The University of Southampton
University of Southampton Institutional Repository

2019 ARIA Care pathways for allergen immunotherapy

2019 ARIA Care pathways for allergen immunotherapy
2019 ARIA Care pathways for allergen immunotherapy

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 health 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 on 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. This article is protected by copyright. All rights reserved.

0105-4538
Bousquet, J
fda25127-be6f-45cd-a455-883cc90d8e0e
Pfaar, O
85c41012-6b31-4ab5-bc5a-bc89d094e3c4
Togias, A
0c1c16e6-fcc0-46b9-9b7f-0e34d79be7a5
Schünemann, H J
eb3ceb01-391d-47eb-93af-3ccbc2729144
Ansotegui, I
d185908b-28c9-4df8-afcc-40a48c122b0a
Papadopoulos, N G
245190e1-f850-414c-973a-780c4ffae728
Tsiligianni, I
880cb774-c4e0-4344-9cff-dfe04a164bbd
Agache, I
2c1d12ef-a70a-4395-a5d7-fe3a657044bb
Anto, J M
10b41b86-8bf2-4b5e-933e-408899989175
Bachert, C
8c8c352e-288f-47bd-9fb5-1ead1b20fcbd
Bedbrook, A
3c67de32-c95e-4699-bcf3-a1b118f68096
Bergmann, K C
e18eb2e6-c9f6-41b5-ae64-2d79ec42c886
Bosnic-Anticevich, S
28900b01-dd0f-4153-a932-187cc383a1cb
Bosse, I
fdaee6ac-645a-40f1-8bba-e43b97733d49
Brozek, J
009e958f-fffe-4079-ae66-6b8a31b56502
Calderon, M
d82c14c4-ae80-4954-a599-84468d21f9af
Canonica, G W
1a2769c1-7a4a-4b60-bab2-4ef2c087f1e1
Caraballo, L
3d75bb54-9596-4f5d-85e7-83d8808a95b0
Cardona, V
32f38d87-4966-4042-85d2-cb6548dc50ed
Casale, T
368e395b-87fb-4c02-becd-2e9423fd5a21
Cecchi, L
87d2296c-489d-4176-9843-eb42cd73e82d
Chu, D K
0e602cc5-eacc-47cd-8ea4-533740555a57
Costa, E
8eddaf2e-6486-439e-8f4c-123e9c41890c
Cruz, A A
35c073a4-664c-42b0-9705-f3416d5f8ade
Czarlewski, W
a73d8ac6-f3f4-460c-ab84-93aa62649ec1
Durham, S R
99964123-7d76-411f-94d6-fbddfb1840c8
Du Toit, G
bd3ee72d-f4fa-4e4f-bf73-f0a0678ca7b0
Dykewicz, M
77e8d435-a060-4e99-a5b2-f697844fef96
Ebisawa, M
699c8426-c605-4345-b115-6036f293722b
Fauquert, J L
b0cd37b4-a63b-4e09-9154-ff1c5ac368e0
Fernandez-Rivas, M
ed083572-3435-4946-87d3-405a63ddd679
Fokkens, W J
52a2db87-9e81-4306-b93b-c1a59865f986
Fonseca, J
e0a5b205-d05e-45b3-a736-21fe0fdeccb8
Fontaine, J F
2528608c-bdd4-4db2-8e98-bba68b2bb9b1
van Wijk, R Gerth
64d21a3b-ed5a-46ae-a2d2-35478f0ea484
Haahtela, T
042ac931-34c5-4c89-91ed-6b1774b98076
Halken, S
6204ce6f-7b6e-4041-9da2-a5f250467fbb
Hellings, P W
19f5408b-5d49-4035-8923-dd574e535e8f
Ierodiakonou, D
3adc89c7-6bcd-4b7d-9ea0-e2df8e275af2
Iinuma, T
1977402a-365f-4f50-b44d-ae0fe8c58fa6
Ivancevich, J C
d75021ef-868d-4fa2-8ad8-6b95463eca61
Jacobsen, L
62969f94-18f8-44a3-b718-b85d174fa7fd
Jutel, M
754b883c-2636-43e0-83f0-764b4bac754c
Kaidashev, I
0a11f9ec-0b71-40de-92e2-892c330ba70e
Khaitov, M
44de9b94-6d7e-4953-9eae-f8280201de49
Kalayci, O
3d2c8172-4379-473b-81d6-86c0d4976329
Lau, S
f9e1fe62-a3e1-4178-a9a0-7e650a307445
