A Streamlined Treatment Algorithm for Allergic Rhinitis in the Arab Region: Expert Panel Opinion

Allergic rhinitis (AR) is a prevalent atopic condition that is frequently misdiagnosed, mistreated, or overlooked, despite its high prevalence and significant economic burden. Pharmacotherapy effectively controls symptoms in the majority of cases; however, the current local guidelines and recommendations are ambiguous regarding the initiation and cessation of combined antihistamines and intranasal corticosteroids treatment. Additionally, guidelines do not specify the duration of AR therapy or identify cases eligible for combination therapy. In contrast, the current era emphasizes personalized medicine, which considers genetic variants that may clinically alter the tolerance and intended outcome of specific drugs. Moreover, there has been a noticeable surge in the number of individuals affected by AR in the Arab region. A systematic treatment algorithm tailored to the Arab region's population is urgently needed. This consensus outlines the recommendations of experts from three scientific meetings that gathered specialists in otolaryngology, pediatrics, and immuno-allergology from Egypt, Tunisia, the Kingdom of Saudi Arabia, and the United Arab Emirates. The expert panel opinion encompassed pre-meeting surveys followed by discussions about diversified topics related to AR management in the Arab region, including AR diagnosis and disease characteristics, patient profiling, and conventional and advanced treatment options. The experts developed a streamlined algorithm to enhance decision-making for AR treatment in Arab countries, based on discussions and a comprehensive literature review. To our knowledge, this manuscript presents the first region-specific, consensus-based management algorithm tailored to the Arab region, addressing unique local considerations.