ARIA Classification of Allergic Rhinitis

• The Allergic Rhinitis and its Impact on Asthma (ARIA) Classification system is used to categorize allergic rhinitis.¹²³
• Allergic rhinitis is classified by chronicity (either intermittent or persistent), as well as symptomatically (either mild or moderate-severe)
  1. Intermittent: Symptoms for less than 4 days per week or for less than 4 weeks in duration.
  2. Persistent: Symptoms for more than 4 days a week and for more than 4 weeks in duration.
  3. Mild: All of the following features:
     1. Normal sleep.
     2. No impairment of activities of daily living, sport, leisure.
     3. No impairment of work and school.
     4. Symptoms are not troublesome.
  4. Moderate-Severe: Any of the following features:
     1. Impaired sleep
     2. Impaired activities of daily living, sport, leisure.
     3. Impaired work or school.
     4. Troublesome symptoms.
• The ARIA classification supplanted the prior classification of allergic rhinitis into seasonal, perennial, or occupational.
• The reasons for this change were multifactorial:
  • Historically, perennial allergens were thought to be indoor (dust mites, insects, moulds, animal dander) while seasonal allergens were outdoor (such as grasses or pollens). However in some geographic areas, pollens and moulds can be perennial allergens.
  • Many patients are sensitized to many different allergens and will have perennial symptoms with seasonal exacerbations.
  • Allergens have a priming effect on nasal mucosa so symptoms may not be entirely concordant with the allergen season.

ARIA Classification of Allergic Rhinitis