Roberts, G
1a20cab3-ea1a-403a-8b15-1068bf2e52cb
Walker, S
8043af74-efc1-4b3d-a2c2-1a4f3d6f55f3
Wallace, D
ba9a6075-3385-4541-adaf-4190f7dfb0d1
Roberts, Graham
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
ARIA Working Group
Bousquet, J
fda25127-be6f-45cd-a455-883cc90d8e0e
Pfaar, O
85c41012-6b31-4ab5-bc5a-bc89d094e3c4
Togias, A
0c1c16e6-fcc0-46b9-9b7f-0e34d79be7a5
Schünemann, H J
eb3ceb01-391d-47eb-93af-3ccbc2729144
Ansotegui, I
d185908b-28c9-4df8-afcc-40a48c122b0a
Papadopoulos, N G
245190e1-f850-414c-973a-780c4ffae728
Tsiligianni, I
880cb774-c4e0-4344-9cff-dfe04a164bbd
Agache, I
2c1d12ef-a70a-4395-a5d7-fe3a657044bb
Anto, J M
10b41b86-8bf2-4b5e-933e-408899989175
Bachert, C
8c8c352e-288f-47bd-9fb5-1ead1b20fcbd
Bedbrook, A
3c67de32-c95e-4699-bcf3-a1b118f68096
Bergmann, K C
e18eb2e6-c9f6-41b5-ae64-2d79ec42c886
Bosnic-Anticevich, S
28900b01-dd0f-4153-a932-187cc383a1cb
Bosse, I
fdaee6ac-645a-40f1-8bba-e43b97733d49
Brozek, J
009e958f-fffe-4079-ae66-6b8a31b56502
Calderon, M
d82c14c4-ae80-4954-a599-84468d21f9af
Canonica, G W
1a2769c1-7a4a-4b60-bab2-4ef2c087f1e1
Caraballo, L
3d75bb54-9596-4f5d-85e7-83d8808a95b0
Cardona, V
32f38d87-4966-4042-85d2-cb6548dc50ed
Casale, T
368e395b-87fb-4c02-becd-2e9423fd5a21
Cecchi, L
87d2296c-489d-4176-9843-eb42cd73e82d
Chu, D K
0e602cc5-eacc-47cd-8ea4-533740555a57
Costa, E
8eddaf2e-6486-439e-8f4c-123e9c41890c
Cruz, A A
35c073a4-664c-42b0-9705-f3416d5f8ade
Czarlewski, W
a73d8ac6-f3f4-460c-ab84-93aa62649ec1
Durham, S R
99964123-7d76-411f-94d6-fbddfb1840c8
Du Toit, G
bd3ee72d-f4fa-4e4f-bf73-f0a0678ca7b0
Dykewicz, M
77e8d435-a060-4e99-a5b2-f697844fef96
Ebisawa, M
699c8426-c605-4345-b115-6036f293722b
Fauquert, J L
b0cd37b4-a63b-4e09-9154-ff1c5ac368e0
Fernandez-Rivas, M
ed083572-3435-4946-87d3-405a63ddd679
Fokkens, W J
52a2db87-9e81-4306-b93b-c1a59865f986
Fonseca, J
e0a5b205-d05e-45b3-a736-21fe0fdeccb8
Fontaine, J F
2528608c-bdd4-4db2-8e98-bba68b2bb9b1
van Wijk, R Gerth
64d21a3b-ed5a-46ae-a2d2-35478f0ea484
Haahtela, T
042ac931-34c5-4c89-91ed-6b1774b98076
Halken, S
6204ce6f-7b6e-4041-9da2-a5f250467fbb
Hellings, P W
19f5408b-5d49-4035-8923-dd574e535e8f
Ierodiakonou, D
3adc89c7-6bcd-4b7d-9ea0-e2df8e275af2
Iinuma, T
1977402a-365f-4f50-b44d-ae0fe8c58fa6
Ivancevich, J C
d75021ef-868d-4fa2-8ad8-6b95463eca61
Jacobsen, L
62969f94-18f8-44a3-b718-b85d174fa7fd
Jutel, M
754b883c-2636-43e0-83f0-764b4bac754c
Kaidashev, I
0a11f9ec-0b71-40de-92e2-892c330ba70e
Khaitov, M
44de9b94-6d7e-4953-9eae-f8280201de49
Kalayci, O
3d2c8172-4379-473b-81d6-86c0d4976329
Lau, S
f9e1fe62-a3e1-4178-a9a0-7e650a307445
Roberts, G
1a20cab3-ea1a-403a-8b15-1068bf2e52cb
Walker, S
8043af74-efc1-4b3d-a2c2-1a4f3d6f55f3
Wallace, D
ba9a6075-3385-4541-adaf-4190f7dfb0d1
Roberts, Graham
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3

