Current controversies and challenges in allergic rhinitis management.
There are many obstacles in the path of effective allergy management, in general, and allergic rhinitis (AR) control, in particular. Chief among them are: insufficient symptom relief in some patients provided by some currently considered first-line AR treatments in real life; an over-reliance on randomized controlled trials to direct AR guideline recommendations; the need for a broader interpretation of the AR evidence base (to include randomized controlled trials and real-life studies); poorly designed and interpreted studies; and lack of an AR control concept and common language of control. These controversies are fully reviewed here and challenging solutions have been presented.
a 1 Research in Real Life, Singapore, Singapore.
David
D
Price
b 2 Department of Clinical Medicine, Griffith University, Southport, Australia.
Pete
P
Smith
c 3 Department of Otorhinolaryngology, University Hospitals Leuven, Leuven, Belgium.
Peter
P
Hellings
d 4 Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
Nikos
N
Papadopoulos
e 5 Department of Otorhinolaryngology, Academic Medical Center (AMC) Amsterdam, Amsterdam, The Netherlands.
Wytske
W
Fokkens
f 6 Food Allergy Referral Centre, Veneto Region, Department of Women and Child Health, Padua University Hospital, Padua, Italy.
Antonella
A
Muraro
g 7 Medscript (Scientific & Medical Affairs), Dundalk, Ireland.
Ruth
R
Murray
h 8 Respiratory Effectiveness Group, Cambridge, UK.
Alison
A
Chisholm
i 9 Department of Pulmonology - Division of Allergy, University Hospital of Montpellier, Hôpital Arnaud de Villeneuve, France.
Pascal
P
Demoly
j 10 RNTNE Hospital, London, UK.
Glenis
G
Scadding
k 11 Hospital Clinic, IDIBAPS, CIBERES, Barcelona, Catalonia, Spain.
Joaquim
J
Mullol
l 12 University of Tennessee College of Medicine, Memphis, USA.
Phil
P
Lieberman
m 13 Upper Airways Research Laboratory (URL), University Hospital Ghent, Ghent, Belgium.
Claus
C
Bachert
n 14 Institute of Medical Statistics, Informatics, and Epidemiology, Medical Faculty, University of Köln, Cologne, Germany.
Ralph
R
Mösges
o 15 University of Edinburgh, Edinburgh, UK and Optimum Patient Care, Cambridge, UK.
Dermot
D
Ryan
p 16 University Hospital, Montpellier, France.|q 17 MACVIA-LR, Contre les Maladies Chronique spour un Vieillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, France.|r 18 INSERM, VIMA: Ageing and chronic diseases. Epidemiological and public health approaches, U1168, Paris, and UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, France.
Jean
J
Bousquet
D006801:Humans; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D065631:Rhinitis, Allergic / Q000276:immunology / Q000628:therapy*
allergic rhinitis; clinical relevance; control; guidelines; randomized controlled trials; real life