Rhinitis and asthma represent hot topics for Allergy

Bousquet, Philippe‐Jean; Bieber, Thomas; Fokkens, Wytske J.; Kowalski, Marcin; Humbert, Marc; Niggemann, B.; Simon, Hans‐Uwe

doi:10.1111/j.1398-9995.2008.01954.x

Cited by 47 publications

(59 citation statements)

References 75 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The ARIA initially informed that doses-at least 50 to 100 times higher than those administered with SCIT by the same extracts-are needed for treatment success [8]. World Allergy Organization updated that a dose of about 600 mg of the major allergens every month was suggested as an optimal dose for patients with grass-induced seasonal rhinitis [26]. Di Bona et al [16] in his meta-analysis concluded that a monthly dose of major allergens showed that the SMD of symptom scores was -0.47 in patients receiving doses from 276 to 600 mg compared with -0.16 in patients treated with a monthly dose up to 275 mg.…”

Section: Efficacy Of Slitmentioning

confidence: 99%

Sublingual Immunotherapy in Allergic Rhinitis: Efficacy, Safety, Adherence and Guidelines

Aboshady

Elghanam

2014

Clin Exp Otorhinolaryngol

View full text Add to dashboard Cite

Allergic rhinitis (AR) is a globally increasing health problem affecting the quality of life. Specific immunotherapy is an available causal treatment changing the basic allergic mechanisms of the disease. Over one hundred years, subcutaneous immunotherapy (SCIT) was developed and proved its efficacy but many adverse effects were recorded including anaphylaxis. In 1986, sublingual immunotherapy (SLIT) was introduced as an alternative solution to solve this problem. Our study aims to discuss SLIT from the points of efficacy, safety, adherence and guidelines developed. A literature search was conducted in Medline/PubMed and the Cochrane Library in January 2013 using the keywords "allergic rhinitis, sublingual immunotherapy, efficacy, safety, compliance, adherence, guidelines." All types of publications were included. We augmented our study by searching the reference lists of identified reviews. SLIT has been established in many guidelines as an evidence-based effective treatment in AR with safer profile than SCIT. The meta-analyses confirmed its efficacy and showed a significant reduction in both symptoms and medication scores. The most common recorded adverse effects were minor local effects in the mouth, gastrointestinal reactions with few cases of anaphylaxis and no fatality. Adherence is more favorable for SLIT mainly because it is safe, noninvasive and easily taken at home. We support the call to conduct large multi-centric studies to gain more statistical power and overcome the problem of heterogeneity observed in the meta-analyses.

show abstract

Section: Efficacy Of Slitmentioning

confidence: 99%

Sublingual Immunotherapy in Allergic Rhinitis: Efficacy, Safety, Adherence and Guidelines

Aboshady

Elghanam

2014

Clin Exp Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…In particular, the position paper on SLIT by the World Allergy Organization stated “a dose dependency of the efficacy of SLIT was observed, and the optimal monthly maintenance dose for grasses was identified as about 600 mcg of the major allergen” 10. This requirement is fulfilled by modern products for SLIT, such as Staloral BM grasses,28 but not by many pollen extracts commercially available.…”

Section: Grass Pollenmentioning

confidence: 99%

“…As for AIT with inhalant allergens in general,10,26 the treatment must be performed for 3 consecutive years to ensure the so-called carry-over effect; that is, the persistence over time of the clinical benefit following the discontinuation of treatment 30…”

Section: Grass Pollenmentioning

confidence: 99%

“…In a recent survey, specialists evaluated the importance of the different issues with respect to AIT, ranking high the documentation of the content of the major allergens in μg, along with the level of evidence-based validation of efficacy and safety, and the standardization of the products 9. Actually, consensus documents on AIT view the documentation on the content of major allergens in μg as a need to be met by producers 10,11. This is also a requirement by the European Medicine Agency guidelines for the production and quality of AIT preparations 12…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

New product development with the innovative biomolecular sublingual immunotherapy formulations for the management of allergic rhinitis

