scholarly journals Allergen Immunotherapy in Pediatric Respiratory Allergy

2021 ◽  
Author(s):  
Ali Doroudchi ◽  
Kamran Imam ◽  
Maria Ines Garcia Lloret
Keyword(s):  
Allergic Rhinitis ◽  
Allergic Asthma ◽  
Allergen Immunotherapy ◽  
Treatment Options ◽  
Disease Process ◽  
House Dust Mites ◽  
Subcutaneous Immunotherapy ◽  
Activation Markers ◽  
Safety And Efficacy ◽  
Asthma In Children

Abstract Purpose of Review Atopic diseases such as asthma and allergic rhinitis are highly prevalent in children. Common triggers include tree and grass pollens, house dust mites, molds, and animal dander. These diseases are most often treated symptomatically; however, many patients show partial or poor response and require long-term medication use. Allergen immunotherapy (AIT) stands as the only treatment modality that can alter the underlying disease process and potentially offer a cure. In this review article, we discuss the merits of AIT with particular emphasis on its efficacy and safety in pediatric patients. We also discuss the challenges for AIT implementation and present an overview of current research that aims at improving its applicability for the treatment of allergic diseases. Recent Findings Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are both safe and efficacious treatment options in children with allergic rhinitis and allergic asthma. Additionally, AIT has efficacy in preventing the development of asthma in children. Although there are clear advantages with AIT, there are challenges to overcome to optimize treatment. Solutions include improved diagnostics with pre-treatment biomarkers and molecular multiplex assays, biomarkers for prediction of response (e.g., basophil activation markers), improved allergen immunogenicity with the use of recombinant AIT, adjuvants, and allergoids, and lastly improved safety with the concurrent use of omalizumab. Summary AIT has shown safety and efficacy in major clinical trials for the treatment of allergic rhinitis and allergic asthma in children. AIT provides a curative treatment option for atopic disorders and should be considered in children with allergic rhinitis and allergic asthma. There are many continued advances being made in the field of allergy to further improve the safety and efficacy profile and shorten the duration of AIT treatment.

Allergic Rhinitis

2021 ◽  
Author(s):  
Sonya Marcus
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Congestion ◽  
Treatment Options ◽  
The United States ◽  
Subcutaneous Immunotherapy ◽  
Allergy Testing ◽  
Intranasal Corticosteroids ◽  
Substantial Economic Burden ◽  
Key Words Allergic Rhinitis

Allergic rhinitis is a common condition that affects 10-40% of adults in the United States annually. It has a significant impact on patient quality of life and poses a substantial economic burden on society. Knowledge regarding accurate diagnosis, testing and treatment options are important in the management of this prevalent condition. Treatment options include allergen avoidance, pharmacotherapy and allergy immunotherapy. This review contains 7 figures, 6 tables and 28 references. Key words: allergic rhinitis, rhinorrhea, nasal congestion, intranasal corticosteroids, antihistamines, skin prick allergy testing, intradermal allergy testing, subcutaneous immunotherapy, sublingual immunotherapy, anaphylaxis

scholarly journals Cost-effectiveness of allergic rhinitis treatment: An exploratory study

2018 ◽  
Vol 6 ◽  
pp. 205031211879458
Author(s):  
Jan Titulaer ◽  
Habibollah Arefian ◽  
Michael Hartmann ◽  
Mustafa Z Younis ◽  
Orlando Guntinas-Lichius
Keyword(s):  
Allergic Rhinitis ◽  
Cost Effectiveness ◽  
Side Effects ◽  
Symptom Score ◽  
Treatment Options ◽  
Local Therapy ◽  
Cost Effective ◽  
Subcutaneous Immunotherapy ◽  
Control Group ◽  
Placebo Control

