2019 Aria Care Pathways For Allergen Immunotherapy
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Date
2019Author
Bousquet, Jean
Pfaar, Oliver
Togias, Alkis
Schuenemann, Holger J.
Ansotegui, Ignacio
Papadopoulos, Nikolaos G.
Tsiligianni, Ioanna
Agache, Ioana
Anto, Josep M.
Bachert, Claus
Bedbrook, Anna
Bergmann, Karl-Christian
Bosnic-Anticevich, Sinthia
Bosse, Isabelle
Brozek, Jan
Calderon, Moises A.
Canonica, Giorgio W.
Caraballo, Luigi
Cardona, Victoria
Casale, Thomas
Cecchi, Lorenzo
Chu, Derek
Costa, Elisio
Cruz, Alvaro A.
Czarlewski, Wienczyslawa
Durham, Stephen R.
Du Toit, George
Dykewicz, Mark
Ebisawa, Motohiro
Fauquert, Jean Luc
Fernandez-Rivas, Montserrat
Fokkens, Wytske J.
Fonseca, Joao
Fontaine, Jean-Francois
van Wijk, Roy Gerth
Haahtela, Tari
Halken, Susanne
Hellings, Peter W.
Ierodiakonou, Despo
Iinuma, Tomohisa
Carlos Ivancevich, Juan
Jacobsen, Lars
Jute, Marek
Kaidashev, Igor
Khaitov, Musa
Kalayci, Omer
Tebbe, Joerg Kleine
Klimek, Ludger
Kowalski, Marek L.
Kuna, Piotr
Kvedariene, Violeta
La Grutta, Stefania
Larenas-Linemann, Desiree
Lau, Susanne
Laune, Daniel
Le, Lan
Carlsen, Karin Lodrup
Lourenco, Olga
Malling, Hans-Jorgen
Marien, Gert
Menditto, Enrica
Mercier, Gregoire
Mullol, Joaquim
Muraro, Antonella
O'Hehir, Robyn
Okamoto, Yoshitaka
Pajno, Giovanni B.
Park, Hae-Sim
Panzner, Petr
Passalacqua, Giovanni
Pham-Thi, Nhan
Roberts, Graham
Pawankar, Ruby
Rolland, Christine
Rosario, Nelson
Ryan, Dermot
Samolinski, Boleslaw
Sanchez-Borges, Mario
Scadding, Glenis
Shamji, Mohamed H.
Sheikh, Aziz
Sturm, Gunter J.
Bom, Ana Todo
Toppila-Salmi, Sanna
Valentin-Rostan, Maryline
Valiulis, Arunas
Valovirta, Erkka
Ventura, Maria-Teresa
Wahn, Ulrich
Walker, Samantha
Wallace, Dana
Waserman, Susan
Yorgancioglu, Arzu
Zuberbier, Torsten
Grp, ARIA Working
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Show full item recordAbstract
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.