW 53 , Mullol J 54 , Nayak JV 55 , Oppenheimer J 56 , Orlandi RR 13 , Phillips K 8 , Platt M 27 , Ramanathan M 39 , Raymond M 57 , Rhee CS 58 , Reitsma S 59 , Ryan M 33 , Sastre J 60 , Schlosser RJ 61 , Schuman TA 62 , Shaker MS 63 , Sheikh A 64 , Smith KA 13 , Soyka MB 65 , Takashima M 66 , Tang M 67 , Tantilipikorn P 68 , Taw MB 69 , Tversky J 15 , Tyler MA 70 , Veling MC 33 , Wallace D 71 , Wang Y 72 , White A 73 , Zhang L 74

Affiliations 

  • 1 Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
  • 2 Otolaryngology-HNS, Private Practice, University of Central Florida, Lake Mary, Florida, USA
  • 3 Otolaryngology-HNS, Washington University, St. Louis, Missouri, USA
  • 4 Otolaryngology-HNS, University of North Carolina, Chapel Hill, North Carolina, USA
  • 5 Otolaryngology-HNS, University of Wisconsin, Madison, Wisconsin, USA
  • 6 Otolaryngology-HNS, McGovern Medical School of the University of Texas, Houston, Texas, USA
  • 7 Otolaryngology-HNS, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
  • 8 Otolaryngology-HNS, University of Cincinnati, Cincinnati, Ohio, USA
  • 9 Otolaryngology-HNS, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  • 10 Otolaryngology-HNS, University of Kansas, Kansas City, Kansas, USA
  • 11 Otolaryngology-HNS, Universiti Sains Malaysia, Kubang, Kerian, Kelantan, Malaysia
  • 12 Immunology, Infectious Diseases, Swiss Institute of Allergy and Asthma Research, Davos, Switzerland
  • 13 Otolaryngology-HNS, University of Utah, Salt Lake City, Utah, USA
  • 14 Allergy/Immunology, Hospital Quironsalud Bizkala, Bilbao, Spain
  • 15 Allergy/Immunology, Johns Hopkins University, Baltimore, Maryland, USA
  • 16 Otolaryngology-HNS, University of Chicago, Chicago, Illinois, USA
  • 17 Otolaryngology-HNS, Cleveland Clinic, Cleveland, Ohio, USA
  • 18 Allergy/Immunology, University of Cincinnati, Cincinnati, Ohio, USA
  • 19 Otolaryngology-HNS, Harvard University, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  • 20 Otolaryngology-HNS, Macquarie University, Sydney, NSW, Australia
  • 21 Allergy/Immunology, University of South Florida College of Medicine, Tampa, Florida, USA
  • 22 Otolaryngology-HNS, Cleveland Clinic, Case Western Reserve University, Cleveland, Ohio, USA
  • 23 Allergy/Immunology, Genetics, National University of Singapore, Singapore, Singapore
  • 24 Allergy/Immunology, University of Texas Southwestern, Dallas, Texas, USA
  • 25 Allergy/Immunology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
  • 26 Pediatric allergy, Imperial College London, London, UK
  • 27 Otolaryngology-HNS, Boston University, Boston, Massachusetts, USA
  • 28 Allergy/Immunology, Queens University, Kingston, ON, Canada
  • 29 Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, Netherlands
  • 30 Otolaryngology-HNS, University of Missouri, Columbia, Missouri, USA
  • 31 Allergy/Immunology, Pediatrics, University of Colorado, Children's Hospital Colorado, Aurora, Colorado, USA
  • 32 Otolaryngology-HNS, University of Michigan, Ann Arbor, Michigan, USA
  • 33 Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
  • 34 Respiratory Medicine, Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Hannover Medical School, German Center for Lung Research, Hannover, Germany
  • 35 Allergy, Private Practice, Milan, Italy
  • 36 Otolaryngology-HNS, University of Illinois Chicago, Chicago, Illinois, USA
  • 37 Allergy/Immunology, Oregon Health and Science University, Portland, Oregon, USA
  • 38 Allergy/Immunology, Emory University, Atlanta, Georgia, USA
  • 39 Otolaryngology-HNS, Johns Hopkins University, Baltimore, Maryland, USA
