Extrapolating Evidence-Based Medicine of AIT Into Clinical Practice in the United States

Is allergen immunotherapy a model of personalized treatment in pediatric respiratory allergy?

“…The optimal duration time for AIT is three to five years after initiating the maintenance phase. AIT should be maintained for at least three years to achieve lasting efficacy [14–16,17 ▪▪ ,18–20].…”

“…AIT is the only therapeutic strategy with curative potential, promoting the reduction of drug use and long-term symptom control even after treatment ends [13,16,17 ▪▪ ,18–20]. The clinical practice of AIT expresses the essence of precision medicine as we identify a specific etiology and seek to modify the natural history of respiratory allergies by modulating the immune response in a personalized way [13–16,17 ▪▪ ].…”

“…Numerous studies have focused on determining the appropriate concentrations of main allergens in allergenic extracts for AIT [19][20][21][22][23][24]. Low doses are well tolerated, but they prove ineffective.…”

“…Standard initial dilutions from the concentrate are typically 1 : 10 000 (vol/vol) or 1 : 1000 (vol/vol). More diluted concentrations are often employed for highly sensitive patients, as suggested by clinical history or SPT reactions [19][20][21][22].…”

“…For SCIT, the main allergen range can vary from 5 to 20 mcg [19][20][21]. In SLIT, it can vary from 15 to 187 mcg [19,[22][23][24][25][26]. Based on precision medicine strategies, the proposed doses must consider the specific allergens and each demographic's and child's characteristics.…”