EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis
Allergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of...
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| Published in: | Allergy (Copenhagen) Vol. 73; no. 4; pp. 765 - 798 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Denmark
Blackwell Publishing Ltd
01.04.2018
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| Subjects: | |
| ISSN: | 0105-4538, 1398-9995, 1398-9995 |
| Online Access: | Get full text |
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| Abstract | Allergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of life; pharmacotherapy may also induce some side‐effects. Allergen immunotherapy (AIT) represents the only currently available treatment that targets the underlying pathophysiology, and it may have a disease‐modifying effect. Either the subcutaneous (SCIT) or sublingual (SLIT) routes may be used. This Guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on AIT for AR and is part of the EAACI presidential project “EAACI Guidelines on Allergen Immunotherapy.” It aims to provide evidence‐based clinical recommendations and has been informed by a formal systematic review and meta‐analysis. Its generation has followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included involvement of the full range of stakeholders. In general, broad evidence for the clinical efficacy of AIT for AR exists but a product‐specific evaluation of evidence is recommended. In general, SCIT and SLIT are recommended for both seasonal and perennial AR for its short‐term benefit. The strongest evidence for long‐term benefit is documented for grass AIT (especially for the grass tablets) where long‐term benefit is seen. To achieve long‐term efficacy, it is recommended that a minimum of 3 years of therapy is used. Many gaps in the evidence base exist, particularly around long‐term benefit and use in children. |
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| AbstractList | Allergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of life; pharmacotherapy may also induce some side-effects. Allergen immunotherapy (AIT) represents the only currently available treatment that targets the underlying pathophysiology, and it may have a disease-modifying effect. Either the subcutaneous (SCIT) or sublingual (SLIT) routes may be used. This Guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on AIT for AR and is part of the EAACI presidential project "EAACI Guidelines on Allergen Immunotherapy." It aims to provide evidence-based clinical recommendations and has been informed by a formal systematic review and meta-analysis. Its generation has followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included involvement of the full range of stakeholders. In general, broad evidence for the clinical efficacy of AIT for AR exists but a product-specific evaluation of evidence is recommended. In general, SCIT and SLIT are recommended for both seasonal and perennial AR for its short-term benefit. The strongest evidence for long-term benefit is documented for grass AIT (especially for the grass tablets) where long-term benefit is seen. To achieve long-term efficacy, it is recommended that a minimum of 3 years of therapy is used. Many gaps in the evidence base exist, particularly around long-term benefit and use in children. Allergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of life; pharmacotherapy may also induce some side-effects. Allergen immunotherapy (AIT) represents the only currently available treatment that targets the underlying pathophysiology, and it may have a disease-modifying effect. Either the subcutaneous (SCIT) or sublingual (SLIT) routes may be used. This Guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on AIT for AR and is part of the EAACI presidential project "EAACI Guidelines on Allergen Immunotherapy." It aims to provide evidence-based clinical recommendations and has been informed by a formal systematic review and meta-analysis. Its generation has followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included involvement of the full range of stakeholders. In general, broad evidence for the clinical efficacy of AIT for AR exists but a product-specific evaluation of evidence is recommended. In general, SCIT and SLIT are recommended for both seasonal and perennial AR for its short-term benefit. The strongest evidence for long-term benefit is documented for grass AIT (especially for the grass tablets) where long-term benefit is seen. To achieve long-term efficacy, it is recommended that a minimum of 3 years of therapy is used. Many gaps in the evidence base exist, particularly around long-term benefit and use in children.Allergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of