Allergic rhinitis is serious public health problems and one of the most common chronic diseases worldwide. We aimed to assess the cost-effectiveness of clinically relevant treatment options for allergic rhinitis using evidence-based literature. In addition, we aimed to develop recommendations for allergic rhinitis treatment based on health economic facts. We searched MEDLINE via PubMed from 2009 to 2014 to identify all therapeutic options described in the current literature and selected randomized controlled trials that used a symptom score, had at least one placebo control group and used adult patients. We analyzed the side effects and the number of cases in which treatment was discontinued for each treatment option. Local antihistamines were the most cost-effective local therapy and are recommended due to the low number of complications. Regarding systemic therapies, although the use of oral steroids is indeed significantly cost-effective, this treatment was found to be associated with strong side effects. Sublingual immunotherapy was identified as the most cost-effective immunotherapy and exhibits a good side-effect profile. Overall, local therapy with antihistamines was found to be the most cost-effective option of all therapies. This study showed that there are only minor differences between sublingual and subcutaneous immunotherapy. Based on our results, we recommend the use of an international, uniform nasal symptom score to facilitate the comparison of clinical trials on allergic rhinitis in the future.

scholarly journals Impact of house dust mite-driven asthma on children’s school performance and activity

2021 ◽  
Author(s):  
Catalina Gómez ◽  
Judit Barrena ◽  
Vanesa García-Paz ◽  
Ana M. Plaza ◽  
Paula Crespo ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Allergic Asthma ◽  
House Dust ◽  
Allergen Immunotherapy ◽  
House Dust Mites ◽  
Dust Mites ◽  
Activity Impairment ◽  
Daily Lives ◽  
School Work ◽  
Clinical Benefits

AbstractEvidence regarding asthma’s impact on children’s daily lives is limited. This prospective and cross-sectional, observational, multicenter study assessed school/work and activity impairment in children and adolescents with allergic asthma and their caregivers and allergen immunotherapy (AIT) effects. Included patients were schooled children and adolescents (5 to 17 years) with allergic asthma due to house dust mites (HDM). Impairment of school/work (i.e., absenteeism and presenteeism) and activity was measured in patients and their caregivers using the Work Productivity Impairment Questionnaire plus Classroom Impairment Questions: Allergy Specific (WPAI + CIQ:AS). HDM allergic patients with school impairment received subcutaneous AIT with a MicroCrystalline Tyrosine-associated allergoid. WPAI + CIQ:AS and effectiveness variables were compared between baseline and 1-year post-AIT. Of the 113 patients included, 59 (52.2%) and 51 (45.1%) showed school and activity impairment, respectively, missing a mean (SD) of 37.6 (24.4) % and 42.6 (25.6) % of school and activity time, respectively. Twenty-six (23%) caregivers reported activity impairment and, of the 79 (69.9%) employed, 30 (38%) reported work impairment. Of the 65 patients with school/activities impairment, 41 (63.1%) received AIT, of which 21 (51.2%) completed 1 year of treatment. Effectiveness variables and WPAI + CIQ:AS significantly improved: Mean (SD) school impairment decreased from 39.7 (26.7) to 2.1 (7.1) % (p < 0.001) and activity impairment from 46.2 (34.6) to 1.4 (3.6) % (p < 0.001).Conclusion: Allergic asthma due to HDMs results in school/work and activity impairment in children and adolescents and their caregivers. One year of AIT provided clinical benefits and reduced school and activity impairment. What is Known:• Allergic asthma impairs children’s school performance and daily activities.• Allergen immunotherapy modifies allergic disease course and ameliorates its symptoms. What is New:• Asthma symptoms due to allergy to house dust mites impair children’s school attendance and productivity and daily activity and their caregivers’ work performance and daily lives.• Allergen immunotherapy with a house dust mite MicroCrystalline Tyrosine (MCT)-associated allergoid seems to provide clinical benefits, associated with decreased school and activity impairment, supporting it as an effective treatment option.

scholarly journals Dropouts From Sublingual Immunotherapy and the Transition to Subcutaneous Immunotherapy in House Dust Mite-Sensitized Allergic Rhinitis Patients

2022 ◽  
Vol 2 ◽  
Author(s):  
Huan Chen ◽  
Guo-qing Gong ◽  
Mei Ding ◽  
Xiang Dong ◽  
Yuan-li Sun ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Allergic Asthma ◽  
House Dust ◽  
House Dust Mite ◽  
Sublingual Immunotherapy ◽  
Dropout Rates ◽  
Subcutaneous Immunotherapy ◽  
Transition Rates ◽  
Dust Mite

