Allergic Rhinitis

Risk assessment of asthma and allergic rhinitis in atopic dermatitis patients treated with biologics and JAK inhibitors: a systematic review and network meta-analysis of randomized controlled trials.

Zeng L, Zhou T, Zhang L, Xian M, Zhu Z, Liu J · BMC medicine · 2026 · n=69

Numerous emerging systemic therapies, including monoclonal antibodies and Janus kinase (JAK) inhibitors, are effective for atopic dermatitis (AD). However, their effects on the incidence of airway comorbidities like asthma and allergic rhinitis in AD patients remain unclear. This network meta-analysis evaluates and compares the risks of these adverse events among patients with AD receiving different biologics and systemic JAK inhibitors. PubMed, Cochrane Library, Embase, and Web of Science were searched for randomized controlled trials (RCTs) evaluating asthma and allergic rhinitis in AD patients receiving JAK inhibitors or biologics, from inception to January 4, 2025. Data synthesis employed a Bayesian network meta-analysis with random-effects modeling, using relative risk (RR) and 95% credible intervals (CI) as effect measures. Meta-regression assessed the impact of study design and participant characteristics on intervention effectiveness. The surface under the cumulative ranking c

Systematic review of maternal dietary patterns during pregnancy and offspring allergy.

Tan W, Amara S, Venter M, Wang L, Bodén S, Simonpietri Tesoro ME · Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2025

Individual studies indicate that maternal diet during pregnancy may be associated with child allergy outcomes. We performed a systematic review to summarize the available data focusing on overall maternal dietary intake rather than single foods and nutrients. Searches included PubMed, OVID Medline, Web of Science, and Embase up to November 28, 2024. Searches were not restricted by geographical location and included studies published in English only. The ROBINS-I Cochrane tool was used to assess risk of bias. Meta-analysis was conducted when ≥2 studies examined the same dietary pattern-outcome-age combination; a fixed- or random-effects model was used based on I2. When studies reported multiple effect sizes, a multilevel meta-analysis accounted for within-study clustering. We included 28 papers reporting on 29 diet patterns, indices, or diversity. Diet patterns included healthy and unhealthy diet patterns, healthy and unhealthy diet indices, and healthy and unhealthy diet diversi

Association between air pollution and allergic upper respiratory diseases: a meta-analysis.

Zhang ZQ, Li JY, Guo Q, Li YL, Bao YW, Song YQ · European respiratory review : an official journal of the European Respiratory Society · 2025 · n=647

The prevalence of allergic upper respiratory diseases is rising, and while air pollution may worsen them, study results vary, and comprehensive analyses are lacking. This study aimed to systematically evaluate the link between air pollution and these diseases (allergic rhinitis, asthma and chronic sinusitis (with/without nasal polyps)) to provide evidence for reducing their prevalence. A systematic search of PubMed, Embase, Web of Science and Scopus was conducted to find studies published up to 1 September 2024, regarding association between air pollution and allergic upper respiratory diseases. Meta-analyses calculated odds ratios and 95% confidence intervals for the outcomes. Sensitivity and subgroup analyses were performed to explore heterogeneity, and publication bias was assessed using Egger and Begg tests with funnel plots. We included 64 studies with 12 440 647 participants. The prevalence of allergic rhinitis, asthma and chronic sinusitis due to air pollution was

Mendelian Randomization Studies in Atopic Dermatitis: A Systematic Review.

Elhage KG, Kranyak A, Jin JQ, Haran K, Spencer RK, Smith PL · The Journal of investigative dermatology · 2024

Prior studies have found associations between atopic dermatitis (AD) and comorbidities, including depression, obesity, asthma, and allergic rhinitis. Although observational studies often cannot establish robust causality between potential risk factors and AD, Mendelian randomization minimizes confounding when exploring causality by relying on random allelic assortment at birth. In this study, we systematically reviewed 30 Mendelian randomization studies in AD. Body mass index, gut microbial flora, the IL-18 signaling pathway, and gastroesophageal reflux disease were among the causal factors for AD, whereas AD was causal for several medical conditions, including heart failure, rheumatoid arthritis, and conjunctivitis. These insights may improve preventive counseling in AD.

Complementary and Allergenic Food Introduction in Infants: An Umbrella Review.

