Specific allergen immunotherapy for the treatment of atopic eczema

Tam, Herman; Calderón, Moisés A.; Manikam, Logan; Nankervis, Helen; Núñez, Ignacio García; Williams, Hywel C; Durham, Stephen R.; Boyle, Robert

doi:10.1002/14651858.cd008774.pub2

Cited by 35 publications

(30 citation statements)

References 83 publications

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“…It is still controversial whether AIT may be beneficial for patients with AD. Considering the clinical effectiveness of AIT in IgE-associated allergic diseases, several trials, often uncontrolled, investigated the efficacy of AIT for patients with “extrinsic” AD and reported overall controversial results [9, 113, 114]. It is true that some proofs of clinical efficacy in extrinsic AD are available [114, 115], but no clear indication or recommendation can be made.…”

Section: Allergen-specific Immunotherapy For “Extrinsic” Atopic Dermamentioning

confidence: 99%

“…In food allergy, although the available studies described an effective clinical desensitization in the majority of patients, this approach remains so far an experimental strategy [8]. The same holds true for atopic dermatitis (AD) associated with IgE-sensitization to inhalant allergens [9]. This document also contains specific recommendations for the prevention and therapeutic management of adverse effects caused by AIT.…”

Section: Introductionmentioning

confidence: 99%

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Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report

et al. 2017

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Allergen-specific immunotherapy (AIT) is currently recognized as a clinically effective treatment for allergic diseases, with a unique disease-modifying effect. AIT was introduced in clinical practice one century ago, and performed in the early years with allergenic extracts of poor quality and definition. After the mechanism of allergic reaction were recognized, the practice of AIT was refined, leading to remarkable improvement in the efficacy and safety profile of the treatment. Currently AIT is accepted and routinely prescribed worldwide for respiratory allergies and hymenoptera venom allergy. Both the subcutaneous (SCIT) and sublingual (SLIT) routes of administration are used in the pediatric population.AIT is recommended in allergic rhinitis/conjunctivitis with/without allergic asthma, with an evidence of specific IgE-sensitization towards clinically relevant inhalant allergens. Long-term studies provided evidence that AIT can also prevent the onset of asthma and of new sensitizations. The favorable response to AIT is strictly linked to adherence to treatment, that lasts 3–5 years. Therefore, several factors should be carefully evaluated before starting this intervention, including the severity of symptoms, pharmacotherapy requirements and children and caregivers’ preference and compliance.In recent years, there have been increasing interest in the role of AIT for the treatment of IgE-associated food allergy and extrinsic atopic dermatitis. A growing body of evidence shows that oral immunotherapy represents a promising treatment option for IgE-associated food allergy. On the contrary, there are still controversies on the effectiveness of AIT for patients with atopic dermatitis.This consensus document was promoted by the Italian Society of Pediatric Allergy and Immunology (SIAIP) to provide evidence-based recommendations on AIT in order to implement and optimize current prescription practices of this treatment for allergic children.

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Section: Allergen-specific Immunotherapy For “Extrinsic” Atopic Dermamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report

et al. 2017

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“…The use of sublingual immunotherapy for mite-sensitised children with AD is not proven 44 45. Melatonin, which has immunomodulatory, anti-inflammatory and antioxidative effects, is found to be safe and efficacious at 3 mg/day in a paediatric RCT 46.…”

Section: Other Systemic Agentsmentioning

confidence: 99%

Non-topical management of recalcitrant paediatric atopic dermatitis

Chong

Koh

2017

Arch Dis Child

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Atopic dermatitis (AD) is a common chronic, pruritic skin disease in children. As the incidence of AD increases, especially in high-income countries, paediatricians may see an increasing number of recalcitrant AD cases in their practice. Although these cases are principally managed by paediatric dermatologists, it is important for paediatricians to be aware of the use and side effects of non-topical treatment like phototherapy and systemic agents as well as the evidence for alternative treatment, which caregivers may ask about. This review presents paediatric evidence for the practical use of phototherapy and certain oral immunosuppressants for paediatric AD including doses, duration of use and monitoring of adverse effects. The use of alternative therapy including traditional medicine, probiotics and the role of nutrition are also discussed. Narrow band ultraviolet B phototherapy is effective in recalcitrant paediatric AD. When phototherapy is ineffective or contraindicated, systemic drugs may be administered cautiously with close surveillance of side effects. The use of azathioprine, ciclosporin, methotrexate and mycophenolate mofetil is generally safe in the short term under close monitoring and can be effective alongside compliance to topical treatment. Alternative complementary treatment is not known to be effective. Holistic management including therapeutic patient education is important. Good quality paediatric studies for non-topical AD treatment are needed for definitive guidelines.

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“…AIT for skin allergy A Cochrane review found limited evidence that AIT may be effective for people with atopic eczema [112]. The treatments used in these trials were not associated with an increased risk of local or systemic reactions.…”

Section: Rationale Of Allergy Immunotherapy Across the Life Cycle In mentioning

confidence: 99%

Allergy immunotherapy across the life cycle to promote active and healthy ageing: from research to policies

Calderón

Demoly

Casale

et al. 2016

Clin Transl Allergy

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Allergic diseases often occur early in life and persist throughout life. This life-course perspective should be considered in allergen immunotherapy. In particular it is essential to understand whether this al treatment may be used in old age adults. The current paper was developed by a working group of AIRWAYS integrated care pathways for airways diseases, the model of chronic respiratory diseases of the European Innovation Partnership on active and healthy ageing (DG CONNECT and DG Santé). It considered (1) the political background, (2) the rationale for allergen immunotherapy across the life cycle, (3) the unmet needs for the treatment, in particular in preschool children and old age adults, (4) the strategic framework and the practical approach to synergize current initiatives in allergen immunotherapy, its mechanisms and the concept of active and healthy ageing.

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Specific allergen immunotherapy for the treatment of atopic eczema

Cited by 35 publications

References 83 publications

Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report

Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report

Non-topical management of recalcitrant paediatric atopic dermatitis

Allergy immunotherapy across the life cycle to promote active and healthy ageing: from research to policies

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