Clinical Practice of Allergen Immunotherapy for Allergic Rhinoconjunctivitis and Asthma: An Expert Panel Report

Moisés A Calderon¹, Susan Waserman², David I Bernstein³, Pascal Demoly⁴, Jo Douglass⁵, Remi Gagnon⁶, Constance H Katelaris⁷, Harold Kim⁸, Harold S Nelson⁹, Yoshitaka Okamoto¹⁰, Kimihiro Okubo¹¹, J Christian Virchow¹², Lawrence DuBuske¹³, Thomas B Casale¹⁴, G Walter Canonica¹⁵, Hendrik Nolte¹⁶

Affiliations

¹ Section of Allergy and Clinical Immunology, Imperial College London-NHLI, London, United Kingdom. Electronic address: m.calderon@imperial.ac.uk.
² Department of Medicine, McMaster University, Hamilton, ON, Canada.
³ Division of Allergy, Rheumatology and Immunology, Department of Medicine, University of Cincinnati, Cincinnati, Ohio.
⁴ Department of Pulmonology, University Hospital of Montpellier, & IPLESP, Sorbonne Université - Inserm, Paris, France.
⁵ The Royal Melbourne Hospital & The University of Melbourne, Melbourne, VIC, Australia.
⁶ Clinique Spécialisée en Allergie de la Capitale, Québec, QC, Canada.
⁷ Campbelltown Hospital and the School of Medicine, Western Sydney University, Sydney, NSW, Australia.
⁸ Division of Clinical Immunology and Allergy, Western University, London, ON, Canada; Division of Clinical Immunology & Allergy, Department of Medicine, McMaster University, Hamilton, ON, Canada.
⁹ Department of Medicine, National Jewish Health, Denver, Colo.
¹⁰ Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.
¹¹ Department of Otolaryngology, Nippon Medical School, Nippon, Japan.
¹² Department of Pneumology/Intensive Care Medicine, University of Rostock, Rostock, Germany.
¹³ Department of Medicine, Division of Allergy and Immunology, The George Washington University School of Medicine and Health Sciences, Washington, DC.
¹⁴ Division of Allergy/Immunology, University of South Florida, Tampa, Fla.
¹⁵ Personalized Medicine Clinic Asthma & Allergy, Humanitas Clinical and Research Center, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
¹⁶ ALK, Bedminster, NJ.

PMID: 32422372
DOI: 10.1016/j.jaip.2020.04.071

Review

Clinical Practice of Allergen Immunotherapy for Allergic Rhinoconjunctivitis and Asthma: An Expert Panel Report

Moisés A Calderon et al. J Allergy Clin Immunol Pract. 2020 Oct.

. 2020 Oct;8(9):2920-2936.e1.

doi: 10.1016/j.jaip.2020.04.071. Epub 2020 May 16.

Authors

Affiliations

¹ Section of Allergy and Clinical Immunology, Imperial College London-NHLI, London, United Kingdom. Electronic address: m.calderon@imperial.ac.uk.
² Department of Medicine, McMaster University, Hamilton, ON, Canada.
³ Division of Allergy, Rheumatology and Immunology, Department of Medicine, University of Cincinnati, Cincinnati, Ohio.
⁴ Department of Pulmonology, University Hospital of Montpellier, & IPLESP, Sorbonne Université - Inserm, Paris, France.
⁵ The Royal Melbourne Hospital & The University of Melbourne, Melbourne, VIC, Australia.
⁶ Clinique Spécialisée en Allergie de la Capitale, Québec, QC, Canada.
⁷ Campbelltown Hospital and the School of Medicine, Western Sydney University, Sydney, NSW, Australia.
⁸ Division of Clinical Immunology and Allergy, Western University, London, ON, Canada; Division of Clinical Immunology & Allergy, Department of Medicine, McMaster University, Hamilton, ON, Canada.
⁹ Department of Medicine, National Jewish Health, Denver, Colo.
¹⁰ Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.
¹¹ Department of Otolaryngology, Nippon Medical School, Nippon, Japan.
¹² Department of Pneumology/Intensive Care Medicine, University of Rostock, Rostock, Germany.
¹³ Department of Medicine, Division of Allergy and Immunology, The George Washington University School of Medicine and Health Sciences, Washington, DC.
¹⁴ Division of Allergy/Immunology, University of South Florida, Tampa, Fla.
¹⁵ Personalized Medicine Clinic Asthma & Allergy, Humanitas Clinical and Research Center, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
¹⁶ ALK, Bedminster, NJ.

PMID: 32422372
DOI: 10.1016/j.jaip.2020.04.071

Abstract

Allergen immunotherapy (AIT) reduces symptoms and medication use associated with allergic rhinitis with or without conjunctivitis and allergic asthma. Although several AIT guidelines exist, there remain unanswered questions about AIT that are relevant to everyday practice. Our objective was to prepare an evidence-based overview addressing the practical aspects of AIT in clinical practice based on published evidence and the experience of international experts in the field. Topics covered include interpretation and translation of clinical trial data into everyday clinical practice (eg, allergen doses and treatment duration), assessment of risk and treatment of local and systemic allergic reactions, recommendations for improvement of AIT guidelines, and identification of appropriate data for seeking regulatory approval, to name a few. Many informational gaps in AIT practice need further evaluation as products and practices evolve.

Keywords: Allergic rhinitis; Allergy immunotherapy; Asthma; Clinical practice; Guidelines.

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Clinical Practice of Allergen Immunotherapy for Allergic Rhinoconjunctivitis and Asthma: An Expert Panel Report

Affiliations

Clinical Practice of Allergen Immunotherapy for Allergic Rhinoconjunctivitis and Asthma: An Expert Panel Report

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Abstract

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Medical