life; pharmacotherapy may also induce some side-effects. Allergen immunotherapy (AIT) represents the only currently available treatment that targets the underlying pathophysiology, and it may have a disease-modifying effect. Either the subcutaneous (SCIT) or sublingual (SLIT) routes may be used. This Guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on AIT for AR and is part of the EAACI presidential project "EAACI Guidelines on Allergen Immunotherapy." It aims to provide evidence-based clinical recommendations and has been informed by a formal systematic review and meta-analysis. Its generation has followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included involvement of the full range of stakeholders. In general, broad evidence for the clinical efficacy of AIT for AR exists but a product-specific evaluation of evidence is recommended. In general, SCIT and SLIT are recommended for both seasonal and perennial AR for its short-term benefit. The strongest evidence for long-term benefit is documented for grass AIT (especially for the grass tablets) where long-term benefit is seen. To achieve long-term efficacy, it is recommended that a minimum of 3 years of therapy is used. Many gaps in the evidence base exist, particularly around long-term benefit and use in children. Allergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of life; pharmacotherapy may also induce some side‐effects. Allergen immunotherapy (AIT) represents the only currently available treatment that targets the underlying pathophysiology, and it may have a disease‐modifying effect. Either the subcutaneous (SCIT) or sublingual (SLIT) routes may be used. This Guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on AIT for AR and is part of the EAACI presidential project “EAACI Guidelines on Allergen Immunotherapy.” It aims to provide evidence‐based clinical recommendations and has been informed by a formal systematic review and meta‐analysis. Its generation has followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included involvement of the full range of stakeholders. In general, broad evidence for the clinical efficacy of AIT for AR exists but a product‐specific evaluation of evidence is recommended. In general, SCIT and SLIT are recommended for both seasonal and perennial AR for its short‐term benefit. The strongest evidence for long‐term benefit is documented for grass AIT (especially for the grass tablets) where long‐term benefit is seen. To achieve long‐term efficacy, it is recommended that a minimum of 3 years of therapy is used. Many gaps in the evidence base exist, particularly around long‐term benefit and use in children. |
| Author | Hellings, P. Knol, E. F. Lin, S. Y. van Ree, R. Pawankar, R. Akdis, C. A. Roberts, G. Dhami, S. Arasi, S. Lau, S. Wijk, R. Angier, E. Maggina, P. Pfaar, O. Cingi, C. Penagos, M. Varga, E.‐M. Zhang, L. Ansotegui, I. J. Worm, M. Fernandez‐Rivas, M. Jutel, M. Timmermans, F. Jacobsen, L. Wilkinson, J. N. Ryan, D. Calderon, M. A. Fauquert, J. L. Muraro, A. Pastorello, E. A. Rotiroti, G. Tsilochristou, O. Sheikh, A. Durham, S. R. Larenas‐Linnemann, D. Schmidt‐Weber, C. B. Sturm, G. J. Pitsios, C. Oude Elberink, J. N. G. Williams, A. Hamelmann, E. Halken, S. Agache, I. Pajno, G. B. Mösges, R. |
| Author_xml | – sequence: 1 givenname: G. orcidid: 0000-0003-2252-1248 surname: Roberts fullname: Roberts, G. organization: University of Southampton – sequence: 2 givenname: O. orcidid: 0000-0003-4374-9639 surname: Pfaar fullname: Pfaar, O. organization: Center for Rhinology and Allergology – sequence: 3 givenname: C. A. surname: Akdis fullname: Akdis, C. A. organization: Christine Kühne Center for Allergy Research and Education – sequence: 4 givenname: I. J. surname: Ansotegui fullname: Ansotegui, I. J. organization: Hospital Quironsalud Bizkaia – sequence: 5 givenname: S. R. surname: Durham fullname: Durham, S. R. organization: Imperial College London – sequence: 6 givenname: R. surname: Wijk fullname: Wijk, R. organization: Erasmus Medical Center – sequence: 7 givenname: S. surname: Halken fullname: Halken, S. organization: Odense University Hospital – sequence: 8 givenname: D. surname: Larenas‐Linnemann fullname: Larenas‐Linnemann, D. organization: Hospital Médica Sur – sequence: 9 givenname: R. surname: Pawankar fullname: Pawankar, R. organization: Nippon Medical School – sequence: 10 givenname: C. surname: Pitsios fullname: Pitsios, C. organization: University of Cyprus – sequence: 11 givenname: A. surname: Sheikh fullname: Sheikh, A. organization: The University of Edinburgh – sequence: 12 givenname: M. surname: Worm fullname: Worm, M. organization: Universitätsmedizin Berlin – sequence: 13 givenname: S. surname: Arasi fullname: Arasi, S. organization: Charite