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2019 ARIA Care pathways for allergen immunotherapy

(2019) ALLERGY. 74(11). p.2087-2102
Author
Organization
Abstract
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.
Keywords
allergen immunotherapy, asthma, children, mHealth, rhinitis, stratification KeyWords Plus:EAACI AIT GUIDELINES, SUBLINGUAL IMMUNOTHERAPY, COST-EFFECTIVENESS, DOUBLE-BLIND, SUBCUTANEOUS IMMUNOTHERAPY, EUROPEAN-UNION, RHINITIS, ASTHMA, MANAGEMENT, EFFICACY

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MLA
Bousquet, Jean, et al. “2019 ARIA Care Pathways for Allergen Immunotherapy.” ALLERGY, vol. 74, no. 11, 2019, pp. 2087–102.
APA
Bousquet, J., Pfaar, O., Togias, A., Schünemann, H. J., Ansotegui, I., Papadopoulos, N. G., … Zuberbier, T. (2019). 2019 ARIA Care pathways for allergen immunotherapy. ALLERGY, 74(11), 2087–2102.
Chicago author-date
Bousquet, Jean, Oliver Pfaar, Alkis Togias, Holger J Schünemann, Ignacio Ansotegui, Nikolaos G Papadopoulos, Ioanna Tsiligianni, et al. 2019. “2019 ARIA Care Pathways for Allergen Immunotherapy.” ALLERGY 74 (11): 2087–2102.
Chicago author-date (all authors)
Bousquet, Jean, Oliver Pfaar, Alkis Togias, Holger J Schünemann, Ignacio Ansotegui, Nikolaos G Papadopoulos, Ioanna Tsiligianni, Ioana Agache, Josep M Anto, Claus Bachert, Anna Bedbrook, Karl‐Christian Bergmann, Sinthia Bosnic‐Anticevich, Isabelle Bosse, Jan Brozek, Moises A Calderon, Giorgio W Canonica, Luigi Caraballo, Victoria Cardona, Thomas Casale, Lorenzo Cecchi, Derek Chu, Elisio Costa, Alvaro A Cruz, Wienczyslawa Czarlewski, Stephen R Durham, George Du Toit, Mark Dykewicz, Motohiro Ebisawa, Jean Luc Fauquert, Montserrat Fernandez‐Rivas, Wytske J Fokkens, João Fonseca, Jean‐François Fontaine, Roy Gerth van Wijk, Tari Haahtela, Susanne Halken, Peter Hellings, Despo Ierodiakonou, Tomohisa Iinuma, Juan Carlos Ivancevich, Lars Jacobsen, Marek Jutel, Igor Kaidashev, Musa Khaitov, Omer Kalayci, Jörg Kleine Tebbe, Ludger Klimek, Marek L Kowalski, Piotr Kuna, Violeta Kvedariene, Stefania La Grutta, Désirée Larenas‐Linemann, Susanne Lau, Daniel Laune, Lan Le, Karin Lodrup Carlsen, Olga Lourenço, Hans‐Jørgen Malling, Gert Marien, Enrica Menditto, Gregoire Mercier, Joaquim Mullol, Antonella Muraro, Robyn O’Hehir, Yoshitaka Okamoto, Giovanni B Pajno, Hae‐Sim Park, Petr Panzner, Giovanni Passalacqua, Nhan Pham‐Thi, Graham Roberts, Ruby Pawankar, Christine Rolland, Nelson Rosario, Dermot Ryan, Bolesław Samolinski, Mario Sanchez‐Borges, Glenis Scadding, Mohamed H Shamji, Aziz Sheikh, Gunter J Sturm, Ana Todo Bom, Sanna Toppila‐Salmi, Maryline Valentin‐Rostan, Arunas Valiulis, Erkka Valovirta, Maria‐Teresa Ventura, Ulrich Wahn, Samantha Walker, Dana Wallace, Susan Waserman, Arzu Yorgancioglu, and Torsten Zuberbier. 2019. “2019 ARIA Care Pathways for Allergen Immunotherapy.” ALLERGY 74 (11): 2087–2102.
Vancouver
1.
