Common characteristics of upper and lower airways in rhinitis and asthma: ARIA update, in collaboration with GA2LEN

A. A. Cruz, T. Popov, R. Pawankar, I. Annesi-Maesano, W. Fokkens, J. Kemp, K. Ohta, David Brendan Price, J. Bousquet, ARIA Initiative Scientific Committee

Research output: Contribution to journalEditorialpeer-review

235 Citations (Scopus)


This update aimed to review the new evidence available to support or refute prior Allergic Rhinitis and its Impact on Asthma (ARIA) statements. A Medline search of publications between 2000 and 2005 was conducted, with articles selected by experts. New evidence supports previous ARIA statements, such as: (i) allergic rhinitis (AR) is a risk factor for asthma; (ii) patients with persistent rhinitis should be evaluated for asthma; (iii) most patients with asthma have rhinitis; (iv) a combined strategy should be used to treat the airways and (v) in low- to middle-income countries, a different strategy may be needed. The increased risk of asthma has also been found among sufferers from non-AR. Recent reports show AR is a global problem. Many studies demonstrated parallel increasing prevalence of asthma and rhinitis, but in regions of highest prevalence, it may be reaching a plateau. Factors associated with a reduced risk of asthma and AR have been identified, confirming previous findings of protection related to exposure to infections. Treatment of rhinitis with intranasal glucocorticosteroids, antihistamines, leukotriene antagonists or immunotherapy may reduce morbidity because of asthma. To take advantage of the paradigm of unified airways, there is a need to rationalize diagnosis and treatment to optimize management.

Original languageEnglish
Pages (from-to)1-41
Number of pages41
Issue numbers84
Early online date8 Oct 2007
Publication statusPublished - Nov 2007

Bibliographical note

We are grateful to Anna Bedbrook for her administrative assistance.
Source of funding: Allergic Rhinitis and its Impact on Asthma Initiative, which is a nongovernment organization member of the Global Alliance against Chronic Respiratory Diseases. Member of GA2 LEN, supported by EU Framework programme for research, contract no. FOOD-CT-2004-506378.


  • allergy
  • asthma
  • atopy
  • review
  • rhinitis


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