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Cited by 322Allergic Rhinitis and SensitizationAsthma and respiratory diseasesSinusitis and nasal conditions

Non‐allergic rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology

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Hellings, P. W., Klimek, L., Cingi, C., Agache, I., Akdis, C., Bachert, C., Bousquet, J., Demoly, P. +19 more·2017·Allergy
DOI 10.1111/all.13200
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Abstract

This EAACI position paper aims at providing a state‐of‐the‐art overview on nonallergic rhinitis ( NAR ). A significant number of patients suffering from persistent rhinitis are defined as nonallergic noninfectious rhinitis ( NANIR ) patients, often denominated in short as having NAR . NAR is defined as a symptomatic inflammation of the nasal mucosa with the presence of a minimum of two nasal symptoms such as nasal obstruction, rhinorrhea, sneezing, and/or itchy nose, without clinical evidence of endonasal infection and without systemic signs of sensitization to inhalant allergens. Symptoms of NAR may have a wide range of severity and be either continuously present and/or induced by exposure to unspecific triggers, also called nasal hyperresponsiveness ( NHR ). NHR represents a clinical feature of both AR and NAR patients. NAR involves different subgroups: drug‐induced rhinitis, (nonallergic) occupational rhinitis, hormonal rhinitis (including pregnancy rhinitis), gustatory rhinitis, senile rhinitis, and idiopathic rhinitis ( IR ). NAR should be distinguished from those rhinitis patients with an allergic reaction confined to the nasal mucosa, also called “entopy” or local allergic rhinitis ( LAR ). We here provide an overview of the current consensus on phenotypes of NAR , recommendations for diagnosis, a treatment algorithm, and defining the unmet needs in this neglected area of research.

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  • Intranasal corticosteroids are first-line drugs for treating nonallergic rhinitis.

    “They are also the first-line drugs for treating NAR [135].”

    From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [135]

    The therapeutic algorithm (section 8; page unavailable) recommends tailoring treatment to the NAR phenotype, not using intranasal corticosteroids as first-line drugs for NAR generally. It says most randomized trials of local corticosteroids in NAR showed a lack of efficacy, although inflammatory phenotypes may benefit. (LLM, conf=0.88)

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Authors
Hellings, P. W., Klimek, L., Cingi, C., Agache, I., Akdis, C., Bachert, C., Bousquet, J., Demoly, P., Gevaert, P., Hox, V., Hupin, C., Kalogjera, L., Manole, F., Mösges, R., Mullol, J., Muluk, N. B., Muraro, A., Papadopoulos, N., Pawankar, R., Rondon, C., Rudenko, M., Seys, S. F., Toskala, E., Van Gerven, L., Zhang, L., Zhang, N., & Fokkens, W. J.
Affiliations
  • Universitair Ziekenhuis Leuven (BE)
  • Zentrum für Rhinologie und Allergologie (DE)
  • Eskişehir Osmangazi University (TR)
  • Transilvania University of Brașov (RO)
  • Swiss Institute of Allergy and Asthma Research Christine Kuhne-Center for Allergy Research and Education University of Zurich Davos Switzerland
  • Ghent University Hospital (BE)
  • Centre Hospitalier Universitaire de Montpellier (FR)
  • Cliniques Universitaires Saint-Luc (BE)
  • Sisters of Charity Hospital (HR)
  • University of Oradea (RO)
  • Institute of Medical Statistics, Informatics, and Epidemiology Medical Faculty University of Köln Cologne Germany
  • Hospital Clínic de Barcelona (ES)
  • Kırıkkale University (TR)
  • University of Padua (IT)
  • National and Kapodistrian University of Athens (GR)
  • Nippon Medical School (JP)
  • Allergy Service Carlos Haya Hospital Malaga Spain
  • London Allergyology and Immunology Center London UK
  • KU Leuven (BE)
  • Department of Otorhinolaryngology-Head and Neck Surgery Temple University Philadelphia USA
  • Clinical division of Otorhinolaryngology Head & Neck Surgery University Hospitals Leuven Leuven Belgium
  • Beijing Tongren Hospital (CN)
  • Amsterdam UMC Location University of Amsterdam (NL)
Corresponding author
Hellings, P. W.
ORCID
Venue
Allergy
Publisher
Wiley
Published
2017-06-02
Volume
72
Issue
11
Pages
1657-1665
ISSN
  • 0105-4538 (ISSN-L)
  • 1398-9995
DOI
10.1111/all.13200
OpenAlex
W4245191120
Cited by
322
References
8
Citations by year
2026: 23 · 2025: 36 · 2024: 34 · 2023: 37 · 2022: 49 · 2021: 41 · 2020: 44 · 2019: 27 · 2018: 23 · 2017: 6
FWCI
22.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Allergy (publishedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • HAL (submittedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion)
  • DIAL (Catholic University of Leuven) (submittedVersion)
  • Lirias (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Topics
  • Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
Keywords
non-allergic rhinitis, nasal hyperreactivity, drug-induced rhinitis, occupational rhinitis, vasomotor rhinitis, local allergic rhinitis, nasal mucosa inflammation, diagnosis, treatment algorithm, phenotypes

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