Health economic analysis of allergen immunotherapy for the management of allergic rhinitis, asthma, food allergy and venom allergy: A systematic overview

Asaria, Miqdad; Dhami, Sangeeta; Ree, Ronald van; Wijk, Roy Gerth van; Muraro, Antonella; Roberts, Graham; Sheikh, Aziz

doi:10.1111/all.13254

Cited by 71 publications

(82 citation statements)

References 26 publications

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“…[213][214][215][216][217][218][219] The studies comparing SCIT and SLIT have given mixed results and do not allow us to conclude whether either treatment is more cost-effective. 220 ICERs for cost evaluations of AIT seem to vary substantially between different health systems suggesting that straightforward conclusions may not be generalizable even across seemingly similar countries. 215 Finally, the quality of the studies and the general lack of attention to characterizing uncertainty and handling missing data should be taken into account when interpreting these results.…”

Section: Pharmacoeconomic Aspe Cts Of Ait Versus Pharmacothe Rapy Fmentioning

confidence: 99%

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

Roberts

Pfaar

Akdiş

et al. 2017

Allergy

Self Cite

561

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: Pharmacoeconomic Aspe Cts Of Ait Versus Pharmacothe Rapy Fmentioning

confidence: 99%

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

Roberts

Pfaar

Akdiş

et al. 2017

Allergy

Self Cite

561

705

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“…Altogether, albeit not all of the highest quality, there is evidence that AIT can halt the allergic march in patients with AR . Moreover, there is some evidence that AIT is cost‐effective in AR with or without asthma …”

Section: Unmet Needs and Future Research Areas In Treatment Of Allergmentioning

confidence: 99%

“…213 Moreover, there is some evidence that AIT is cost-effective in AR with or without asthma. 214 Allergen-specific immunotherapy is usually given as subcutaneous injections 215,216 or sublingually, [217][218][219] but novel treatment forms such as peptide immunotherapy, 11,220 intralymphatic immunotherapy 11,220 and use of recombinant allergens, and immune-modulating adjuvants and nanoparticles 21,220,221 are under development.…”

Section: Novel Therapeutic Concepts In Ait For Airway Diseasementioning

confidence: 99%

Future research trends in understanding the mechanisms underlying allergic diseases for improved patient care

Breiteneder

Diamant

Eiwegger

et al. 2019

Allergy

101

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This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. AbstractThe specialties of allergy and clinical immunology have entered the era of precision medicine with the stratification of diseases into distinct disease subsets, specific diagnoses, and targeted treatment options, including biologicals and small molecules.This article reviews recent developments in research and patient care and future trends in the discipline. The section on basic mechanisms of allergic diseases summarizes the current status and defines research needs in structural biology, type 2 inflammation, immune tolerance, neuroimmune mechanisms, role of the microbiome and diet, environmental factors, and respiratory viral infections. In the section on diagnostic challenges, clinical trials, precision medicine and immune monitoring Zuzana Diamanthttps://orcid.org/0000-0003-0133-0100Thomas Eiwegger https://orcid.org/0000-0002-2914-7829Wytske J. Fokkens https://orcid.org/0000-0003-4852-229X

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“…Validated measures of quality of life should be included in future FA clinical trials to recognize the baseline characteristics that could potentially help identify the most suitable candidates for FA‐AIT. In terms of health economics, cost‐effectiveness of OIT needs to be assessed in well‐designed large studies …”

Section: Issues For Clinical Practicementioning

confidence: 99%

Allergen immunotherapy for IgE‐mediated food allergy: There is a measure in everything to a proper proportion of therapy

Pajno

Castagnoli

Muraro³

et al. 2019

Pediatric Allergy Immunology

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IgE‐mediated food allergy (FA) is a potentially life‐threatening condition with a negative impact on quality of life and an increasing prevalence in westernized countries in the recent two decades. A strict avoidance of the triggering food(s) represents the current standard approach. However, an elimination diet may be difficult and frustrating, in particular for common foods, (eg, milk, egg, and peanut). Food allergy immunotherapy (FA‐AIT) may provide an active treatment that enables to increase the amount of food that the patient can intake without reaction during treatment (ie, desensitization), and reduces the risk of potential life‐threatening allergic reaction in the event of accidental ingestion. However, several gaps need still to be filled. A memorable Latin orator stated: “Est modus in rebus” (Horace, Sermones I, 1, 106‐07). This sentence remembers that there is a measure in everything to a proper proportion of therapy. The common sense of measure should find application in each stage of treatment. A personalized approaching should consider the specific willing and features of each patient. Efforts are devoted to improve the efficacy, the safety but also the quality of life of patients suffering from FA. In the near future, it will be important to clarify immunologic pathways of FA‐AIT, and to identify reliable biomarkers in order to recognize the most suitable candidates to FA‐AIT and algorithms for treatments tailored on well‐characterized subpopulations of patients.

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Health economic analysis of allergen immunotherapy for the management of allergic rhinitis, asthma, food allergy and venom allergy: A systematic overview

Abstract: Background: The European Academy of Allergy and Clinical Immunology (EAACI) is

Cited by 71 publications

References 26 publications

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

Future research trends in understanding the mechanisms underlying allergic diseases for improved patient care

Allergen immunotherapy for IgE‐mediated food allergy: There is a measure in everything to a proper proportion of therapy

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