TY - JOUR
T1 - EAACI Guidelines on Allergen Immunotherapy
T2 - Prevention of allergy
AU - Halken, Susanne
AU - Larenas-Linnemann, Desiree
AU - Roberts, Graham
AU - Calderón, Moises A
AU - Angier, Elisabeth
AU - Pfaar, Oliver
AU - Ryan, Dermot D
AU - Agache, Ioana
AU - Ansotegui, Ignacio J I J
AU - Arasi, Stefania
AU - Du Toit, George
AU - Fernandez-Rivas, Montserrat
AU - Geerth van Wijk, Roy
AU - Jutel, Marek
AU - Kleine-Tebbe, Jörg
AU - Lau, Susanne
AU - Matricardi, Paolo M
AU - Pajno, Giovanni B
AU - Papadopoulos, Nikolaos G
AU - Penagos, Martin
AU - Santos, Alexandra F
AU - Sturm, Gunter J
AU - Timmermans, Frans
AU - Van Ree, R
AU - Varga, Eva-Maria
AU - Wahn, Ulrich
AU - Kristiansen, Maria
AU - Dhami, Sangeeta
AU - Sheikh, Aziz
AU - Antonella, Muraro
N1 - This article is protected by copyright. All rights reserved.
PY - 2017/12
Y1 - 2017/12
N2 - Allergic diseases are common and frequently coexist. Allergen immunotherapy (AIT) is a disease-modifying treatment for IgE-mediated allergic disease with effects beyond cessation of AIT that may include important preventive effects. The European Academy of Allergy and Clinical Immunology (EAACI) has developed a clinical practice guideline to provide evidence-based recommendations for AIT for the prevention of (i) development of allergic comorbidities in those with established allergic diseases, (ii) development of first allergic condition, and (iii) allergic sensitization. This guideline has been developed using the Appraisal of Guidelines for Research & Evaluation (AGREE II) framework, which involved a multidisciplinary expert working group, a systematic review of the underpinning evidence, and external peer-review of draft recommendations. Our key recommendation is that a 3-year course of subcutaneous or sublingual AIT can be recommended for children and adolescents with moderate-to-severe allergic rhinitis (AR) triggered by grass/birch pollen allergy to prevent asthma for up to 2 years post-AIT in addition to its sustained effect on AR symptoms and medication. Some trial data even suggest a preventive effect on asthma symptoms and medication more than 2 years post-AIT. We need more evidence concerning AIT for prevention in individuals with AR triggered by house dust mites or other allergens and for the prevention of allergic sensitization, the first allergic disease, or for the prevention of allergic comorbidities in those with other allergic conditions. Evidence for the preventive potential of AIT as disease-modifying treatment exists but there is an urgent need for more high-quality clinical trials.
AB - Allergic diseases are common and frequently coexist. Allergen immunotherapy (AIT) is a disease-modifying treatment for IgE-mediated allergic disease with effects beyond cessation of AIT that may include important preventive effects. The European Academy of Allergy and Clinical Immunology (EAACI) has developed a clinical practice guideline to provide evidence-based recommendations for AIT for the prevention of (i) development of allergic comorbidities in those with established allergic diseases, (ii) development of first allergic condition, and (iii) allergic sensitization. This guideline has been developed using the Appraisal of Guidelines for Research & Evaluation (AGREE II) framework, which involved a multidisciplinary expert working group, a systematic review of the underpinning evidence, and external peer-review of draft recommendations. Our key recommendation is that a 3-year course of subcutaneous or sublingual AIT can be recommended for children and adolescents with moderate-to-severe allergic rhinitis (AR) triggered by grass/birch pollen allergy to prevent asthma for up to 2 years post-AIT in addition to its sustained effect on AR symptoms and medication. Some trial data even suggest a preventive effect on asthma symptoms and medication more than 2 years post-AIT. We need more evidence concerning AIT for prevention in individuals with AR triggered by house dust mites or other allergens and for the prevention of allergic sensitization, the first allergic disease, or for the prevention of allergic comorbidities in those with other allergic conditions. Evidence for the preventive potential of AIT as disease-modifying treatment exists but there is an urgent need for more high-quality clinical trials.
KW - Journal Article
KW - Review
UR - https://www.ncbi.nlm.nih.gov/pubmed/28902467
U2 - 10.1111/pai.12807
DO - 10.1111/pai.12807
M3 - Review
C2 - 28902467
SN - 0906-5784
VL - 28
SP - 728
EP - 745
JO - Pediatric Allergy and Immunology, Supplement
JF - Pediatric Allergy and Immunology, Supplement
IS - 8
ER -