Medical University – sequence: 14 givenname: M. A. surname: Calderon fullname: Calderon, M. A. organization: Imperial College London – sequence: 15 givenname: C. surname: Cingi fullname: Cingi, C. organization: Eskisehir Osmangazi University – sequence: 16 givenname: S. surname: Dhami fullname: Dhami, S. organization: Evidence Based Health Care Ltd – sequence: 17 givenname: J. L. surname: Fauquert fullname: Fauquert, J. L. organization: Unité d'allergologie de l'enfant – sequence: 18 givenname: E. surname: Hamelmann fullname: Hamelmann, E. organization: Bielefeld University – sequence: 19 givenname: P. surname: Hellings fullname: Hellings, P. organization: Academic Medical Center Amsterdam – sequence: 20 givenname: L. surname: Jacobsen fullname: Jacobsen, L. organization: Allergy Learning and Consulting – sequence: 21 givenname: E. F. surname: Knol fullname: Knol, E. F. organization: University Medical Center Utrecht – sequence: 22 givenname: S. Y. surname: Lin fullname: Lin, S. Y. organization: Johns Hopkins Department of Otolaryngology – Head and Neck Surgery – sequence: 23 givenname: P. surname: Maggina fullname: Maggina, P. organization: NKUA Athens University – sequence: 24 givenname: R. surname: Mösges fullname: Mösges, R. organization: Clinical Research International Ltd – sequence: 25 givenname: J. N. G. surname: Oude Elberink fullname: Oude Elberink, J. N. G. organization: University Medical Center Groningen – sequence: 26 givenname: G. B. surname: Pajno fullname: Pajno, G. B. organization: University of Messina – sequence: 27 givenname: E. A. surname: Pastorello fullname: Pastorello, E. A. organization: University of Milano – sequence: 28 givenname: M. surname: Penagos fullname: Penagos, M. organization: Imperial College London – sequence: 29 givenname: G. surname: Rotiroti fullname: Rotiroti, G. organization: University College Hospital – sequence: 30 givenname: C. B. surname: Schmidt‐Weber fullname: Schmidt‐Weber, C. B. organization: Helmholtz Center Munich – sequence: 31 givenname: F. surname: Timmermans fullname: Timmermans, F. organization: European Anaphylaxis Taskforce – Nederlands Anafylaxis Netwerk – sequence: 32 givenname: O. surname: Tsilochristou fullname: Tsilochristou, O. organization: Guy's and St. Thomas’ National Health Service Foundation Trust – sequence: 33 givenname: E.‐M. surname: Varga fullname: Varga, E.‐M. organization: Medical University of Graz – sequence: 34 givenname: J. N. surname: Wilkinson fullname: Wilkinson, J. N. organization: Pharmaceutical Group of the European Union – sequence: 35 givenname: A. surname: Williams fullname: Williams, A. organization: Guys and St Thomas’ NHS Foundation Trust – sequence: 36 givenname: L. surname: Zhang fullname: Zhang, L. organization: Capital Medical University – sequence: 37 givenname: I. surname: Agache fullname: Agache, I. organization: Transylvania University Brasov – sequence: 38 givenname: E. surname: Angier fullname: Angier, E. organization: Northern General Hospital – sequence: 39 givenname: M. surname: Fernandez‐Rivas fullname: Fernandez‐Rivas, M. organization: Hospital Clinico San Carlos, IdISSC – sequence: 40 givenname: M. surname: Jutel fullname: Jutel, M. organization: Wroclaw Medical University – sequence: 41 givenname: S. surname: Lau fullname: Lau, S. organization: Charité Universitätsmedizin – sequence: 42 givenname: R. surname: van Ree fullname: van Ree, R. organization: University of Amsterdam – sequence: 43 givenname: D. surname: Ryan fullname: Ryan, D. organization: University of Edinburgh Medical School – sequence: 44 givenname: G. J. surname: Sturm fullname: Sturm, G. J. organization: Outpatient Allergy Clinic Reumannplatz – sequence: 45 givenname: A. surname: Muraro fullname: Muraro, A. email: muraro@centroallergiealimentari.eu organization: University of Padua |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28940458$$D View this record in MEDLINE/PubMed |
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| Keywords | rhinoconjunctivitis allergy allergic conjunctivitis allergic rhinitis allergen immunotherapy |
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| Snippet | Allergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be... |
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| SubjectTerms | allergen immunotherapy Allergens allergic conjunctivitis allergic rhinitis Allergies allergy Children Conjunctivitis, Allergic - prevention & control Desensitization, Immunologic - methods Desensitization, Immunologic - standards Drug therapy Humans Immunotherapy Nose Quality of life Rhinitis, Allergic - prevention & control Rhinoconjunctivitis Tablets |
| Title | EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis |
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