Duration of Allergen Immunotherapy for Long-Term Efficacy in Allergic Rhinoconjunctivitis.

Autor: Penagos M; Allergy and Clinical Immunology, Division of Respiratory Science, National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital Imperial College London, Dovehouse Street, London, SW3 6LY UK., Eifan AO; Allergy and Clinical Immunology, Division of Respiratory Science, National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital Imperial College London, Dovehouse Street, London, SW3 6LY UK., Durham SR; Allergy and Clinical Immunology, Division of Respiratory Science, National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital Imperial College London, Dovehouse Street, London, SW3 6LY UK., Scadding GW; Allergy and Clinical Immunology, Division of Respiratory Science, National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital Imperial College London, Dovehouse Street, London, SW3 6LY UK.
Jazyk: angličtina
Zdroj: Current treatment options in allergy [Curr Treat Options Allergy] 2018; Vol. 5 (3), pp. 275-290. Date of Electronic Publication: 2018 Aug 31.
DOI: 10.1007/s40521-018-0176-2
Abstrakt: Rationale: Subcutaneous and sublingual immunotherapy are effective for allergic rhinitis. An important question is whether allergen immunotherapy provides a sustained clinical effect after treatment cessation. In view of potential side effects, cost and the necessary patient commitment, long-term benefit is an important consideration for the recommendation of immunotherapy over standard pharmacotherapy.
Purpose of Review: In this review, we analyse the existing evidence for long-term effects of both routes of administration in the context of double-blind, placebo-controlled, randomised clinical trials that included a follow-up phase of at least 1 year after treatment cessation.
Recent Findings: Overall, evidence suggests that 3 years of either subcutaneous or sublingual immunotherapy result in clinical benefit and immunological changes consistent with allergen-specific tolerance sustained for at least 2-3 years after treatment cessation.
Summary: The data presented here support recommendations in international guidelines that both routes of administration should be continued for a minimum of 3 years. Gaps in the evidence remain regarding the long-term efficacy of immunotherapy for perennial rhinitis and studies performed in children.
Competing Interests: SR Durham has received consultancy fees from manufacturers of allergy vaccines, including ALK Abello Denmark, Allergy Therapeutics UK, Anergis Switzerland, Asics Biotech Belgium, Biomay Austria, and from Boehringer Ingelheim Germany and Glaxo Smith Kline UK and lecture fees from Med Update GmBH Germany. GW Scadding has received lecture fees from ALK Abello Denmark and Glaxo Smith Kline UK. M Penagos has received personal fees from Stallergenes and ALK outside the submitted work. Aarif O. Eifan declares that he has no competing interests.This article contains reference to studies of clinical trials and mechanistic studies in human subjects undergoing allergen immunotherapy that were performed by the authors of this manuscript. All such studies were performed with approval of the national ethics committee in UK and with the written informed consent of the participants.
Databáze: MEDLINE
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