FAQ: The ARISE Trial

Published

Thursday, March 20, 2025 - 12:01 PM

What is hay fever or allergic rhinitis?

Hay fever, or allergic rhinitis, is a long-term inflammatory condition that affects about one-quarter of Australians. It’s triggered by the nose and/or eyes coming into contact with allergens in the environment, which causes the immune system to react. Hay fever may be:

• Seasonal: occurring during specific seasons usually in spring and summer triggered by outdoor pollens from grasses, weeds or trees
• Perennial: occurring year-round triggered by indoor allergens such as house dust mites, animal dander and mould
• Perennial with seasonal exacerbations
• Occupational: triggered by allergens in the workplace.

When a person with hay fever comes into contact with an allergen, their immune system mistakenly identifies it as a threat and produces an antibody called immunoglobulin E, or IgE, to neutralise it. The IgE antibodies then attach themselves to a type of immune cell called mast cells, which are found in your nose, eyes and lungs. When the allergen comes into contact with IgE antibodies on mast cells, it triggers the release of histamine and other mediators, causing inflammation and the symptoms of hay fever, experts explain. 

What are common hay fever symptoms?

Symptoms can vary, but often include sneezing, itchy eyes and a runny or blocked nose. Hay fever can also contribute to sinus and ear infections, snoring, poor sleep and asthma, as well as decreased mental health and underperformance at school and work.

Why does hay fever most commonly start in adolescence or young adulthood?

The long-term inflammatory condition affects all age groups, however the majority of allergy symptoms experienced by young people are attributable to allergic rhinitis, including 10 per cent of one to 14 year olds and 21 per cent of 15 to 24 year olds.

Many people develop symptoms as a teenager or young adult due to a range of genetic, hormone and environmental factors. NACE experts explain:

• Genetics: Our genes underpin our risk of hay fever, and whether this and other related allergic diseases persist. For instance, babies with the skin condition eczema (known as atopic dermatitis) have a three times greater risk of developing hay fever (and asthma) later in life. Having a food allergy in childhood is also a risk factor for developing hay fever later in life. For example, in the case of a peanut allergy, that risk is more than five times greater.
• Hormones: Hormonal changes at puberty may also help drive the onset of hay fever. This may relate to sex hormones, such as oestrogen and progesterone, affecting histamine levels, immune regulation, and the response of cells in the lining of the nose and lower airways.
• Environment: Some people develop hay fever as an adult simply because they’ve had more time to become sensitised to specific allergens. Migration or moving to a new location can also change someone’s risk of developing hay fever. This may be due to exposure to different pollens, climate and weather, green space and/or air quality factors.

How common is hay fever?

Hay fever is the country’s most common allergic disease now affecting 24 per cent of Australians, up from 15 per cent in 2008, according to the Australian Bureau of Statistics. Prevalence rates appear to be increasing year-on-year and are the highest in the south-eastern parts of the country, affecting up to 30 per cent of people living in the ACT, 23 per cent in Victoria, 14 per cent in the Northern Territory and 15 per cent in Queensland.

Why has there been an increase in hay fever cases in Australia?

Climate change is a contributing factor for the unpredictable pollen seasons predisposing more people to pollen allergens, according to NACE experts. Pollen count data shows an uptick in seasonal loads of pollen in the air in subtropical environments. The spring pollen season starts earlier in temperate climates, causing problems for seasonal allergic rhinitis sufferers, while summer grasses are now flowering and weed pollen will flower until around April in some places. Perennial hay fever sufferers are triggered by indoor allergens like house dust mites and pet dander all year round.

How common is hay fever globally?

Worldwide, allergic rhinitis affects between 10 and 30 per cent of the population.

Is there a cure for hay fever?

There is no cure for hay fever but it can be controlled. First, you need to see your doctor to have it diagnosed and understand what the triggers are, then your doctor or pharmacist can help recommend the best treatment options for you.

How is hay fever diagnosed?

Diagnosis requires a clinical history of allergen-triggered symptoms and evidence of associated aeroallergen sensitisation, which is confirmed with either a skin prick test or serological test of allergen-specific immunoglobulin E (IgE).

How is hay fever treated?

A doctor or pharmacist can recommend treatments for hay fever. If you have mild, occasional hay fever symptoms, you could take non-drowsy antihistamines such as tablets, syrups, nasal sprays, eye drops, and saline nasal sprays and rinses. These can be bought at the pharmacy.

