Challenges in the implementation of the <scp>EAACI AIT</scp> guidelines: A situational analysis of current provision of allergen immunotherapy

Ryan, Dermot; Wijk, Roy Gerth van; Angier, Elisabeth; Kristiansen, Maria; Zaman, Hadar; Sheikh, Aziz; Cardona, Victòria; Vidal, Carmen; Warner, Amena; Agache, Ioana; Arasi, Stefania; Fernández-Rivas, M; Halken, Susanne; Jutel, Marek; Lau, Susanne; Pajno, Giovanni Battista; Pfaar, Oliver; Roberts, Graham; Sturm, Gunter J.; Varga, Eva‐Maria; Ree, Ronald van; Muraro, Antonella

doi:10.1111/all.13264

Cited by 49 publications

(62 citation statements)

References 58 publications

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“…11 This approach is more difficult across Europe with differing local regulations 47 and availability of products. 48 The specific recommendations in this guideline need to be seen in this context; only standardized AIT products with evidence of efficacy in the clinical documentation should be prescribed. The only exception should be orphan allergens where only a few patients are affected; these are discussed below in the specific allergen section.…”

Section: Ait For Ar : E Vid Ence-based Clinical Re Commendationsmentioning

confidence: 99%

“…221 This would allow product-specific recommendations to be made. The different local regulations 47 and availability of products 48 makes this difficult at a European level. So before treatment with a specific product is initiated, clinicians need to undertake an individual product-based evaluation of the evidence for efficacy, focusing on low risk of bias studies which are generally the larger, more recent ones.…”

Section: Summary Gaps In the Evide Nce And Future Perspectivesmentioning

confidence: 99%

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EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

Roberts

Pfaar

Akdiş

et al. 2017

Allergy

Self Cite

564

705

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drawn on data from a systematic review of the literature, more recent published studies and multistakeholder expert clinical opinion. This Guideline is aimed at healthcare professionals who are encouraged to take the recommendations into account in the context of delivering clinical care. This Guideline is not a substitute for professional clinical judgment, which professionals need to exercise in the context of delivering personalised healthcare. AbstractAllergic 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 766 | ROBERTS, PFAAR ET AL. 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. | ME TH ODOLOGYThis Guideline was produced using the Appraisal of Guidelines forResearch & Evaluation (AGREE II) approach, 17,18 a structured approach to guideline production (see Table S1). This is designed to ensure appropriate representation of the full range of stakeholders, a careful search for and critical appraisal of the relevant literature, a systematic approach to the formulation and presentation of recommendations and steps to ensure that the risk of bias is minimized at each step of the process. The process started on April 2015 beginning with detailed face-to-face discussions agreeing on the process and the key clinical areas to address, followed by face-to-face meetings, and regular web conferences in which professional and lay representatives participated. | Clarifying the scope and purpose of the guidelinesThe scope of this EAACI Guideline is multifaceted...

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Section: Ait For Ar : E Vid Ence-based Clinical Re Commendationsmentioning

confidence: 99%

Section: Summary Gaps In the Evide Nce And Future Perspectivesmentioning

confidence: 99%

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

Roberts

Pfaar

Akdiş

et al. 2017

Allergy

Self Cite

564

705

View full text Add to dashboard Cite

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“…Greater awareness of the need for and availability of AIT within primary care and partnership with specialists will be necessary to overcome this. 11 Clinical care pathways and better quality standards of care are required to facilitate this. The guidelines highlight many gaps in the evidence base, particularly around the long-term effectiveness of AIT, the evidence for effectiveness of many commercial products, and a shortage of data in children and for health economic considerations.…”

Section: Future Challengesmentioning

confidence: 99%

EAACI guidelines on allergen immunotherapy: Executive statement

Muraro

Roberts

Halken

et al. 2018

Allergy

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132

131

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“…asthma, and food allergy in 2016 1,2 and 2017. 3 EAACI published allergen-specific immunotherapy guidelines (AIT) in 2018, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] and there have been extensive literature reviews and meta-analyses on the subject. [19][20][21][22][23][24] Allergic diseases and asthma concern over 25% of the European population and cause a very high socio-economic burden.…”

mentioning

confidence: 99%

Highlights and recent developments in airway diseases in EAACI journals (2018)

Bousquet

Akdiş

Grattan

et al. 2019

Allergy

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The European Academy of Allergy and Clinical Immunology (EAACI) supports three journals: Allergy, Pediatric Allergy and Immunology, and Clinical and Translational Allergy. EAACI's major goals include supporting the promotion of health, in which the prevention of allergy and asthma plays a critical role, and disseminating the knowledge of allergic disease to all stakeholders. In 2018, the remarkable progress in the identification of basic mechanisms of allergic and respiratory diseases as well as the translation of these findings into clinical practice were observed. Last year's highlights include publication of EAACI guidelines for allergen immunotherapy, many EAACI Position Papers covering important aspects for the specialty, better understanding of molecular and cellular mechanisms, identification of biomarkers for disease prediction and progress monitoring, novel prevention and intervention studies, elucidation of mechanisms of multimorbidities, introduction of new drugs to the clinics, recently completed phase three clinical studies, and publication of a large number of allergen immunotherapy studies and meta‐analyses.

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Challenges in the implementation of the EAACI AIT guidelines: A situational analysis of current provision of allergen immunotherapy

Abstract: Purpose: The European Academy of Allergy and Clinical Immunology (EAACI) has produced Guidelines on Allergen Immunotherapy (AIT). We sought to gauge the preparedness of primary care to participate in the delivery of AIT in Europe.

Cited by 49 publications

References 58 publications

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

EAACI guidelines on allergen immunotherapy: Executive statement

Highlights and recent developments in airway diseases in EAACI journals (2018)

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