Soriano VX, Ciciulla D, Gell G, Wang Y, Peters RL, McWilliam V · Pediatrics · 2023

Multiple systematic reviews examine the introduction of foods in relation to individual health outcomes, but the balance of harms and benefits has not been overviewed systematically. We aimed to perform an overview of systematic reviews on age of introduction of complementary and allergenic foods to the infant diet and long and short-term health outcomes. We searched Medline, Embase, Cochrane, and PubMed (July 25, 2022). Included systematic reviews examining the introduction of complementary or allergenic foods before age 1. Outcomes included allergic, autoimmune, and inflammatory diseases, neurodevelopment, nutrition, and weight. Extraction and quality assessment were performed in duplicate (A Measurement Tool to Assess Systematic Reviews) and strength of evidence was assessed. We screened 4015 articles and included 32 systematic reviews. There was moderate evidence that peanut and egg should be introduced from 4 to 11 months to prevent food allergy (6 of 10 reviews). Complementa

Health supplements for allergic rhinitis: A mixed-methods systematic review.

Pellow J, Nolte A, Temane A, Solomon EM · Complementary therapies in medicine · 2020

Allergic rhinitis is a chronic inflammatory condition caused by an exaggerated response of the immune system to common allergens. Most pharmacological therapies tend to be palliative and in some cases are associated with adverse effects. There is a growing tendency for people to self-medicate with health supplements as they are generally considered safe, however clinical studies relating to their efficacy and safety are limited. This mixed-methods systematic review aims to synthesise the available evidence relating to the treatment of allergic rhinitis with a variety of health supplements. A total of 57 062 articles were derived from searching seven online databases and evidence from 48 RCTs and 10 observational studies were reviewed for methodological quality and risk of bias. No qualitative studies meeting the inclusion criteria could be found, therefore only a quantitative review was performed. Promising evidence for the following single supplements were found: apple polyphenols, to

Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines-2024-2025 Revision: Part I-Guidelines on Intranasal Treatments.

Sousa-Pinto B, Bousquet J, Vieira RJ, Schünemann HJ, Zuberbier T, Bognanni A · Allergy · 2026

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. 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. Eleven guideline questions concerning intranasal treatments for AR were prioritized, leading to recommendations. Overall, these questions concern t

Practical guideline for the management of allergic rhinitis in Japan 2024.

Okano M, Okubo K, Gotoh M, Asako M, Ohta N, Kamijo A · Auris, nasus, larynx · 2025

The Practical Guideline for the Management of Allergic Rhinitis in Japan was first published in 1993. After the COVID-19 pandemic, the current 10th edition was published in 2024. The most recent collection of evidence from the literature, such as the sustained post-treatment effect of sublingual immunotherapy on Japanese cedar pollinosis, was added to the revised guideline, which incorporates evidence-based medicine. In this revised guideline, a diagram illustrating the pathogenesis of allergic rhinitis and the mechanisms of action of various pharmacological treatments has been added. Also included is a diagram that shows the mechanism of action of allergen immunotherapy and a more detailed description of the oral allergy syndrome. The clinical question and answer section was also revised along with the introduction of new questions, such as: Does anti-IgE antibody treatment effectively reduce the symptoms of severe seasonal allergic rhinitis? Also updated was the evidence-based step-b

Clinical practice guideline for acupuncture and moxibustion: Allergic rhinitis.

Du SH, Chen S, Wang SZ, Wang GQ, Du S, Guo W · Journal of integrative medicine · 2024

Acupuncture is one of the most effective complementary therapies for allergic rhinitis (AR) and has been recommended by several clinical practice guidelines (CPGs) for AR. However, these CPGs mentioned acupuncture without making recommendations for clinical implementation and therapeutic protocols, therefore limiting the applicability of acupuncture therapies for AR. Hence, for the benefit of acupuncture practitioners around the world, the World Federation of Acupuncture-moxibustion Societies have initiated a project to develop the CPG for the use of acupuncture and moxibustion to treat AR. This CPG was developed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, referring to the principles of the World Health Organization Handbook for Guideline Development. During the development of the CPG, the guideline development group (GDG) played an important role. The clinical questions, recommendations and therapeutic protocols were all for

Effect of prenatal high-dose vitamin D on childhood atopic dermatitis is modified by maternal cotinine metabolome: A secondary analysis of a randomized clinical trial.