Bousquet J, Pfaar O, Togias A, Schünemann HJ, Ansotegui I, Papadopoulos NG, et al. 2019 ARIA Care pathways for allergen immunotherapy. ALLERGY. 2019;74(11):2087–102.
IEEE
[1]
J. Bousquet et al., “2019 ARIA Care pathways for allergen immunotherapy,” ALLERGY, vol. 74, no. 11, pp. 2087–2102, 2019.
@article{8648886,
  abstract     = {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.},
  author       = {Bousquet, Jean and Pfaar, Oliver and Togias, Alkis and Schünemann, Holger J and Ansotegui, Ignacio and Papadopoulos, Nikolaos G and Tsiligianni, Ioanna and Agache, Ioana and Anto, Josep M and Bachert, Claus and Bedbrook, Anna and Bergmann, Karl‐Christian and Bosnic‐Anticevich, Sinthia and Bosse, Isabelle and Brozek, Jan and Calderon, Moises A and Canonica, Giorgio W and Caraballo, Luigi and Cardona, Victoria and Casale, Thomas and Cecchi, Lorenzo and Chu, Derek and Costa, Elisio and Cruz, Alvaro A and Czarlewski, Wienczyslawa and Durham, Stephen R and Du Toit, George and Dykewicz, Mark and Ebisawa, Motohiro and Fauquert, Jean Luc and Fernandez‐Rivas, Montserrat and Fokkens, Wytske J and Fonseca, João and Fontaine, Jean‐François and Gerth van Wijk, Roy and Haahtela, Tari and Halken, Susanne and Hellings, Peter and Ierodiakonou, Despo and Iinuma, Tomohisa and Ivancevich, Juan Carlos and Jacobsen, Lars and Jutel, Marek and Kaidashev, Igor and Khaitov, Musa and Kalayci, Omer and Kleine Tebbe, Jörg and Klimek, Ludger and Kowalski, Marek L and Kuna, Piotr and Kvedariene, Violeta and La Grutta, Stefania and Larenas‐Linemann, Désirée and Lau, Susanne and Laune, Daniel and Le, Lan and Lodrup Carlsen, Karin and Lourenço, Olga and Malling, Hans‐Jørgen and Marien, Gert and Menditto, Enrica and Mercier, Gregoire and Mullol, Joaquim and Muraro, Antonella and O’Hehir, Robyn and Okamoto, Yoshitaka and Pajno, Giovanni B and Park, Hae‐Sim and Panzner, Petr and Passalacqua, Giovanni and Pham‐Thi, Nhan and Roberts, Graham and Pawankar, Ruby and Rolland, Christine and Rosario, Nelson and Ryan, Dermot and Samolinski, Bolesław and Sanchez‐Borges, Mario and Scadding, Glenis and Shamji, Mohamed H and Sheikh, Aziz and Sturm, Gunter J and Todo Bom, Ana and Toppila‐Salmi, Sanna and Valentin‐Rostan, Maryline and Valiulis, Arunas and Valovirta, Erkka and Ventura, Maria‐Teresa and Wahn, Ulrich and Walker, Samantha and Wallace, Dana and Waserman, Susan and Yorgancioglu, Arzu and Zuberbier, Torsten},
  issn         = {0105-4538},
  journal      = {ALLERGY},
  keywords     = {allergen immunotherapy,asthma,children,mHealth,rhinitis,stratification   KeyWords Plus:EAACI AIT GUIDELINES,SUBLINGUAL IMMUNOTHERAPY,COST-EFFECTIVENESS,DOUBLE-BLIND,SUBCUTANEOUS IMMUNOTHERAPY,EUROPEAN-UNION,RHINITIS,ASTHMA,MANAGEMENT,EFFICACY},
  language     = {eng},
  number       = {11},
  pages        = {2087--2102},
  title        = {2019 ARIA Care pathways for allergen immunotherapy},
  url          = {http://dx.doi.org/10.1111/all.13805},
  volume       = {74},
  year         = {2019},
}

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