SLIT w alergiach układu oddechowego – status quo 2017

• Authors: Marita Nittner-Marszalska

Title variants

EN

SLIT in respiratory allergy – status quo 2017

• Languages of publication: PL EN

Abstracts

PL

Artykuł przedstawia miejsce SLIT w immunoterapii alergii układu oddechowego w oparciu o (1) wytyczne EAACI z 2017 roku opracowane z wykorzystaniem instrumentu AGREE II (Appraisal of Guidelines for Research and Evaluation), a dedykowane ocenie efektywności immunoterapii alergenowej w leczeniu alergicznego nieżytu nosa i astmy alergicznej, (2) wytyczne AAAAI dotyczące SLIT oraz (3) w oparciu o wyniki opublikowanych w roku 2017 przeglądów systematycznych i metaanaliz autorstwa Dhami i wsp. W kontekście powyższych dokumentów przedstawiono: aktualne wskazania i przeciwskazania do SLIT w alergiach układu oddechowego, ocenę skuteczności krótko- i długoterminowej SLIT, rekomendacje dotyczące stosowania poszczególnych form SLIT tj. roztworów wodnych i tabletek podjęzykowych, rekomendacje dotyczące poszczególnych protokołów SLIT oraz problem bezpieczeństwa SLIT. Przedstawiono również opinie ekspertów na temat stosowania SLIT w przypadkach uczulenia i alergii poliwalentnej. Problem adherencji do SLIT zilustrowano wynikami najnowszego badania typu „real life” – badania „Breath”.

EN

The article presents the utilization of SLIT in the immunotherapy of respiratory allergies based on: (1) EAACI 2017 guidelines formulated using AGREE II (Appraisal of Guidelines for Research and Evaluation), dedicated to the assessment of the efficacy of allergen immunotherapy in the treatment of allergic rhinitis and bronchial asthma, (2) current AAAAI recommendations concerning SLIT, (3) systematic reviews and meta-analyses by Dhami et al., published in 2017. Drawing on these sources, the following issues have been dealt with: current recommendations and contra-recommendations for SLIT in respiratory allergies, short- and long-term efficacy of SLIT, recommendations regarding the use of specific forms of SLIT application, wiz. aqueous solutions and sublingual tablets, recommendations regarding different SLIT protocols and safety of this form of therapy. Additionally, expert opinions on the uses of SLIT in the case of polyvalent allergy and sensitization. Adherence in SLIT has been highlighted based on the most recent “real life” Breath study.

Keywords

EN

AGREE II; adherencja; alergiczny nieżyt nos; astma alergiczna; atopia; bezpieczeństwoSLIT; immunoterapia alergenowa; immunoterapia podjęzykowa

Discipline

• MEDICINE: MEDICINE

• Publisher: Mediton
• Journal: Alergia Astma Immunologia - przegląd kliniczny
• Year: 2017
• Volume: 22
• Issue: 2-3
• Pages: 24-29