Frati¹,

Cecchi²,

Scala³

et al. 2014

BTT

View full text Add to dashboard Cite

The molecular allergy technique, currently defined as component-resolved diagnosis, significantly improved the diagnosis of allergy, allowing for differentiation between molecules actually responsible for clinical symptoms (genuine sensitizers) and those simply cross-reacting or shared by several sources (panallergens), thus influencing the appropriate management of a patient’s allergy. This also concerns allergen immunotherapy (AIT), which may be prescribed more precisely based on the component-resolved diagnosis results. However, the advance in diagnosis needs to be mirrored in AIT. According to consensus documents and to expectations of specialists, therapy should be based on standardized extracts containing measured amounts of the clinically relevant molecules, ie, the major allergens. The new generation of extracts for sublingual immunotherapy fulfills these requirements and are thus defined as biomolecular (BM). BM refers to natural extracts with a defined content of major allergens in micrograms. All Staloral BM products are indicated for the treatment of allergic rhinitis with or without asthma. The effectiveness of AIT is related to its ability to modify the immunological response of allergic subjects. The 5-grass and house dust mite extracts were evaluated addressing the T helper 1, T helper 2, and T helper 3 cells by polymerase chain reaction array on mRNA extracted from Waldeyer’s ring tissue (adenoids). Sublingual immunotherapy with a defined content of major allergens in micrograms induced a strong downregulation of genes involved in T helper 2 and T helper 1 activation and function, allowing the definition of the immunologic effect as “bio-homeostatic”. This clinical and immunological model must be implemented with respect to other allergens, thus expanding the application of a treatment with a unique disease-modifying capacity.

show abstract

“…As immunotherapy often involves treatment with a single allergen extract over a period of 3 years or more, it is possible that variation in efficacy documented by this systematic review was at least partly a consequence of sensitisation to multiple allergens and differences in experimental setting and design, patient selection and other parameters related to immunotherapy. Nevertheless, a position paper from the World Allergy Organisation has recently indicated that while subcutaneous immunotherapy is not generally prescribed to young children, primarily because of safety concerns, sublingual immunotherapy may lead to adverse events in 5–15% of the children younger than 5 years of age [37]. Furthermore, there are still many unmet needs with sublingual immunotherapy use in children, among which are the lack of optimal dose and dosing frequency of allergen administration, lack of data for long-term efficacy, duration of treatment, preventive capacity, sublingual immunotherapy use in preschool children, efficacy in patients unresponsive to pharmacotherapy and safety of sublingual immunotherapy with multiple allergens [37].…”

Section: Management Of Ar In Paediatric Patientsmentioning

confidence: 99%

Evidence for Clinical Safety, Efficacy, and Parent and Physician Perceptions of Levocetirizine for the Treatment of Children with Allergic Disease

Пампура¹,

Papadopoulos

Špičák

et al. 2011

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Allergic rhinitis (AR) and chronic idiopathic urticaria (CIU) are highly burdensome diseases, which are increasing in prevalence, especially in the paediatric population. Despite the availability of a large number of medications for treatment of AR and CIU, their use in children has primarily been based on data obtained from a limited number of clinical trials in children and/or testing in adults. The H₁-antihistamines have traditionally been used as first-line treatment for the relief of both AR and CIU symptoms in children. The first-generation H₁-antihistamines are associated with marked adverse effects such as sedation, sleepiness/drowsiness as well as difficulties in learning and cognitive processing; thus, they are recommended for limited or discontinued use in children with AR or CIU. In contrast, second-generation H₁-antihistamines are more adapted for the use in children with AR and CIU due to better safety profiles. However, only a limited number of trials with these agents have been conducted and generally, data from well-designed trials in children are lacking. Levocetirizine is one of the most extensively investigated H₁-antihistamines for its pharmacologic properties, safety, efficacy as well as overall global satisfaction in children aged 2–12 years. Levocetirizine is the only H₁-antihistamine launched in the 21st century shown to lack clinically relevant adverse effects on physical and psychomotor development or routine laboratory tests over a long-term period of 18 months in 1- to 3-year-old children predisposed to development of allergic disease. Available data suggest that levocetirizine is a suitable treatment option for AR and CIU in children aged 6 months to 12 years.

show abstract

Rhinitis and asthma represent hot topics for Allergy

Cited by 47 publications

References 75 publications

Sublingual Immunotherapy in Allergic Rhinitis: Efficacy, Safety, Adherence and Guidelines

Sublingual Immunotherapy in Allergic Rhinitis: Efficacy, Safety, Adherence and Guidelines

New product development with the innovative biomolecular sublingual immunotherapy formulations for the management of allergic rhinitis

Evidence for Clinical Safety, Efficacy, and Parent and Physician Perceptions of Levocetirizine for the Treatment of Children with Allergic Disease

Contact Info

Product

Resources

About