For more severe or persistent symptoms, intranasal steroid sprays, or an intranasal spray containing a steroid combined with antihistamine, are the most effective treatments. However, it is important to use these regularly and correctly.

Allergen immunotherapy (AIT), also known as desensitisation, is a long-term treatment option for people with severe symptoms. It changes the way the immune system reacts to allergens, such as pollens and dust mites, and involves taking regular, gradually increasing amounts of allergen extracts by injections or sublingual (under the tongue) tablets, sprays or drops.

What is the ARISE trial?

Allergic Rhinitis Improvement through Strategic Education: The ARISE Trial aims to improve how young people manage hay fever.

To help tackle the chronic condition, 18 general practices and allergy clinics across Australia have partnered with the National Allergy Centre of Excellence (NACE), hosted at Murdoch Children’s Research Institute (MCRI), to launch the ARISE Trial.

The clinical trial is seeking 14 to 29 year olds with hay fever, with participants to follow a specifically designed education package alongside their daily nasal spray. The trial will explore whether they experience less symptoms and have better quality of life. 

Over three months, participants will complete three online surveys and video calls with the study team. Researchers will monitor whether the group records better outcomes than those who only receive the standard education from their doctor.

If successful, the trial will change the way hay fever is managed, reducing the burden on those living with the disease, their families and the healthcare system. 

What is included in the trial’s education package?

NACE allergy experts, in collaboration with the National Allergy Council (NAC), Allergy & Anaphylaxis Australia (A&AA) and the Australasian Society of Clinical Immunology and Allergy (ASCIA), have developed a toolkit for a group of young people to follow during the trial. This includes weekly electronic alerts on how and when to use intranasal steroid spray, their region’s pollen count, tips for managing symptoms and the latest research.

Why is better education about hay fever important?

Research suggests improving education about how to manage hay fever is urgently required, especially for young adults when it comes to effectively using their treatment medication.

Who can take part in the trial?

Participants must be aged between 14 to 29 at the time of enrolment, have doctor-diagnosed hay fever, be recommended combination nasal spray treatment (RYALTRIS Nasal Spray or DYMISTA 125/50 Nasal Spray), and be given an ASCIA Allergic Rhinitis Treatment Plan.

What’s involved?

Every participant will receive a $50 voucher at the end of the study! Participants need to:

• Complete three short online questionnaires
• Attend three video calls with the study team
• Have a skin-prick and blood test
• Follow the educational resources provided 

How can people get involved?

If you are between 14 and 29 and have been diagnosed with – or think you have – hay fever, the first step is to contact a participating clinic.

If you are eligible, your doctor or allergist will give you a flyer with a QR code. Follow the code to complete an online form, which connects you with the study team.

*A referral from your GP may be required to attend a specialist site. **Private consultation fees may be charged at some sites. ***Some sites may only accept certain age groups. A receptionist at the site can help clarify these details for you.

What clinics are involved?

General practices and allergy clinics in every state and territory across Australia are recruiting participants. Recruitment capacity at each site will depend on demand and resources.

• Victoria: The Alfred, Melbourne Allergy Asthma & Immunology Consultants, Goulburn Valley Health, Melbourne Allergy Centre & Children’s Specialists (MACCS), The Royal Children’s Hospital and Latrobe Regional Health.

• South Australia: Adelaide Allergy and Immunology Centre.

• Western Australia: Perth Allergy.

• Northern Territory: Royal Darwin Hospital, Darwin Children’s Clinic and Territory Medical Group.

• Queensland: Compass Immunology Clinic (Main Clinic, Mount Gravatt, Compass Kids, Toowoomba),Allergy Medical Centre Townsville and Specialist Network Benowa.

• NSW: Campbelltown Hospital and Trinity Medical Centre Wagga.

• ACT: Canberra Allergy.

• Tasmania: Allergy Tasmania.

How can other clinics become a recruitment site?

If you are a GP or allergist and would like to find out how to become a recruitment site for the ARISE Trial, please complete this form or email [email protected] as soon as possible.

Why is Australia the allergy capital of the world?

Australia is the allergy capital of the world with an estimated five million people living with allergic disease. Researchers have identified several risk factors, including infant diet and eczema. Other environmental factors and factors related to our modern lifestyle may also be contributing.

Learn more about The ARISE Trial and follow the NACE on X and LinkedIn for more allergy research news.