2019 ARIA Care pathways for allergen immunotherapy.
Allergens
/ administration & dosage
Animals
Asthma
/ epidemiology
Attitude of Health Personnel
Biomarkers
Clinical Decision-Making
Comorbidity
Cost of Illness
Cost-Benefit Analysis
Critical Pathways
Desensitization, Immunologic
/ adverse effects
Disease Management
Disease Susceptibility
Humans
Practice Guidelines as Topic
Precision Medicine
/ methods
Rhinitis, Allergic
/ epidemiology
Treatment Outcome
allergen immunotherapy
asthma
children
mHealth
rhinitis
stratification
Journal
Allergy
ISSN: 1398-9995
Titre abrégé: Allergy
Pays: Denmark
ID NLM: 7804028
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
22
01
2019
revised:
19
02
2019
accepted:
22
02
2019
pubmed:
8
4
2019
medline:
4
9
2020
entrez:
8
4
2019
Statut:
ppublish
Résumé
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.
Substances chimiques
Allergens
0
Biomarkers
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2087-2102Subventions
Organisme : Medical Research Council
ID : G1000758
Pays : United Kingdom
Informations de copyright
© 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
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