  • 40 Otorhinolaryngology Nursing, University of Texas Rio Grande Valley, Edinburg, Texas, USA
  • 41 Otolaryngology-HNS, University of California Irvine, Orange, California, USA
  • 42 Allergy/Immunology, Cleveland Clinic, Cleveland, Ohio, USA
  • 43 Allergy/Immunology, Pediatric, Medica Sur Clinical Foundation and Hospital, Mexico City, Mexico
  • 44 Otolaryngology-HNS, Bellevue ENT, Bellevue, Washington, USA
  • 45 Otolaryngology-HNS, University College London, Barts Health NHS Trust, London, UK
  • 46 Otolaryngology-HNS, Brigham and Women's Hospital, Boston, Massachusetts, USA
  • 47 Otolaryngology-HNS, University of California San Francisco, San Francisco, California, USA
  • 48 Otolaryngology-HNS, Stony Brook University, Stony Brook, New York, USA
  • 49 Otolaryngology-HNS, State University of New York Upstate, Syracuse, New York, USA
  • 50 Otolaryngology-HNS, University of Virginia, Charlottesville, Virginia, USA
  • 51 Otolaryngology-HNS, Ochsner Clinic, New Orleans, Louisiana, USA
  • 52 Pediatric Allergy, Karolinska Institutet, Stockholm, Sweden
  • 53 Otolaryngology-HNS, Wake Forest University, Winston Salem, North Carolina, USA
  • 54 Otorhinolaryngology, Hospital Clinic Barcelona, Barcelona, Spain
  • 55 Otolaryngology-HNS, Stanford University, Palo Alto, California, USA
  • 56 Allergy/Immunology, Rutgers, State University of New Jersey, Newark, New Jersey, USA
  • 57 Otolaryngology-HNS, Mayo Clinic, Jacksonville, Florida, USA
  • 58 Rhinology/Allergy, Seoul National University Hospital and College of Medicine, Seoul, Korea
  • 59 Otolaryngology-HNS, University of Amsterdam, Amsterdam, Netherlands
  • 60 Allergy, Fundacion Jiminez Diaz, University Autonoma de Madrid, Madrid, Spain
  • 61 Otolaryngology-HNS, Medical University of South Carolina, Charleston, South Carolina, USA
  • 62 Otolaryngology-HNS, Virginia Commonwealth University, Richmond, Virginia, USA
  • 63 Allergy/Immunology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
  • 64 Primary Care, University of Edinburgh, Edinburgh, Scotland
  • 65 Otolaryngology-HNS, University of Zurich, University Hospital of Zurich, Zurich, Switzerland
  • 66 Otolaryngology-HNS, Houston Methodist Academic Institute, Houston, Texas, USA
  • 67 Allergy/Immunology, University of California San Francisco, San Francisco, California, USA
  • 68 Rhinology/Allergy, Mahidol University, Siriraj Hospital, Bangkok, Thailand
  • 69 Integrative East-West Medicine, University of California Los Angeles, Westlake Village, California, USA
  • 70 Otolaryngology-HNS, University of Minnesota, Minneapolis, Minnesota, USA
  • 71 Allergy/Immunology, Nova Southeastern University, Ft. Lauderdale, Florida, USA
  • 72 Otolaryngology-HNS, National University of Singapore, Singapore, Singapore
  • 73 Allergy/Immunology, Scripps Clinic, San Diego, California, USA
  • 74 Otolaryngology-HNS, Beijing Tongren Hospital, Beijing, China
Int Forum Allergy Rhinol, 2023 Apr;13(4):293-859.
PMID: 36878860 DOI: 10.1002/alr.23090

Abstract

BACKGROUND: In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR-Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR-Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence-based findings and recommendation from the full document.

METHODS: ICAR-Allergic Rhinitis 2023 employed established evidence-based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work.

RESULTS: ICAR-Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost.

CONCLUSION: The ICAR-Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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