TY - JOUR
T1 - 2019 ARIA Care pathways for allergen immunotherapy
AU - the ARIA Working Group
AU - Bousquet, Jean
AU - Pfaar, Oliver
AU - Togias, Alkis
AU - Schünemann, Holger J.
AU - Ansotegui, Ignacio
AU - Papadopoulos, Nikolaos G.
AU - Tsiligianni, Ioanna
AU - Agache, Ioana
AU - Anto, Josep M.
AU - Bachert, Claus
AU - Bedbrook, Anna
AU - Bergmann, Karl Christian
AU - Bosnic-Anticevich, Sinthia
AU - Bosse, Isabelle
AU - Brozek, Jan
AU - Calderon, Moises A.
AU - Canonica, Giorgio W.
AU - Caraballo, Luigi
AU - Cardona, Victoria
AU - Casale, Thomas
AU - Cecchi, Lorenzo
AU - Chu, Derek
AU - Costa, Elisio
AU - Cruz, Alvaro A.
AU - Czarlewski, Wienczyslawa
AU - Durham, Stephen R.
AU - Du Toit, George
AU - Dykewicz, Mark
AU - Ebisawa, Motohiro
AU - Fauquert, Jean Luc
AU - Fernandez-Rivas, Montserrat
AU - Fokkens, Wytske J.
AU - Fonseca, João
AU - Fontaine, Jean François
AU - Gerth van Wijk, Roy
AU - Haahtela, Tari
AU - Halken, Susanne
AU - Hellings, Peter W.
AU - Ierodiakonou, Despo
AU - Iinuma, Tomohisa
AU - Ivancevich, Juan Carlos
AU - Jacobsen, Lars
AU - Jutel, Marek
AU - Kaidashev, Igor
AU - Khaitov, Musa
AU - Kalayci, Omer
AU - Kleine Tebbe, Jörg
AU - Klimek, Ludger
AU - Kowalski, Marek L.
AU - Kuna, Piotr
N1 - Publisher Copyright:
© 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including healthcare professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow-up of patients.
AB - Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including healthcare professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow-up of patients.
KW - allergen immunotherapy
KW - asthma
KW - children
KW - mHealth
KW - rhinitis
KW - stratification
UR - https://www.scopus.com/pages/publications/85068241434
U2 - 10.1111/all.13805
DO - 10.1111/all.13805
M3 - Review article
C2 - 30955224
AN - SCOPUS:85068241434
SN - 0105-4538
VL - 74
SP - 2087
EP - 2102
JO - Allergy: European Journal of Allergy and Clinical Immunology
JF - Allergy: European Journal of Allergy and Clinical Immunology
IS - 11
ER -