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2019 ARIA Care pathways for allergen immunotherapy.

Jean Bousquet1,2,3,4,5,6, Oliver Pfaar7, Alkis Togias8

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This summary is machine-generated.

Allergen immunotherapy (AIT) offers a proven treatment for allergic rhinitis and asthma. This review simplifies AIT care pathways, providing recommendations for healthcare professionals and patients to optimize treatment decisions.

Keywords:
allergen immunotherapyasthmachildrenmHealthrhinitisstratification

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Area of Science:

  • Allergy and Immunology
  • Respiratory Medicine
  • Pharmacotherapy

Background:

  • Allergen immunotherapy (AIT) is an established treatment for allergic rhinitis and asthma.
  • Existing guidelines for AIT are varied, complex, and lack proposed care pathways.
  • There is a need for standardized, evidence-based AIT care pathways.

Purpose of the Study:

  • To review existing care pathways for allergen immunotherapy (AIT) based on strict criteria.
  • To provide simple, actionable recommendations for AIT implementation for all stakeholders.
  • To standardize and improve the application of AIT in clinical practice.

Main Methods:

  • Systematic review of AIT care pathways using predefined strict criteria.
  • Analysis of guideline recommendations for AIT prescription and patient selection.
  • Evaluation of factors influencing AIT efficacy and patient stratification.

Main Results:

  • The decision for AIT should be individualized, considering allergen relevance, symptom persistence, and extract quality.
  • AIT is typically prescribed by specialists for stratified patients; validated biomarkers for success prediction are lacking.
  • AIT is recommended for moderate/severe allergic rhinitis or moderate asthma in adolescents/adults, potentially beneficial in multimorbidity and for preventing asthma in children.
  • mHealth tools show promise for patient stratification and follow-up.

Conclusions:

  • Development of simplified, evidence-based AIT care pathways is crucial for consistent patient care.
  • Individualized patient assessment and specialist involvement are key to successful AIT.
  • Future research should focus on predictive biomarkers and leveraging mHealth for AIT management.