Purpose: Both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are effective in reducing symptoms and medication scores and inducing long-term efficacy in patients with allergic rhinitis (AR). However, SLIT has been associated with poor patient adherence. This study investigates the factors impacting dropout rates from SLIT in house dust mite (HDM)-sensitized AR patients.Methods: A retrospective study was performed to analyze dropout rates and reasons in AR patients receiving Dermatophagoides farinae (Der f) SLIT with a follow-up period of 2 years.Results: A total of 719 HDM-sensitized AR patients received Der f-SLIT. Dropout rates increased with time and most occurred after 1 year of SLIT. By month 24, 654 (91%) patients had discontinued SLIT. The dropout rates by month 24 were 100, 90.1, and 91.1% in children &lt;5 years old, children aged 5–18 years old, and adults ≥ 18 years old, respectively. Combination with allergic asthma and mono- or multi-sensitization to other aeroallergens did not affect the dropout rates. The most common self-reported reasons for dropouts were refusal of continuation, dissatisfaction with the efficacy, transition to SCIT, and adverse effects. Refusal of continuation increased with age, whereas transition to SCIT decreased with age. Ninety-seven cases transitioned from SLIT to SCIT, and the transition rates increased with time. Comorbid allergic asthma did not affect the transition rates. However, multi-sensitization was associated with a slightly higher rate of transition to SCIT. The most common reason for the transition was dissatisfaction with the efficacy (54.6%), which was only reported by patients older than 5 years. For children who began SLIT at younger than 5 years old, the most common reason (81.2%) for transition was age reaching 5 years.Conclusions: HDM-SLIT has a very high dropout rate, which is mainly due to refusal of continuation and dissatisfaction with the efficacy. Transitioning from SLIT to SCIT may help keep these patients on AIT and thus increase adherence and long-term efficacy.

Comparision Between Treatment Persistence With Omalizumab in Severe Allergic Asthma and Subcutaneous Immunotherapy in Severe Allergic Rhinitis

CHEST Journal ◽  
2013 ◽  
Vol 144 (4) ◽  
pp. 77A
Author(s):  
Zeynep Ozseker ◽  
Ismet Bulut ◽  
Derya Erdogdu ◽  
Asli Gelincik ◽  
Fusun Erdenen ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Allergic Asthma ◽  
Subcutaneous Immunotherapy ◽  
Treatment Persistence ◽  
Severe Allergic Asthma

Safety of Subcutaneous Immunotherapy with House Dust Mites in Patients with Allergic Rhinitis in Real World

2013 ◽  
Vol 131 (2) ◽  
pp. AB185
Author(s):  
Mario Henrique de Almeida Fonseca ◽  
Norma de Paula Motta Rubini ◽  
Albertina Varandas Capelo ◽  
Eliane Miranda da Silva ◽  
Fernando Samuel Sion ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
House Dust ◽  
Real World ◽  
House Dust Mites ◽  
Subcutaneous Immunotherapy ◽  
Dust Mites

Allergen immunotherapy against house dust mites in patients with local allergic rhinitis and asthma

2021 ◽  
pp. 1-11
Author(s):  
Andrzej Bozek ◽  
Beata Galuszka ◽  
Radosław Gawlik ◽  
Maciej Misiolek ◽  
Wojciech Ścierski ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
House Dust ◽  
Allergen Immunotherapy ◽  
House Dust Mites ◽  
Dust Mites ◽  
Local Allergic Rhinitis

scholarly journals Long-term Effects of Specific Allergen Immunotherapy Against House Dust Mites in Polysensitized Patients With Allergic Rhinitis

2014 ◽  
Vol 6 (6) ◽  
pp. 535 ◽  
Author(s):  
Sang Hoon Kim ◽  
Seung Youp Shin ◽  
Kun Hee Lee ◽  
Sung Wan Kim ◽  
Joong Saeng Cho
Keyword(s):  
Allergic Rhinitis ◽  
House Dust ◽  
Allergen Immunotherapy ◽  
House Dust Mites ◽  
Dust Mites ◽  
Long Term Effects ◽  
Specific Allergen
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