Subcutaneous Allergen Immunotherapy in Children: Real Life Compliance and Effect of COVID-19 Pandemic on Compliance

Feng

2022

Allergy

Allergic rhinitis (AR) is a global health problem with increasing prevalence and association with an enormous medical and socioeconomic burden. New recognition of immune cells such as type 2 innate lymphocytes (ILC2s), T helper (Th2) 2 cells, follicular helper T cells, follicular regulatory T cells, regulatory T cells, B cells, dendritic cells, and epithelial cells in AR pathogenesis has been updated in this review paper. An in‐depth understanding of the mechanisms underlying AR will aid the identification of biomarkers associated with disease and ultimately provide valuable parameters critical to guide personalized targeted therapy. As the only etiological treatment option for AR, allergen‐specific immunotherapy (AIT) has attracted increasing attention, with evidence for effectiveness of AIT recently demonstrated in several randomized controlled trials and long‐term real‐life studies. The exploration of biologics as therapeutic options has only involved anti‐IgE and anti‐type 2 inflammatory agents; however, the cost‐effectiveness of these agents remains to be elucidated precisely. In the midst of the currently on‐going COVID‐19 pandemic, a global life‐threatening disease, although some studies have indicated that AR is not a risk factor for severity and mortality of COVID‐19, this needs to be confirmed in multi‐centre, real‐life studies of AR patients from different parts of the world.

Section: Ar Patient Manag Ement During the Covid -19 Pandemi Cmentioning

confidence: 99%

Section: Ar Patient Management During the Covid‐19 Pandemicmentioning

confidence: 99%

Update on pathomechanisms and treatments in allergic rhinitis

Feng

2022

Allergy

Pediatric Allergy Immunology

“…Some real‐life and modeling studies at the time of pandemic demonstrated that home immunotherapy self‐administration can be a safe and cost‐effective option if patients are carefully preselected 113 . On average, one in three patients managed with subcutaneous immunotherapy (SCIT) discontinued the treatment during the COVID‐19 pandemic 92,114 with being infected with COVID‐19 and thinking that the AIT practice stopped because of pandemic were among the most common reasons for cessation. An international survey of physicians carried out by EAACI reported no concerns regarding reduced tolerability of AIT under real‐life circumstances 115 .…”

Section: Management Of Allergic Diseases During Pandemicmentioning

confidence: 99%

Allergic diseases and immunodeficiencies in children, lessons learnt from COVID‐19 pandemic by 2022: A statement from the EAACI‐section on pediatrics

Munblit

Greenhawt

Brough

et al. 2022

By the April 12, 2022, the COVID‐19 pandemic had resulted in over half a billion people being infected worldwide. There have been 6.1 million deaths directly due to the infection, but the pandemic has had many more short‐ and long‐term pervasive effects on the physical and mental health of the population. Allergic diseases are among the most prevalent noncommunicable chronic diseases in the pediatric population, and health‐care professionals and researchers were seeking answers since the beginning of pandemic. Children are at lower risk of developing severe COVID‐19 or dying from infection. Allergic diseases are not associated with a higher COVID‐19 severity and mortality, apart from severe/poorly controlled asthma. The pandemic disrupted routine health care, but many mitigation strategies, including but not limited to telemedicine, were successfully implemented to continue delivery of high‐standard care. Although children faced a multitude of pandemic‐related issues, allergic conditions were effectively treated remotely while reduction in air pollution and lack of contact with outdoor allergens resulted in improvement, particularly respiratory allergies. There is no evidence to recommend substantial changes to usual management modalities of allergic conditions in children, including allergen immunotherapy and use of biologicals. Allergic children are not at greater risk of multisystem inflammatory syndrome development, but some associations with Long COVID were reported, although the data are limited, and further research is needed. This statement of the EAACI Section on Pediatrics provides recommendations based on the lessons learnt from the pandemic, as available evidence.

“…Although there is evidence that the COVID-19 pandemic could have interrupted or altered the administration of AIT, there is limited data on the extent of these disruptions and their potential clinical effects. [10][11][12] Italy was the first European country to experience the spread of the COVID-19 virus in February 2020, which greatly impacted the healthcare system of the country, 13 and Italian physicians pioneered the organization of an allergy clinic during the breakout. 14 However, the experience of allergists with respect to ongoing or new AIT prescriptions is unknown.…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 in allergen immunotherapy: An Italian survey

Sánchez-López

Heffler

Canonica

2022

Allergol Immunopathol

Allergen immunotherapy (AIT) is a common treatment for patients with allergic asthma and allergic rhinoconjunctivitis. There is evidence that the COVID-19 pandemic could have altered the administration of AIT in patients in some countries, as the pandemic caused major limita-tions to healthcare access and delivery. The objective of this study was to evaluate the impact of the disruption imposed by the pandemic on the perceptions and administration of AIT therapies in Italy. An online survey was carried out among Italian allergists between 22 February 2021 and 12 April 2021. The results show that Italian physicians (N=66) did not consider that the COVID-19 pandemic presented an added risk to patients with allergic asthma or rhinitis receiving AIT. Although most treatments continued, there were reduced rates of AIT therapy initiations and sublingual AIT was favored over subcutaneous AIT.