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INCS is recommended by various guidelines for allergic rhinitis

ARIA 2016

ARIA 2016 1 
First-line treatment option for symptomatic patients with or without previous treatment.


AAOHNS 2015 2 
Recommended for patients with a clinical diagnosis of AR where symptoms affect QoL.

BSACI 2017

BSACI 2017 3 
Mainstay of anti-inflammatory intervention in AR and first-line therapy for moderate-to-severe persistent symptoms.


AAAAI / ACAAI 2017 4 
Strongly recommends first-line use in patients ≥12 years of age (over OAH and INCS combination and LTRA) in SAR.

BSACI Guidelines 2017 3

Visual representation of BSACI guidelines 2017

Adapted from BSACI guidelines 2017.3

Treatment of AR in children and teenagers5

Recommended treatment pattern for children and teenagers with Allergic Rhinitis
  • Approach depends on the severity of rhinitis symptoms
  • Use a step-up or step-down therapy, depending on control obtained in response to treatment
  • OAH may be better tolerated, INAH have a more rapid onset of action
  • Reconsider diagnosis if not controlled within 1 to 2 weeks


AAAAI: American Academy of Allergy, Asthma and Immunology; AAOHNS: American Academy of Otolaryngology - Head and Neck Surgery; ACAAI: American College of Allergy, Asthma, and Immunology; AH: Antihistamine; AR: Allergic rhinitis; ARIA: Allergic Rhinitis and its Impact on Asthma; BSACI: British Society for Allergy and Clinical Immunology; INAH: Intranasal antihistamine; INCS: Intranasal corticosteroids; LTRA: Leukotriene receptor antagonist; OAH: Oral antihistamine; QoL: Quality of life; Rx: Medical prescription; SAR: Seasonal allergic rhinitis.


  1. Brozek J, Bousquet J, Agache I, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017;140(4):950-958.
  2. Seidman M, Gurgel RK, Lin SY, et al. Clinical Practice Guideline: Allergic Rhinitis. Otolaryngol Head Neck Surg. 2015:152(18) S1-S43.
  3. Scadding GK, Kariyawasam HH, Scadding G, et al. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2017;47:856-889.
  4. Wallace DV, Dykewicz MS, Oppenheimer J, et al. Pharmacologic Treatment of Seasonal Allergic Rhinitis: Synopsis of Guidance from the 2017 Joint Task Force on Practice Parameters. Ann Intern Med. 2017;167(12):876-881.
  5. Santos A, Borrego LM, Rotiroti G, et al. The need for patient-focused therapy for children and teenagers with allergic rhinitis: a case-based review of current European practice. Clin Transl Allergy. 2015;5:2.

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