Patient initiation and persistence with allergen immunotherapy

Anolik, Robert; Schwartz, Ann; Sajjan, Shiva; Allen‐Ramey, Felicia

doi:10.1016/j.anai.2014.04.008

“…The data are unclear, however, regarding the extend of the medication-sparing effect of AIT, with one study reporting no change in the asthma medication score after 1 year of treatment (43), whereas a pronounced effect was shown in a different work (42). Early treatment termination is a major problem (47) as only 35.4% of children were found to have completed at least 3 years of treatment (48). If AIT has been administrated for a number of years, current evidence suggests that it could induce long-term benefits, after its cessation (40, 46, 49).…”

Section: Duration Of Treatmentmentioning

confidence: 99%

“…In any case, each patient should be evaluated individually by considering the benefits and risks (83). SLIT drops are generally preferred for younger children over SCIT (48). …”

Section: Special Considerationsmentioning

confidence: 99%

Subcutaneous and Sublingual Immunotherapy in Allergic Asthma in Children

Tsabouri

¹

,

Mavroudi

²

,

Feketea³

et al. 2017

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This review presents up-to-date understanding of immunotherapy in the treatment of children with allergic asthma. The principal types of allergen immunotherapy (AIT) are subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). Both of them are indicated for patients with allergic rhinitis and/or asthma, who have evidence of clinically relevant allergen-specific IgE, and significant symptoms despite reasonable avoidance measures and/or maximal medical therapy. Studies have shown a significant decrease in asthma symptom scores and in the use of rescue medication, and a preventive effect on asthma onset. Although the safety profile of SLIT appears to be better than SCIT, the results of some studies and meta-analyses suggest that the efficacy of SCIT is better and that SCIT has an earlier onset than SLIT in children with allergic asthma. Severe, not controlled asthma, and medical error were the most frequent causes of SCIT-induced adverse events.

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“…In pediatric CRS associated with allergic rhinitis, allergen avoidance,anti-histamines, and nasal steroids will help in ameliorating the symptoms. Moreover, allergen immunotherapy may be an underused option that could benefit patients with persistent allergic rhinitis and can change the natural course of the disease by reducing the symptoms and medications use [35]. Whereas data supports the efficacy of immunotherapy for the treatment of allergic rhinitis, there is no evidence for this treatment modality in patients with CRS.…”

Section: Chronic Rhinosinusitismentioning

confidence: 99%

Pediatric Rhinosinusitis

2020

0

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Opinion statement Rhinosinusitis, is defined as an inflammation of the paranasal and nasal sinus mucosae. Chronic rhinosinusitis (CRS)is a common problem in the pediatric age group and the diagnosis and treatment are challenging due to the chronicity and similarity of symptoms with allergic rhinitis and adenoid hypertrophy. Although it is less common than acute rhinosinusitis, CRS is becoming more frequent and significantly affects the quality of life in children and can substantially impair daily function. CRS is characterized by sinus symptoms lasting more than 3 months despite medical therapy. Many factors are involved in the pathogenesis of this disease and include a primary insult with a virus followed bybacterial infection and mucosal inflammation, along with predisposition to allergies. The standard treatment of pediatricacute bacterial rhinosinusitis (ABRS) is nasal irrigation and antibiotic use. Medical treatment of pediatric CRS includes avoidance of allergens in allergic patients (environmental or food) and therapy with nasal irrigation, nasal corticosteroids sprays, nasal decongestants, and antibiotics directed at the most common sinonasalorganisms (Haemophilusinfluenzae, Streptococcus pneumoniae, and Moraxella catarrhalis). Surgical therapy is rarely needed after appropriate medical therapy. Referral to an otolaryngologist and allergy specialist is recommended in case of failure of medical treatment.

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“…Moreover, allergen immunotherapy may be an underused option that could benefit patients with persistent allergic rhinitis and can change the natural course of the disease by reducing the symptoms and medications use[35]. Whereas data supports the efficacy of immunotherapy for the treatment of allergic rhinitis, there is no evidence for this treatment modality in patients with CRS.…”

Section: Treatmentmentioning

confidence: 99%

Pediatric Rhinosinusitis

Badr

¹

,

Gaffin

²

,

Phipatanakul

³

2016

Curr Treat Options Allergy

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Opinion statement Rhinosinusitis, is defined as an inflammation of the paranasal and nasal sinus mucosae. Chronic rhinosinusitis (CRS)is a common problem in the pediatric age group and the diagnosis and treatment are challenging due to the chronicity and similarity of symptoms with allergic rhinitis and adenoid hypertrophy. Although it is less common than acute rhinosinusitis, CRS is becoming more frequent and significantly affects the quality of life in children and can substantially impair daily function. CRS is characterized by sinus symptoms lasting more than 3 months despite medical therapy. Many factors are involved in the pathogenesis of this disease and include a primary insult with a virus followed bybacterial infection and mucosal inflammation, along with predisposition to allergies. The standard treatment of pediatricacute bacterial rhinosinusitis (ABRS) is nasal irrigation and antibiotic use. Medical treatment of pediatric CRS includes avoidance of allergens in allergic patients (environmental or food) and therapy with nasal irrigation, nasal corticosteroids sprays, nasal decongestants, and antibiotics directed at the most common sinonasalorganisms (Haemophilusinfluenzae, Streptococcus pneumoniae, and Moraxella catarrhalis). Surgical therapy is rarely needed after appropriate medical therapy. Referral to an otolaryngologist and allergy specialist is recommended in case of failure of medical treatment.

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Patient initiation and persistence with allergen immunotherapy

Cited by 26 publications

References 29 publications

Subcutaneous and Sublingual Immunotherapy in Allergic Asthma in Children

Subcutaneous and Sublingual Immunotherapy in Allergic Asthma in Children

Pediatric Rhinosinusitis

Pediatric Rhinosinusitis

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