Guideline recommendations on the use of allergen immunotherapy in house dust mite allergy: Time for a change?
Autor: | Jörg Kleine-Tebbe, G. Walter Canonica, Pascal Demoly, Dolores Hernandez Fernandez de Rojas, Lars-Olaf Cardell, Jean Bousquet, Moises A. Calderon |
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Přispěvatelé: | Imperial College London, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Allergy & Respiratory Diseases Clinic - DIMI, University of Genoa (UNIGE), Allergy and Asthma Center Westend (AAZW) |
Rok vydání: | 2016 |
Předmět: |
Allergen immunotherapy
medicine.medical_specialty Allergy [SDV]Life Sciences [q-bio] Immunology Desensitization treatment guidelines House dust mite 03 medical and health sciences 0302 clinical medicine Immunologic Dermatophagoides Hypersensitivity Immunology and Allergy Medicine Animals Humans In patient 030212 general & internal medicine Antigens Dermatophagoides Antigens Intensive care medicine Asthma Clinical Trials as Topic allergic rhinitis biology business.industry House dust mite allergy Pyroglyphidae Guideline biology.organism_classification medicine.disease allergy 3. Good health Clinical trial 030228 respiratory system Desensitization Immunologic Practice Guidelines as Topic business allergic asthma |
Zdroj: | Journal of Allergy and Clinical Immunology Journal of Allergy and Clinical Immunology, Elsevier, 2017, 140 (1), pp.41--52. ⟨10.1016/j.jaci.2017.01.049⟩ JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname |
ISSN: | 1097-6825 0091-6749 |
DOI: | 10.1016/j.jaci.2017.01.049⟩ |
Popis: | International audience; Guidelines on the treatment of asthma, allergic rhinitis (AR), and allergen immunotherapy (AIT) lack recommendations for house dust mite (HDM) allergy. An expert panel reviewed current guidelines in the light of new data to assess whether guidelines could be improved. Most guidelines and key position papers did not provide specific recommendations on treatment of allergic asthma (AA) caused by HDM allergy, although some included AIT as a treatment option for AA in general. Around half of the guidelines stated that AIT with HDM extract was an effective treatment for AR, with several indicating sublingual immunotherapy as an option. This heterogeneity is caused by quality issues affecting studies of AIT with perennial allergens in patients with AA and AR, including use of different diagnosis and severity criteria, lack of consistent scoring or grading systems for primary and safety outcomes, and lack of consensus on treatment parameters. There is a need for well-designed clinical trials to serve as a basis for guideline recommendations. Although results from recent studies strengthen the evidence base for the efficacy and safety of sublingual immunotherapy in patients with HDM-induced AA and AR, their effect on subsequent guideline updates will depend on the methodology and evidence model used by each guideline. |
Databáze: | OpenAIRE |
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