Brustad N, Wang T, Chen L, Kaiser H, Gomes B, Klein A · Journal of the American Academy of Dermatology · 2026

Tobacco exposure has been shown to modulate the effect of vitamin D on the risk of atopic diseases. However, randomized clinical trials investigating the potential effect modification between tobacco exposure and vitamin D supplementation on atopic disease risk are lacking. We sought to investigate the potential effect modification from maternal tobacco exposure on the effect of prenatal high-dose vitamin D supplementation on the risk of child atopic dermatitis, asthma, and allergic rhinitis. A post hoc analysis in the double-blinded COPSAC2010 randomized clinical trial (NCT00856947) including 581 mother-child pairs randomized to 2800 IU/d (high-dose) versus 400 IU/d (standard-dose) from pregnancy week 24. Maternal blood metabolomic profiling was performed at inclusion, reflecting maternal tobacco exposure using a supervised sparse partial least squares model. We found a significant effect modification from the maternal cotinine metabolome score (Pinteraction < .01) where high-do

Clinical Efficacy of Probiotics for Allergic Rhinitis: Results of an Exploratory Randomized Controlled Trial.

Lungaro L, Malfa P, Manza F, Costanzini A, Valentini G, Squarzanti DF · Nutrients · 2024 · n=19

Background: Allergic Rhinitis (AR) is an atopic disease affecting the upper airways of predisposed subjects exposed to aeroallergens. This study evaluates the effects of a mix of specific probiotics (L. acidophilus PBS066, L. rhamnosus LRH020, B. breve BB077, and B. longum subsp. longum BLG240) on symptoms and fecal microbiota modulation in subjects with AR. Methods: Probiotic effects were evaluated at the beginning (T0), at four and eight weeks of treatment (T1 and T2, respectively), and after four weeks of follow-up from the end of treatment (T3) (n = 19) compared to the placebo group (n = 22). AR symptoms and quality of life were evaluated by the mini rhinitis quality of life questionnaire (MiniRQLQ) at each time point. Allergic immune response and fecal microbiota compositions were assessed at T0, T2, and T3. The study was registered on Clinical-Trial.gov (NCT05344352). Results: The probiotic group showed significant improvement in the MiniRQLQ score at T1, T2, and T3 vs. T0 (p &lt

Short-term influence of Immufen™ on mild allergic rhinitis: a randomized, double-blind, placebo-controlled study.

K M, Aryan MK, Prabhakaran P, Mulakal JN, Das S S, Im K · Frontiers in allergy · 2024

Allergic rhinitis (AR) is an IgE-mediated reaction to inhaled allergens, and is a prominent health concern affecting approximately 400 million people worldwide. A comprehensive understanding of AR's pathophysiology is imperative for developing novel therapies, especially considering its frequent co-morbidity with asthma and conjunctivitis. The escalating prevalence of AR is correlated with increased urbanization and environmental pollutants, recognized as prominent contributing factors. Dysregulation in immune networks, Th1/Th2 cytokine imbalance, activation of mast cells and eosinophils are implicated in AR progression. Classic AR symptoms include nasal congestion, nasal itching, rhinorrhea, and sneezing which significantly impact the quality of life, social interactions, and workplace productivity. This randomized, double-blind, placebo-controlled, three-arm, three-sequence study was aimed to assess the efficacy of supplementation of a co-delivery form of turmeric extract with ashwa

Efficacy and Safety of Combined Pharmacotherapies in Moderate-to-Severe Allergic Rhinitis: A Network Meta-Analysis.

Zhang Y, Zhang Z, Wang C, Zhang L · International forum of allergy & rhinology · 2025 · n=188

Combination pharmacotherapies are often selected for moderate-to-severe allergic rhinitis (AR), particularly when monotherapies do not control symptoms effectively. However, few studies have compared the efficacy and safety of different combination regimens. Therefore, we performed this study to investigate the clinical benefits of different combination strategies for moderate-to-severe AR. Electronic databases were searched (inception-May 31, 2024) for randomized controlled trials involving combination therapies for treating moderate-to-severe AR. The medication classes included intranasal corticosteroids (INCS), intranasal antihistamines (INAH), oral antihistamines (OAH), and oral leukotriene receptor antagonists (LTRA). A network meta-analysis with a random-effects model was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Forty-eight eligible studies with 17,188 participants were included. In this meta-analysis, INAH and INCS,

Dietary Bioactive Compounds and Their Role in Allergy Prevention: A Comprehensive Review.

