2019 ARIA Care pathways for allergen immunotherapy

被引：144

作者：

Bousquet, Jean ^{[1
,2
,3
,4
,5
,6
]}

Pfaar, Oliver ^{[7
]}

Togias, Alkis ^{[8
]}

Schuenemann, Holger J. ^{[9
]}

Ansotegui, Ignacio ^{[10
]}

Papadopoulos, Nikolaos G. ^{[11
,12
]}

Tsiligianni, Ioanna ^{[13
,14
]}

Agache, Ioana ^{[15
]}

Anto, Josep M. ^{[16
,17
,18
,19
]}

Bachert, Claus ^{[20
]}

Bedbrook, Anna ^{[1
]}

Bergmann, Karl-Christian ^{[21
,22
,23
]}

Bosnic-Anticevich, Sinthia ^{[24
]}

Bosse, Isabelle

Brozek, Jan ^{[9
]}

Calderon, Moises A. ^{[25
]}

Canonica, Giorgio W. ^{[26
]}

Caraballo, Luigi ^{[27
,28
]}

Cardona, Victoria ^{[29
,30
]}

Casale, Thomas ^{[31
]}

Cecchi, Lorenzo ^{[32
]}

Chu, Derek ^{[9
]}

Costa, Elisio ^{[33
,34
]}

Cruz, Alvaro A. ^{[35
,36
]}

Czarlewski, Wienczyslawa ^{[37
]}

Durham, Stephen R. ^{[38
]}

Du Toit, George ^{[39
]}

Dykewicz, Mark ^{[40
]}

Ebisawa, Motohiro ^{[41
]}

Fauquert, Jean Luc ^{[42
]}

Fernandez-Rivas, Montserrat ^{[43
]}

Fokkens, Wytske J. ^{[44
]}

Fonseca, Joao ^{[45
,46
]}

Fontaine, Jean-Francois

van Wijk, Roy Gerth ^{[47
]}

Haahtela, Tari ^{[48
]}

Halken, Susanne ^{[49
]}

Hellings, Peter W. ^{[50
,51
]}

Ierodiakonou, Despo ^{[13
,14
]}

Iinuma, Tomohisa ^{[52
]}

Carlos Ivancevich, Juan ^{[53
]}

Jacobsen, Lars ^{[54
]}

Jute, Marek ^{[55
]}

Kaidashev, Igor ^{[56
]}

Khaitov, Musa ^{[57
]}

Kalayci, Omer ^{[58
]}

Tebbe, Joerg Kleine ^{[59
]}

Klimek, Ludger ^{[60
]}

Kowalski, Marek L. ^{[61
,62
]}

Kuna, Piotr ^{[63
]}

机构：

[1] MACVIA France, Fondat Partenariale FMC VIA LR, Montpellier, France

[2] INSERM U1168, VIMA Ageing & Chron Dis Epidemiol & Publ Hlth App, Villejuif, France

[3] Univ Versailles St Quentin En Yvelines, UMR S 1168, Montigny Le Bretonneux, France

[4] Euforea, Brussels, Belgium

[5] Charite Univ Med Berlin, Humboldt Univ Berlin, Berlin, Germany

[6] Berlin Inst Hlth, Comprehens Allergy Ctr, Dept Dermatol & Allergy, Berlin, Germany

[7] Philipps Univ Marburg, Univ Hosp Marburg, Dept Otorhinolaryngol Head & Neck Surg, Sect Rhinol & Allergy, Marburg, Germany

[8] NIAID, DAIT, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA

[9] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Div Immunol & Allergy, Hamilton, ON, Canada

[10] Hosp Quironsalud Bizkaia, Bilbao, Spain

[11] Univ Manchester, Royal Manchester Childrens Hosp, Div Infect Immun & Resp Med, Manchester, Lancs, England

[12] Univ Athens, Athens Gen Childrens Hosp P&A Kyriakou, Allergy Dept, Pediat Clin 2, Athens, Greece

