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Allergen immunotherapy in asthma; what is new?
The use and role of allergen immunotherapy (AIT) in asthma is still a matter of debate, and no definite recommendation about this is made in guidelines, both for the subcutaneous and sublingual routes. This is essentially due to the fact that most controlled randomised trials were not specifically d...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4970380/ https://www.ncbi.nlm.nih.gov/pubmed/27965760 http://dx.doi.org/10.1186/s40733-015-0006-2 |
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author | Passalacqua, Giovanni Rogkakou, Anthi Mincarini, Marcello Canonica, Giorgio Walter |
author_facet | Passalacqua, Giovanni Rogkakou, Anthi Mincarini, Marcello Canonica, Giorgio Walter |
author_sort | Passalacqua, Giovanni |
collection | PubMed |
description | The use and role of allergen immunotherapy (AIT) in asthma is still a matter of debate, and no definite recommendation about this is made in guidelines, both for the subcutaneous and sublingual routes. This is essentially due to the fact that most controlled randomised trials were not specifically designed for asthma, and that objective measures of pulmonary function were only occasionally considered. Nonetheless, in many trials, favourable results in asthma (symptoms, medication usage, bronchial reactivity) were consistently reported. There are also several meta analyses in favour of AIT, although their validity is limited by a relevant methodological heterogeneity. In addition to the crude clinical effect, a disease modifying action of AIT (prevention of asthma onset and long-lasting effects) have been reported. The safety is an important aspect to consider in asthma. Fatalities were rare: in Europe no fatality was reported in the last three decades, as in the United States in the last 4 years. Based on previous surveys, and common sense, uncontrolled asthma is still recognized as the most important risk factor for severe adverse events. On the contrary, there is no evidence that AIT can worsen or induce asthma. According to the available evidence, AIT can be safely used as add-on treatment when asthma is associated with rhinitis (a frequent condition), provided that asthma is adequately controlled by pharmacotherapy. AIT cannot be recommended or suggested as single therapy. When asthma is the unique manifestation of respiratory allergy, its use should be evaluated case by case. |
format | Online Article Text |
id | pubmed-4970380 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-49703802016-12-13 Allergen immunotherapy in asthma; what is new? Passalacqua, Giovanni Rogkakou, Anthi Mincarini, Marcello Canonica, Giorgio Walter Asthma Res Pract Review The use and role of allergen immunotherapy (AIT) in asthma is still a matter of debate, and no definite recommendation about this is made in guidelines, both for the subcutaneous and sublingual routes. This is essentially due to the fact that most controlled randomised trials were not specifically designed for asthma, and that objective measures of pulmonary function were only occasionally considered. Nonetheless, in many trials, favourable results in asthma (symptoms, medication usage, bronchial reactivity) were consistently reported. There are also several meta analyses in favour of AIT, although their validity is limited by a relevant methodological heterogeneity. In addition to the crude clinical effect, a disease modifying action of AIT (prevention of asthma onset and long-lasting effects) have been reported. The safety is an important aspect to consider in asthma. Fatalities were rare: in Europe no fatality was reported in the last three decades, as in the United States in the last 4 years. Based on previous surveys, and common sense, uncontrolled asthma is still recognized as the most important risk factor for severe adverse events. On the contrary, there is no evidence that AIT can worsen or induce asthma. According to the available evidence, AIT can be safely used as add-on treatment when asthma is associated with rhinitis (a frequent condition), provided that asthma is adequately controlled by pharmacotherapy. AIT cannot be recommended or suggested as single therapy. When asthma is the unique manifestation of respiratory allergy, its use should be evaluated case by case. BioMed Central 2015-07-15 /pmc/articles/PMC4970380/ /pubmed/27965760 http://dx.doi.org/10.1186/s40733-015-0006-2 Text en © Passalacqua et al. 2016 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Review Passalacqua, Giovanni Rogkakou, Anthi Mincarini, Marcello Canonica, Giorgio Walter Allergen immunotherapy in asthma; what is new? |
title | Allergen immunotherapy in asthma; what is new? |
title_full | Allergen immunotherapy in asthma; what is new? |
title_fullStr | Allergen immunotherapy in asthma; what is new? |
title_full_unstemmed | Allergen immunotherapy in asthma; what is new? |
title_short | Allergen immunotherapy in asthma; what is new? |
title_sort | allergen immunotherapy in asthma; what is new? |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4970380/ https://www.ncbi.nlm.nih.gov/pubmed/27965760 http://dx.doi.org/10.1186/s40733-015-0006-2 |
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