Practical guideline for the management of allergic rhinitis in Japan 2024

Mitsuhiro Okano; Kimihiro Okubo; Minoru Gotoh; Mikiya Asako; Nobuo Ohta; Atsushi Kamijo; Kayoko Kawashima; Masafumi Sakashita; Daiju Sakurai; Tetsuya Terada; Yuji Nakamaru; Takechiyo Yamada; Shuji Yonekura; Aiko Oka; Marie Yamada; Tomokazu Yoshizaki

doi:10.1016/j.anl.2025.05.005

Practical guideline for the management of allergic rhinitis in Japan 2024

Auris Nasus Larynx. 2025 Aug;52(4):426-441. doi: 10.1016/j.anl.2025.05.005. Epub 2025 Jun 21.

Authors

Affiliations

¹ Department of Otorhinolaryngology, International University of Health and Welfare School of Medicine, Narita, Japan. Electronic address: mokano@iuhw.ac.jp.
² Department of Otorhinolaryngology, Nippon Medical School, Tokyo, Japan.
³ Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University, Osaka, Japan.
⁴ Department of Otorhinolaryngology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
⁵ Kamijo Allergy & ENT Clinic, Nagano, Japan.
⁶ Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Habikino Medical Center, Habikino, Japan.
⁷ Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan.
⁸ Department of Otorhinolaryngology, Head and Neck Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan.
⁹ Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.
¹⁰ Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
¹¹ Department of Otorhinolaryngology, Head and Neck Surgery, Akita University, Graduate School of Medicine, Akita, Japan.
¹² Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
¹³ Department of Otorhinolaryngology, International University of Health and Welfare School of Medicine, Narita, Japan.
¹⁴ Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.

PMID: 40544726
DOI: 10.1016/j.anl.2025.05.005

Abstract

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-by-step strategy for treatment.

Keywords: Allergic rhinitis; Guideline; Mechanism of action of pharmacotherapy; Pollinosis; Sublingual immunotherapy.

Publication types

Practice Guideline

MeSH terms

COVID-19 / epidemiology
Desensitization, Immunologic
Humans
Japan
Rhinitis, Allergic* / therapy
Rhinitis, Allergic, Seasonal* / therapy
SARS-CoV-2
Sublingual Immunotherapy