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Practice Guideline
. 2019;66 Suppl 1:1-105.
doi: 10.29262/ram.v66i5.631.

[GUIMIT 2019, Mexican Guideline on Immunotherapy. Guideline on the Diagnosis of IgE-mediated Allergic Disease and Immunotherapy Following the ADAPTE Approach]

[Article in Spanish]
Désirée Larenas-Linnemann  1 Jorge A Luna-PechNoel Rodríguez-PérezMónica Rodríguez-GonzálezAlfredo Arias-CruzMaría Virginia Blandón-VijilMaría Carmen Costa-DomínguezBlanca E Del Río-NavarroAlan Estrada-CardonaElsy Maureen Navarrete-RodríguezJosé Antonio Ortega-MartellCésar Fireth Pozo-BeltránHerson Brito-DíazMaría Rosario Canseco-RaymundoEnrique Emanuel Castelán-ChávezMargarita Gabriela Domínguez-SilvaAlberto José Escalante-DomínguezJosé Luis Gálvez-RomeroMaría Guadalupe García-ReyesJavier Gómez-VeraSandra Nora González-DíazMaría Gracias Belinda Guerrero-NúñezDante Hernández-ColínAlejandra Macías-WeinmannDavid Alejandro Mendoza-HernándezNéstor Alejandro Meneses-SánchezMaría Dolores Mogica-MartínezCarol Vivian Moncayo-CoelloManuel Montiel-HerreraPatricia O'Farril-RomanillosErnesto Onuma-TakaneMargarita Ortega-CisnerosLorena Rangel-GarzaHéctor Stone-AguilarCarlos Torres-LozanoEdna Venegas-MontoyaGuillermo Wakida-KusunokiCarlos Macouzet-SánchezArmando Partida-GaytánAída Inés López-GarcíaAna Paola Macías-RoblesMaría Jesús Ambriz-MorenoAmyra Ali Azamar-JácomeCarlos Báez-LoyolaClaudia Yusdivia Beltrán-De PazChrystopherson Caballero-LópezJuan Carlos Fernández de Córdova-AguirreRoberto Fernández-SotoJosé Santos Lozano-SáenzJosé Joel Oyoqui-FloresRoberto Osorio-EscamillaFernando RamírezDaniela Rivero-YeverinoMaría Socorro Orozco-MartínezMaría Isabel Rojo-GutiérrezEric MartínezMiguel Alejandro Medina-Ávalos
Affiliations
Practice Guideline

[GUIMIT 2019, Mexican Guideline on Immunotherapy. Guideline on the Diagnosis of IgE-mediated Allergic Disease and Immunotherapy Following the ADAPTE Approach]

[Article in Spanish]
Désirée Larenas-Linnemann et al. Rev Alerg Mex. .

Abstract

Background: In Mexico, allergen immunotherapy (AIT) and immunotherapy with hymenoptera venom (VIT) is traditionally practiced combining aspects of the European and American school. In addition, both types of extracts (European and American) are commercially available in Mexico. Moreover, for an adequate AIT/VIT a timely diagnosis is crucial. Therefore, there is a need for a widely accepted, up-to-date national immunotherapy guideline that covers diagnostic issues, indications, dosage, mechanisms, adverse effects and future expectations of AIT (GUIMIT 2019).

Method: With nationwide groups of allergists participating, including delegates from postgraduate training-programs in Allergy/Immunology-forming, the guideline document was developed according to the ADAPTE methodology: the immunotherapy guidelines from European Academy of Allergy and Clinical Immunology, German Society for Allergology and Clinical Immunology, The American Academy of Allergy, Asthma and Immunology and American College of Allergy, Asthma, and Immunology were selected as mother guidelines, as they received the highest AGREE-II score among international guidelines available; their evidence conforms the scientific basis for this document.

Results: GUIMIT emanates strong or weak (suggestions) recommendations about practical issues directly related to in vivo or in vitro diagnosis of IgE mediated allergic diseases and the preparation and application of AIT/VIT and its adverse effects. GUIMIT finishes with a perspective on AIT modalities for the future. All the statements were discussed and voted on until > 80 % consensus was reached.

Conclusions: A wide and diverse group of AIT/VIT experts issued transculturized, evidence-based recommendations and reached consensus that might improve and standardize AIT practice in Mexico.

Antecedentes: En México, la inmunoterapia con alérgenos (ITA) y con veneno de himenópteros (VIT) se practica tradicionalmente combinando criterios de las escuelas europea y estadounidense; los dos tipos de extractos están comercialmente disponibles en México. Para una ITA adecuada es crucial un diagnóstico oportuno. Objetivo: Presentar GUIMIT 2019, Guía Mexicana de Inmunoterapia 2019, de base amplia, actualizada, que abarca temas de diagnóstico, indicaciones, dosificación, mecanismos, efectos adversos de la ITA y expectativas con esta modalidad de tratamiento. Método: Con la participación de múltiples grupos mexicanos de alergólogos, que incluían los centros formadores universitarios en alergia e inmunología, se desarrolló el documento de la guía según la metodología ADAPTE. Las guías de inmunoterapia de la European Academy of Allergy and Clinical Immunology, The American Academy of Allergy, Asthma and Immunology, German Society for Allergology and Clinical Immunology y del American College of Allergy, Asthma, and Immunology se seleccionaron como guías fuente, ya que recibieron la puntuación AGREE-II más alta entre las guías internacionales disponibles; su evidencia conforma la base científica de GUIMIT 2019. Resultados: En GUIMIT 2019 se emiten recomendaciones fuertes o débiles (sugerencias) acerca de temas directamente relacionados con el diagnóstico in vivo o in vitro de las enfermedades alérgicas mediadas por IgE, la preparación y aplicación de ITA o VIT y sus efectos adversos; se incluye la revisión de las modalidades de ITA para el futuro. Todos los argumentos que se exponen fueron discutidos y votados con > 80 % de aprobación. Conclusión: Un grupo amplio y diverso de expertos en ITA y VIT emitió recomendaciones transculturizadas basadas en evidencia, que alcanzaron consenso; con ellas se pretende mejorar y homologar la práctica de la inmunoterapia en México.

Keywords: Adrenaline; Allergenic extract; Anaphylaxis; Immunotherapy with allergens; Immunotherapy with hymenoptera venom; In vitro diagnosis of allergy; Intradermal skin test; Molecular allergy diagnosis; Skin prick test; Subcutaneous immunotherapy; Sublingual immunotherapy.

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