Specific Immunotherapy

Klimek, Ludger; Kopp, Matthias; Virchow, J. Christian

doi:10.3238/arztebl.2013.0148

Cited by 19 publications

(15 citation statements)

References 60 publications

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“…AIT is the practice of administering gradually increasing quantities of an allergen extract to an allergic subject to ameliorate the symptoms associated with the subsequent exposure to the causative allergen 2. It is accepted to be the only causal treatment option that is able to induce an immune tolerance against allergens, and it should be performed for at least 3 years 3,4. For this reason, compliance with AIT is mandatory, as happens for all chronic medical treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Additional benefits of SCIT are its “sustained effect” (during 2 years or 3 years treatment)8–11 and “long-term and disease-modifying efficacy” (eg, prevention of new sensitizations and asthma) 12–14. According to guidelines, a therapy of at least 3 consecutive years is required to achieve the latter effect 4. Lack of compliance is even a contraindication for AIT 15.…”

Section: Introductionmentioning

confidence: 99%

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Patients’ compliance with different administration routes for allergen immunotherapy in Germany

Egert-Schmidt¹,

Kolbe²,

Mussler³

et al. 2014

PPA

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BackgroundAllergen immunotherapy (AIT) is the practice of administering gradually increasing quantities of an allergen extract to an allergic subject to ameliorate the symptoms associated with the subsequent exposure to the causative allergen. It is the only treatment that may alter the natural course of allergic diseases. According to AIT guidelines and summary of product characteristics (SmPCs), the treatment should be carried out for at least 3 years. It is controversially discussed whether subcutaneous or sublingual administration routes cause higher patients’ compliance.MethodsGerman sales data for different preparations of the allergen manufacturer Allergopharma GmbH & Co. KG were retrospectively evaluated for 5 consecutive years, based on prescriptions per patient: pollen sublingual immunotherapy (SLIT) and high-dose hypoallergenic (allergoid) or unmodified depot pollen and mite preparations for subcutaneous immunotherapy (SCIT). To identify patients’ compliance, “completed treatment years” were determined. A completed treatment year was defined by the required number of prescribed allergen preparations according to the recommended dosage scheme given in the respective SmPCs.ResultsPrescription data of 85,241 patients receiving pollen or mite SCIT and 706 patients receiving pollen SLIT were included in this analysis. Patients’ compliance for at least 3 treatment years with high-dose hypoallergenic pollen SCIT was higher when administered perennially (60%) compared to preseasonally (27%). Prescriptions for at least 3 years were received from 42% of patients with pollen SCIT and from 45% of patients with mite SCIT. Compliance with SLIT was lowest with only 16% of patients receiving prescriptions for at least 3 treatment years. Children and adolescents were more compliant than adults, independent of whether they received SLIT or SCIT.ConclusionIn general, patients’ compliance with SCIT using high-dose hypoallergenic or unmodified depot preparations was higher than with pollen SLIT. Perennial application of SCIT seems to increase compliance in comparison to the preseasonal application. Children and adolescents were most compliant, independent of the preparation applied.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patients’ compliance with different administration routes for allergen immunotherapy in Germany

Egert-Schmidt¹,

Kolbe²,

Mussler³

et al. 2014

PPA

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“…Applikationsformen sind die subkutane oder die sublinguale Immuntherapie (SCIT bzw. SLIT) [28]. Durch ansteigende Dosen an Antigenen, gegen die die jeweiligen Probanden allergisch sind, wird eine weitgehende Immuntoleranz erreicht.…”

Section: Immuntherapieunclassified

“…Durch ansteigende Dosen an Antigenen, gegen die die jeweiligen Probanden allergisch sind, wird eine weitgehende Immuntoleranz erreicht. Während bei SCIT mögliche systemische Nebenwirkungen nicht auszuschließen sind, kann es bei SLIT zu Nebenwirkungen im Bereich der Mundhöhle kommen [28]. In den USA wird bei subkutaner Gabe eine Wartezeit von 4 Stunden empfohlen [23].…”

Section: Immuntherapieunclassified

Medikamente und Fliegen – Was müssen Ärzte und Piloten beachten?

Siedenburg¹

2015

Flug u Reisemed.