Bousquet, J, Pfaar, O, Togias, A, Schünemann, H J, Ansotegui, I, Papadopoulos, N G, Tsiligianni, I, Agache, I, Anto, J M, Bachert, C, Bedbrook, A, Bergmann, K C, Bosnic-Anticevich, S, Bosse, I, Brozek, J, Calderon, M, Canonica, G W, Caraballo, L, Cardona, V, Casale, T, Cecchi, L, Chu, D K, Costa, E, Cruz, A A, Czarlewski, W, Durham, S R, Du Toit, G, Dykewicz, M, Ebisawa, M, Fauquert, J L, Fernandez-Rivas, M, Fokkens, W J, Fonseca, J, Fontaine, J F, van Wijk, R Gerth, Haahtela, T, Halken, S, Hellings, P W, Ierodiakonou, D, Iinuma, T, Ivancevich, J C, Jacobsen, L, Jutel, M, Kaidashev, I, Khaitov, M, Kalayci, O, Lau, S, Roberts, G, Walker, S, Wallace, D and Roberts, Graham , ARIA Working Group (2019) 2019 ARIA Care pathways for allergen immunotherapy. Allergy. (doi:10.1111/all.13805).

Record type: Article

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 health 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 on 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. This article is protected by copyright. All rights reserved.

Text
Bousquet_et_al-2019-Allergy - Accepted Manuscript
Restricted to Repository staff only until 7 April 2020.
Request a copy

More information

e-pub ahead of print date: 7 April 2019
Additional Information: This article is protected by copyright. All rights reserved.

Identifiers

Local EPrints ID: 430274
URI: https://eprints.soton.ac.uk/id/eprint/430274
ISSN: 0105-4538
PURE UUID: db971b5d-324a-48c5-b9fa-fcd61dfaa622

Catalogue record

Date deposited: 24 Apr 2019 16:30
Last modified: 28 May 2019 16:30

Export record

Altmetrics

Contributors

Author: J Bousquet
Author: O Pfaar
Author: A Togias
Author: H J Schünemann
Author: I Ansotegui
Author: N G Papadopoulos
Author: I Tsiligianni
Author: I Agache
Author: J M Anto
Author: C Bachert
Author: A Bedbrook
Author: K C Bergmann
Author: S Bosnic-Anticevich
Author: I Bosse
Author: J Brozek
Author: M Calderon
Author: G W Canonica
Author: L Caraballo
Author: V Cardona
Author: T Casale
Author: L Cecchi
Author: D K Chu
Author: E Costa
Author: A A Cruz
Author: W Czarlewski
Author: S R Durham
Author: G Du Toit
Author: M Dykewicz
Author: M Ebisawa
Author: J L Fauquert
Author: M Fernandez-Rivas
Author: W J Fokkens
Author: J Fonseca
Author: J F Fontaine
Author: R Gerth van Wijk
Author: T Haahtela
Author: S Halken
Author: P W Hellings
Author: D Ierodiakonou
Author: T Iinuma
Author: J C Ivancevich
Author: L Jacobsen
Author: M Jutel
Author: I Kaidashev
Author: M Khaitov
Author: O Kalayci
Author: S Lau
Author: G Roberts
Author: S Walker
Author: D Wallace
Author: Graham Roberts

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×