Yang Song-I, Lee Il Hwan, Kim Minji, Ryu Gwanghui, Kang Sung-Yoon, Kim Mi-Ae, Lee Sang Min, Kim Hyun-Jung, Park Do-Yang, Lee Yong Ju, Kim Dong-Kyu, Kim Soo Whan, Kim Do Hyun, Jun Young Joon, Park Sang Chul, Kim Bong-Seong, Chung Soo Jie, Lee Hyun Jong, Kim Hyo-Bin, Choi Jeong-Hee, Choi Gil-Soon, Yang Hyeon-Jong
Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
Allergy Asthma Immunol Res. 2023 Jan;15(1):19-31. doi: 10.4168/aair.2023.15.1.19.
The prevalence of allergic rhinitis (AR) and the socioeconomic burden associated with the medical cost and quality of life (QOL) of AR have progressively increased. Therefore, practical guidelines for the appropriate management of AR need to be developed based on scientific evidence while considering the real-world environment, values, and preferences of patients and physicians. The Korean Academy of Asthma, Allergy and Clinical Immunology revised clinical guidelines of AR to address key clinical questions of the management of AR. Part 1 of the revised guideline covers the pharmacological management of patients with AR in Korea. Through a meta-analysis and systematic review, we made 4 recommendations for AR pharmacotherapy, including intranasal corticosteroid (INCS)/intranasal antihistamine (INAH) combination therapy, oral antihistamine/INCS combination therapy, leukotriene receptor antagonist treatment in AR patients with asthma, and prophylactic treatment for patients with pollen-induced AR. However, all recommendations are conditional because of the low or very low evidence of certainty. Well-designed and strictly executed randomized controlled trials are needed to measure and report appropriate outcomes.
过敏性鼻炎(AR)的患病率以及与AR的医疗成本和生活质量(QOL)相关的社会经济负担已逐渐增加。因此,需要在考虑患者和医生的现实环境、价值观及偏好的同时,依据科学证据制定AR适当管理的实用指南。韩国哮喘、过敏与临床免疫学会修订了AR临床指南,以解决AR管理的关键临床问题。修订指南的第1部分涵盖了韩国AR患者的药物治疗。通过荟萃分析和系统评价,我们对AR药物治疗提出了4项建议,包括鼻内皮质类固醇(INCS)/鼻内抗组胺药(INAH)联合治疗、口服抗组胺药/INCS联合治疗、哮喘合并AR患者的白三烯受体拮抗剂治疗以及花粉诱导性AR患者的预防性治疗。然而,由于证据确定性低或非常低,所有建议都是有条件的。需要设计良好且严格执行的随机对照试验来测量和报告适当的结果。