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Auch bei Piloten oder Kabinenpersonal kommen akute und chronische Erkrankungen vor, die eine medikament?se Behandlung erfordern k?nnen. Medikamente k?nnen neben ihren erw?nschten Wirkungen aber auf vielfache Weise die k?rperliche und mentale Leistungsf?higkeit, insbesondere kognitive Leistungen, Reaktionsschnelligkeit et cetera beeinflussen und auch zu M?digkeit f?hren. F?r fliegendes Personal gelten deshalb gesetzliche Vorgaben bei der Medikamenteneinnahme. Einerseits wird die Einnahme bestimmter Medikamente beschr?nkt, andererseits sind bestimmte Karenzzeiten nach Medikamenteneinnahme oder Narkosen zu beachten. Die vorliegende Arbeit soll Flieger?rzten und behandelnden ?rzten eine Hilfestellung bei der Betreuung von Piloten geben, die Medikamente einnehmen oder auf solche eingestellt werden sollen. Informiert wird ?ber grunds?tzliche Erw?gungen sowie die h?ufigsten Medikamentengruppen in der flieger?rztlichen Praxis.

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“…At present, this goal can only be achieved with allergen-specific immunotherapy (AIT, SIT), a method oriented to treating the immunological cause of allergic disease. Thus, this approach is able to reduce symptoms and drug use, has a disease-modifying effect and counteracts the naturally often seen disease progression and broadening of the allergy spectrum [10–13]. …”

Section: Introductionmentioning

confidence: 99%

Authorised allergen products for intracutaneous testing may no longer be available in Germany

et al. 2015

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Background:Beside the skin prick test, the intracutaneous test represents the most important skin test method for detecting type-1 allergies. With the incorporation of European directives into national law, test allergens used for allergy diagnosis are deemed medicinal products within the meaning of the German Medicinal Products Act (Arzneimittelgesetz) and therefore require marketing authorisation for distribution in Germany. The high costs of acquiring and maintaining these authorisations have lead to no new finished intracutaneous test products being authorized in Germany for more than 20 years. Instead, most manufacturers have voluntarily withdrawn their existing marketing authorisations for intracutaneous test extracts. The last manufacturer to offer approved finished allergen products for intracutaneous tests recently announced that it would now cease production and distribution of these solutions.Methods:Research on the current European and German legislation; selective literature search in Medline, including national and international guidelines and Cochrane meta-analyses; licensing information on the Paul-Ehrlich-Institute homepage (www.pei.de) as well as in the Bundesanzeiger (Federal Gazette).Results:According to information on www.pei.de, marketing authorisations still existed as of 31.01.2015 for intracutaneous test solutions of six grass/cereal/herbal pollens, seven tree pollens, ten food allergens, twelve moulds and yeasts as well as two fungal mixtures, five house dust and storage mites and five animal epithelia/danders, all held by only one company in Germany. These marketing authorisations were granted between 16th March 1987 and 17th January 1992; more recent marketing authorisations do not exist.Conclusions:European legislation and the associated increase in production and licensing costs have already lead to numerous suppliers withdrawing their marketing authorisation for diagnostic test allergens — marketing authorisations for 443 diagnostic allergens were voluntarily withdrawn by manufacturers in 2013 alone. If the announced restrictions on the allergen portfolio go ahead, considerable problems in the management of allergy patients in Germany due to the discontinuation of the intracutaneous test are likely to be encountered. Moreover, the fact that a diagnostic procedure that has been established for decades seems set to disappear quite simply because all the requisite substances vanish from the market in one fell swoop may well be without parallel in modern medicine.The situation for skin prick test allergens is less dramatic, although, here again, the available range is becoming increasingly limited.

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Specific Immunotherapy

Abstract: SUMMARYBackground: It is estimated that up to 24% of the population in Germany suffers from allergic rhinoconjunctivitis and 5% from allergic asthma. Allergic rhinoconjunctivitis is closely related to other atopic diseases.

Cited by 19 publications

References 60 publications

Patients’ compliance with different administration routes for allergen immunotherapy in Germany

Patients’ compliance with different administration routes for allergen immunotherapy in Germany

Medikamente und Fliegen – Was müssen Ärzte und Piloten beachten?

Authorised allergen products for intracutaneous testing may no longer be available in Germany

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Specific Immunotherapy

Abstract: SUMMARYBackground: It is estimated that up to 24% of the population in Germany suffers from allergic rhinoconjunctivitis and 5% from allergic asthma. Allergic rhinoconjunctivitis is closely related to other atopic diseases.

Cited by 19 publications

References 60 publications

Patients&rsquo; compliance with different administration routes for allergen immunotherapy in Germany

Patients&rsquo; compliance with different administration routes for allergen immunotherapy in Germany

Medikamente und Fliegen – Was müssen Ärzte und Piloten beachten?

Authorised allergen products for intracutaneous testing may no longer be available in Germany

Contact Info

Product

Resources

About

Patients’ compliance with different administration routes for allergen immunotherapy in Germany

Patients’ compliance with different administration routes for allergen immunotherapy in Germany