[13] Univ Crete, Fac Med, Dept Social Med, Iraklion, Greece

[14] Int Primary Care Resp Grp, Iraklion, Greece

[15] Transylvania Univ, Fac Med, Brasov, Romania

[16] ISGlobAL, Ctr Res Environm Epidemiol CREAL, Barcelona, Spain

[17] Hosp del Mar, IMIM, Res Inst, Barcelona, Spain

[18] Univ Pompeu Fabra, Barcelona, Spain

[19] CIBERESP, Barcelona, Spain

[20] Ghent Univ Hosp, ENT Dept, Upper Airways Res Lab, Ghent, Belgium

[21] Charite Univ Med Berlin, Dept Dermatol & Allergy, Berlin, Germany

[22] Free Univ Berlin, Comprehens Allergy Ctr, Berlin Inst Hlth, Berlin, Germany

[23] Humboldt Univ, GALEN, Berlin, Germany

[24] Univ Sydney, Woolcock Emphysema Ctr & Local Hlth Dist, Woolcock Inst Med Res, Glebe, NSW, Australia

[25] Imperial Coll London, Royal Brompton Hosp NHS, Natl Heart & Lung Inst, London, England

[26] Humanitas Univ, Humanitas Res Hosp, Personalized Med Clin Asthma & Allergy, Milan, Italy

[27] Univ Cartagena, Inst Immunol Res, Campus Zaragocilla, Cartagena, Colombia

[28] Fdn Dev Med & Biol Sci Fundemeb, Cartagena, Colombia

[29] Hosp Vall dHebron Barcelona, Dept Internal Med, Allergy Sect, Barcelona, Spain

[30] ARADyAL Res Network, Barcelona, Spain

[31] Univ S Florida, Div Allergy Immunol, Tampa, FL USA

[32] USL Toscana Ctr, SOS Allergol & Clin Immunol, Prato, Italy

[33] Univ Porto, Univ Porto AgeUPNetWork, Fac Pharm, REQUIMTE,UCIBIO, Porto, Portugal

[34] Univ Porto, Univ Porto AgeUPNetWork, Competence Ctr Act & Hlth Ageing, Porto, Portugal

[35] Univ Fed Bahia, ProAR Nucleo Excelencia Asma, Salvador, BA, Brazil

[36] WHO GARD Planning Grp, Salvador, BA, Brazil

[37] Med Consulting Czarlewski, Levallois Perret, France

[38] Imperial Coll London, Natl Heart & Lung Inst, Allergy & Clin Immunol Sect, London, England

[39] Kings Coll London, Guys & St Thomas NHS Trust, London, England

[40] St Louis Univ, Sch Med, Sect Allergy & Immunol, St Louis, MO USA

[41] Sagamihara Natl Hosp, Clin Res Ctr Allergy & Rheumatol, Sagamihara, Kanagawa, Japan

[42] CHU Clermont Ferrand Estaing, Unite Pneumoallergol Enfant, Pole Pediat, Clermont Ferrand, France

[43] Hosp Clin San Carlos, Allergy Dept, IdISSC, Madrid, Spain

[44] Acad Med Centres, Dept Otorhinolaryngol, Amsterdam, Netherlands

[45] Univ Porto, Ctr Res Hlth Technol & Informat Syst, CINTESIS, Fac Med, Porto, Portugal

[46] Medida Lda, Porto, Portugal

[47] Erasmus MC, Sect Allergol, Dept Internal Med, Rotterdam, Netherlands

[48] Univ Helsinki, Helsinki Univ Hosp, Skin & Allergy Hosp, Helsinki, Finland

[49] Odense Univ Hosp, Hans Christian Andersen Childrens Hosp, Odense, Denmark

[50] Univ Hosp Leuven, Dept Otorhinolaryngol, Leuven, Belgium

来源：

ALLERGY | 2019年 / 74卷 / 11期

基金：

英国医学研究理事会;

关键词：

allergen immunotherapy; asthma; children; mHealth; rhinitis; stratification; EAACI AIT GUIDELINES; SUBLINGUAL IMMUNOTHERAPY; COST-EFFECTIVENESS; DOUBLE-BLIND; SUBCUTANEOUS IMMUNOTHERAPY; EUROPEAN-UNION; RHINITIS; ASTHMA; MANAGEMENT; EFFICACY;

D O I：

10.1111/all.13805

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

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.

引用

页码：2087 / 2102

页数：16

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