Zafrilla P, Ballester P, Victoria-Montesinos D, Cerdá B, Marhuenda J, Arcusa R · Nutrients · 2025

Background/Objectives: Allergic diseases are highly prevalent worldwide and represent a significant public health burden. Current therapies mainly alleviate symptoms without addressing underlying immune dysfunction, which has increased interest in nutritional bioactive compounds as preventive or modulatory agents. This review summarizes evidence on omega-3 polyunsaturated fatty acids, vitamin D, curcumin, ginger bioactives, quercetin, and epigallocatechin gallate (EGCG) in allergy prevention and management. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science up to July 2025, including preclinical and clinical studies reporting immunological, mechanistic, and clinical outcomes. Results: Omega-3 fatty acids modulate Th2 responses, promote regulatory T cells, and generate specialized pro-resolving mediators, with modest clinical benefits observed in pregnancy and early life. Vitamin D contributes to immune tolerance and epithelial integrity, alth

Efficacy and safety of intranasal medications for allergic rhinitis: Network meta-analysis.

Sousa-Pinto B, Vieira RJ, Bognanni A, Gil-Mata S, Ferreira-da-Silva R, Ferreira A · Allergy · 2025

Intranasal antihistamines (INAH), corticosteroids (INCS), and their fixed combinations (INAH+INCS) are one of the cornerstones of the treatment of allergic rhinitis (AR). We performed a systematic review and network-meta-analysis comparing the efficacy and safety of INAH, INCS, and INAH+INCS in patients with AR. We searched four electronic bibliographic databases and three clinical trial databases for randomised controlled trials assessing the use of INAH, INCS, and INAH+INCS in adults with seasonal or perennial AR. We performed a network meta-analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality-of-Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence was assessed using GRADE-NMA. We included 167 primary studies, most of which assessed patients with seasonal AR. Among individual medications, azelastine-fluticasone, and fluticasone furoate were the most frequently highest-ranked int

Effectiveness of topical intranasal curcumin in the experimentally induced allergic rhinitis model in rats.

Demir E, Koten M, Keskin FEU, Eryıldız C, Güven SG · Allergologia et immunopathologia · 2026

Curcumin, a flavonoid derived from turmeric, has demonstrated antioxidant, anti-inflammatory, and anti-allergic effects. This study evaluated the therapeutic efficacy of intranasal curcumin in an allergic rhinitis (AR) rat model. Forty rats were randomized into five groups: a Sham control, an AR model with no treatment (negative control), an AR model treated with intranasal mometasone furoate (positive control), and an AR model treated with intranasal curcumin. Allergic symptoms (sneezing, itching, nasal discharge) were evaluated by both unblinded and blinded observers. Serum ovalbumin (OVA)-specific IgE levels were measured using ELISA. Nasal mucosal histopathology (edema, cilia loss, goblet cell hyperplasia, inflammation, eosinophilia) was assessed by light microscopy. Intranasal curcumin significantly improved histopathological findings and reduced allergic symptoms, with efficacy comparable to steroid treatment. Intranasal curcumin alleviated allergic rhinitis symptoms and inflamma

Effectiveness of topical intranasal curcumin in the experimentally induced allergic rhinitis model in rats (revised).

Demir E, Koten M, Keskin FEU, Eryıldız C, Güven SG · Allergologia et immunopathologia · 2026

Curcumin, a flavonoid derived from turmeric, has demonstrated antioxidant, anti-inflammatory, and antiallergic effects. This study evaluated the therapeutic efficacy of intranasal curcumin in an allergic rhinitis (AR) rat model. Forty rats were randomized into four groups: a sham control, an AR model with no treatment (negative control), an AR model treated with intranasal mometasone furoate (positive control), and an AR model treated with intranasal curcumin. Allergic symptoms (sneezing, itching, nasal discharge) were evaluated by both unblinded and blinded observers. Serum Ovalbumin (OVA)-specific IgE levels were measured using ELISA. Nasal mucosal histopathology (edema, cilia loss, goblet cell hyperplasia, inflammation, eosinophilia) was assessed by light microscopy. Intranasal curcumin significantly improved histopathological findings and reduced allergic symptoms, with efficacy comparable to steroid treatment. It alleviates AR symptoms and inflammation, suggesting a promising, low

Polypharmacological effects of honokiol on allergic rhinitis: Modulation of TMEM16A, TRPV1, and calcium signaling.

