Hellings P W, Pugin B, Mariën G, Bachert C, Breynaert C, Bullens D M, Ceuppens J L, Clement G, Cox T, Ebo D, Gevaert P, Halewyck S, Hox V, Ladha K, Jacobs R, Rombaux P, Schrijvers R, Speleman K, Van der Brempt X, Van Gerven L, Vanderveken O, Verhaeghe B, Vierstraete K, Vlaminck S, Watelet J-B, Bousquet J, Seys S F
1ENT Clinical Department, University Hospital Leuven, Kapucijnenvoer 33, 3000 Louvain, Belgium.
2Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium.
Clin Transl Allergy. 2019 Feb 4;9:1. doi: 10.1186/s13601-019-0243-1. eCollection 2019.
Allergic rhinitis (AR) affects 23-30% of the European population with equal prevalence reported in Belgium. Despite guidelines on the correct use of effective treatment, up to 40% of AR patients remain uncontrolled. Allergen immunotherapy (AIT) has been shown to improve the level of control up to 84% of patients being controlled by AIT. Recently, new guidelines for AIT have been published, supporting the clinical evidence for effectiveness of various subcutaneous and sublingual products for AIT in patients who are allergic to airborne allergens. AIT in AR patients not only reduces nasal and/or ocular symptoms but also induces tolerance and has preventive potential. Adoption of AIT into daily clinical practice in Belgium and other European countries is hampered primarily by reimbursement issues of each of the single products but also by several patient- and physician-related factors. Patients need to be better informed about the effectiveness of AIT and the different routes of administration of AIT. Physicians dealing with AR patients should inform patients on tolerance-inducing effects of AIT and are in the need of a harmonized and practical guide that supports them in selecting eligible patients for AIT, in choosing evidence-based AIT products and in following treatment protocols with proven efficacy. Therefore, a stepwise and holistic approach is needed for better adoption of AIT in the real-life setting in Belgium.
变应性鼻炎（AR）影响着23%至30%的欧洲人口，比利时报告的患病率与之相当。尽管有关于正确使用有效治疗方法的指南，但仍有高达40%的AR患者病情未得到控制。变应原免疫疗法（AIT）已被证明可提高控制水平，高达84%的患者通过AIT病情得到控制。最近，已发布了AIT的新指南，支持各种皮下和舌下产品对空气传播变应原过敏患者进行AIT有效性的临床证据。AR患者的AIT不仅可减轻鼻和/或眼部症状，还可诱导耐受并具有预防潜力。在比利时和其他欧洲国家，将AIT纳入日常临床实践主要受到每种单一产品报销问题的阻碍，同时也受到一些患者和医生相关因素的影响。需要让患者更好地了解AIT的有效性以及AIT的不同给药途径。治疗AR患者的医生应告知患者AIT的诱导耐受作用，并且需要一份统一且实用的指南，以支持他们选择适合AIT的患者、选择基于证据的AIT产品以及遵循已证实有效的治疗方案。因此，在比利时的现实环境中，需要采取逐步且全面的方法来更好地应用AIT。
