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Review
. 2019 Nov;74(11):2087-2102.
doi: 10.1111/all.13805. Epub 2019 Jul 15.

2019 ARIA Care Pathways for Allergen Immunotherapy

Jean Bousquet  1   2   3   4   5   6 Oliver Pfaar  7 Alkis Togias  8 Holger J Schünemann  9 Ignacio Ansotegui  10 Nikolaos G Papadopoulos  11   12 Ioanna Tsiligianni  13 Ioana Agache  14 Josep M Anto  15   16   17   18 Claus Bachert  19 Anna Bedbrook  1 Karl-Christian Bergmann  20 Sinthia Bosnic-Anticevich  21 Isabelle Bosse  22 Jan Brozek  9 Moises A Calderon  23 Giorgio W Canonica  24 Luigi Caraballo  25   26 Victoria Cardona  27 Thomas Casale  28 Lorenzo Cecchi  29 Derek Chu  9 Elisio Costa  30 Alvaro A Cruz  31   32 Wienczyslawa Czarlewski  33 Stephen R Durham  34 George Du Toit  35 Mark Dykewicz  36 Motohiro Ebisawa  37 Jean Luc Fauquert  38 Montserrat Fernandez-Rivas  39 Wytske J Fokkens  40 João Fonseca  41   42 Jean-François Fontaine  43 Roy Gerth van Wijk  44 Tari Haahtela  45 Susanne Halken  46 Peter W Hellings  47   48 Despo Ierodiakonou  13 Tomohisa Iinuma  49 Juan Carlos Ivancevich  50 Lars Jacobsen  51 Marek Jutel  52 Igor Kaidashev  53 Musa Khaitov  54 Omer Kalayci  55 Jörg Kleine Tebbe  56 Ludger Klimek  57 Marek L Kowalski  58   59 Piotr Kuna  60 Violeta Kvedariene  61   62 Stefania La Grutta  63 Désirée Larenas-Linemann  64 Susanne Lau  65 Daniel Laune  66 Lan Le  67 Karin Lodrup Carlsen  68   69 Olga Lourenço  70 Hans-Jørgen Malling  71 Gert Marien  4 Enrica Menditto  72 Gregoire Mercier  73 Joaquim Mullol  74   75 Antonella Muraro  76 Robyn O'Hehir  77 Yoshitaka Okamoto  49 Giovanni B Pajno  78 Hae-Sim Park  79 Petr Panzner  80 Giovanni Passalacqua  81 Nhan Pham-Thi  82 Graham Roberts  83 Ruby Pawankar  84 Christine Rolland  85 Nelson Rosario  86 Dermot Ryan  87 Bolesław Samolinski  88 Mario Sanchez-Borges  89 Glenis Scadding  90 Mohamed H Shamji  91   92 Aziz Sheikh  93 Gunter J Sturm  94   95 Ana Todo Bom  96 Sanna Toppila-Salmi  45 Maryline Valentin-Rostan  97 Arunas Valiulis  98   99   100 Erkka Valovirta  101 Maria-Teresa Ventura  102 Ulrich Wahn  103 Samantha Walker  104 Dana Wallace  105 Susan Waserman  106 Arzu Yorgancioglu  107 Torsten Zuberbier  20 ARIA Working Group
Affiliations
Review

2019 ARIA Care Pathways for Allergen Immunotherapy

Jean Bousquet et al. Allergy. .

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.

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References

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