Contributors

author

Marita Nittner-Marszalska

• Klinika Chorób Wewnętrznych i Alergologii Uniwersytetu Medycznego we Wrocławiu

References

• 1. Dhami S, Nurmatov U, Arasi S, et al. Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis. Allergy 2017; doi: 10.1111/all.13201 [Epub ahead of print].
• 2. Dhami S, Kakourou A, Asamoah F, et al. Allergen immunotherapy for allergic asthma: A systematic review and meta-analysis. Allergy 2017; doi: 10.1111/all.13208 [Epub ahead of print].
• 3. Bousquet J. Sublingual immunotherapy: validated. Allergy 2006; 61(supplement 81): 5-6.
• 4. Canonica GW, Cox L, Pawankar R et al. . The World Allergy Organization Journal 2014; 7: 6.
• 5. Greenhawt M, Oppenheimer J, Nelson M, et al. Sublingual immunotherapy: A focused allergen immunotherapy practice parameter update. Ann Allergy Asthma Immunol 2017; 118: 276-82.
• 6. Brozek JL, Bousquet J, Baena-Cagnani CE, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol 2010; 126: 466-76.
• 7. Cox L, Nelson H, Lockey R, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol 2011; 127(supplement): S1-55.
• 8. Jutel M, Agache I, Bonini S, et al. International consensus on allergy immunotherapy. J Allergy Clin Immunol 2015; 136: 556-68.
• 9. Jutel M, Bartkowiak-Emeryk M, Bręborowicz A, et al. Sublingual immunotherapy (SLIT)--indications, mechanism, and efficacy: Position paper prepared by the Section of Immunotherapy, Polish Society of Allergy. Ann Agric Environ Med 2016; 23: 44-53.
• 10. Li JT, Bernstein DI, Calderon MA, Casale TB, Cox L, Passalacqua G, Pfaar O, Papadopoulos NG. Sublingual grass and ragweed immunotherapy: Clinical considerations-a PRACTALL consensus report. J Allergy Clin Immunol 2016; 137: 369-76.
• 11. EAACI Guidelines on Allergen Immunotherapy: allergic rhinoconjunctivitis. In press.
• 12. EAACI Guidelines on Allergic asthma. In press.
• 13. Pitsios C, Demoly P, Bilò MB, et al. Clinical contraindications to allergen immunotherapy: an EAACI position paper. Allergy 2015; 70: 897-909.
• 14. Demoly P, Emminger W, Rehm D, et al. Effective treatment of house dust mite-induced allergic rhinitis with 2 doses of the SQ HDM SLIT-tablet: Results from a randomized, double-blind, placebo-controlled phase III trial. J Allergy Clin Immunol 2016; 137: 444-51.
• 15. Horak F, Zieglmayer P, Zieglmayer R, et al. Early onset of action of a 5-grass-pollen 300-IR sublingual immunotherapy tablet evaluated in an allergen challenge chamber. J Allergy Clin Immunol 2009; 124: 471-7.
• 16. Bożek A, Starczewska-Dymek L, Jarzab J. Prolonged effect of allergen sublingual immunotherapy for house dust mites in elderly patients. Ann Allergy Asthma Immunol 2017; 119: 77-82.
• 17. Scadding GW, Calderon MA, Shamji MH, et al. Effect of 2 years of treatment with sublingual grass pollen immunotherapy on nasal response to allergen challenge at 3 years among patients with moderate to severe seasonal allergic rhinitis: The GRASS randomized clinical trial. JAMA 2017; 317: 615-25.
• 18. Valovirta E, Petersen TH, Piotrowska T, Laursen MK, Andersen JS, Sørensen HF, Klink R; GAP investigators. Results from the 5-year SQ grass sublingual immunotherapy tablet asthma prevention (GAP) trial in children with grass pollen allergy. J Allergy Clin Immunol. 2017; S0091-6749(17)31088-6.
• 19. Zielen S, Devillier P, Heinrich J, et al. Sublingual immunotherapy provides long-term relief in allergic rhinitis and reduces the risk of asthma: A retrospective, real-world database analysis. Allergy 2017; doi: 10.1111/all.13213 [Epub ahead of print].
• 20. Röder E, Berger MY, de Groot H, Gerth van Wijk R. Sublingual immunotherapy in youngsters: adherence in a randomized clinical trial. Clin Exp Allergy 2008; 38: 1659-67.
• 21. Vita D, Caminiti L, Ruggeri P, Pajno GB. Sublingual immunotherapy: adherence based on timing and monitoring control visits. Allergy 2010; 65: 668-9.
• 22. Hsu NM, Reisacher WR. A comparison of attrition rates in patients undergoing sublingual immunotherapy vs subcutaneous immunotherapy. Int Forum Allergy Rhinol 2012; 2: 280-4.
• 23. Cox LS, Larenas Linnemann D, Nolte H, et al. Sublingual immunotherapy: a comprehensive review. J Allergy Clin Immunol 2006; 117: 1021-35.
• 24. Blaiss M, Maloney J, Nolte H, et al. Efficacy and safety of timothy 9 grass allergy immunotherapy tablets in North American children and adolescents. J Allergy Clin Immunol 2011; 127: 64-71.
• 25. Casale TB, Cox LS, Wahn U, et al. Safety Review of 5-Grass Pollen Tablet from Pooled Data of Clinical Trials. J Allergy Clin Immunol Pract 2017; 19: S2213-2198.
• 26. Klimek L, Pfaar O, Bousquet J, et al. Allergen immunotherapy in allergic rhinitis: current use and future trends. Expert Rev Clin Immunol 2017; 13: 897-906.
• 27. Portnoy J, Cox LS. Is the Benefit From Prescribing Epinephrine Autoinjectors for Sublingual Immunotherapy Worth the Cost? Lessons Learned From Clinical Trials. J Allergy Clin Immunol Pract 2017; 5: 90-9.
• 28. Lucendo AJ, Arias A, Tenias JM. Relation between eosinophilic esophagitis and oral immunotherapy for food allergy: a systematic review with meta-analysis. Ann Allergy Asthma Immunol 2014; 113: 624e629.
• 29. Miehlke S, Alpan O, Schröder S, Straumann A. Induction of eosinophilic esophagitis by sublingual pollen immunotherapy. Case Rep Gastroenterol 2013; 7: 363e368.
• 30. Sanchez-Garcia S, Rodriguez Del Rio P, Escudero C, et al. Possible eosinophilic esophagitis induced by milk oral immunotherapy. J Allergy Clin Immunol 2012; 129: 1155-7.
• 31. Ridolo E, De Angelis GL, Dall’aglio P. Eosinophilic esophagitis after specific oral tolerance induction for egg protein. Ann Allergy Asthma Immunol 2011; 106: 73-4.

• Document Type: article