Phan HTL, Nam YR, Kim HJ, Van NTH, Vo NT, Woo J · Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2025

Allergic rhinitis (AR) affects approximately 400 million people globally and causes rhinorrhea, nasal congestion, and sneezing. Nonetheless, current treatments often provide incomplete relief and have side effects. Recent studies have indicated that various ion channels contribute to AR symptoms, suggesting that multichannel targeting may offer a more effective treatment. We first demonstrated that the inhibition of either ANO1 or ORAI1 channels individually alleviated symptoms in an ovalbumin-induced AR mouse model, with enhanced effects when both channels were targeted simultaneously. We then investigated whether honokiol, from magnolia bark, exhibited anti-AR effects by inhibiting multiple ion channels (ANO1, TRPV1, ORAI1). These effects were assessed using patch-clamp electrophysiology, calcium imaging, immune cell function assays (in T and mast cells), and in vivo studies. Honokiol inhibited all three ion channels with comparable potency (IC₅₀ values: ANO1, 7.50&#x

Allergies

NHS

This page provides information on allergies, including symptoms, causes, diagnosis, and treatment for allergic rhinitis.

Clinical, Multi-centre,Randomized, Double-blind, Placebo-controlled Subcutaneous Immunotherapy Trial With Depigmented, Polymerised Extract of Phleum Pratense Pollen on Patients With Hypersensitivity to Grass Pollen

n=153 · NCT00916422 · COMPLETED · COMPLETED

The objective of this trial is to assess the clinical efficacy of the modified extract (depigmented and polymerised with glutaraldehyde)of the subcutaneous injection of Phleum pratense pollen in the treatment of patients affected by allergic rhinitis/ rhinoconjunctivitis ( with or without episodic asthma) induced by hypersensitivity to grass pollen, evaluating the Score regarding Symptoms and consumption of the medication.

Effects of Hypertonic Saline Solution (NACL 3%+NAHCO3) on Nasal Inflammation in Children With Allergic Rhinitis. RinASol- Pilot Study (Allergic Rhinitis Solution)

n=30 · NCT02729012 · COMPLETED · COMPLETED

The main objective of RinASol project is to assess in patients with seasonal Allergic Rhinitis the effect of hypertonic saline solution NACL 3%+NAHCO3 vs the effect of standard saline solution on nasal inflammation by means of nasal cytology. The secondary objective is the symptom score assessment by T5SS Questionnaire (Total Symptom Score 5)

Randomized, Multicentric, Controlled Study on the Daily Use of Lipikar Balm AP From Birth in Infants at High Risk of Developing Atopic Dermatitis

n=2 · NCT01577628 · TERMINATED · TERMINATED

There is a lack of prospective scientific data on the regular use of moisturizers in patients at risk of developing atopic dermatitis. Although generally accepted and widely used for secondary prevention, emollients have not been studied as a primary prevention strategy. Strategies previously studied for the prevention of atopic dermatitis include maternal and child's dietary manipulations, allergens avoidance, delay of food introduction, exclusive breastfeeding and probiotic supplementation. Despite years of research, none of those strategies yielded to strong evidence of a protective effect. There is therefore a need to explore novel strategies. There is a need to compare the cumulative incidence rate of atopic dermatitis in newborns using a standard bathing and moisturizing routine with a good moisturizer to a non interventional group. This 2-year study will recruit approximately four hundred and sixty (460) pregnant women with a first degree relative of the child to be born who currently has (or previously had) a diagnosis of atopic dermatitis in order to study approximately 200 eligible newborns in each of the two study groups at the beginning of the study. Pregnant women will be randomized (1:1) to either daily use of the moisturizer Lipikar Balm AP (applied to their infant) starting from birth (Group 1) immediately after bathing or to no intervention (Group 2).

Allergic Rhinitis

TRIP Database

A clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their practice for allergic rhinitis.

TRIP Database search: Allergic Rhinitis

TRIP Database

The TRIP Database is a clinical search engine that allows users to quickly find high-quality research evidence to support practice and care. This search result page compiles various evidence sources related to allergic rhinitis.

Cochrane reviews on Allergic Rhinitis

Cochrane

Cochrane Library provides a collection of systematic reviews and meta-analyses on various interventions for allergic rhinitis, offering high-quality evidence.