Calderon Moisés A, Waserman Susan, Bernstein David I, Demoly Pascal, Douglass Jo, Gagnon Remi, Katelaris Constance H, Kim Harold, Nelson Harold S, Okamoto Yoshitaka, Okubo Kimihiro, Virchow J Christian, DuBuske Lawrence, Casale Thomas B, Canonica G Walter, Nolte Hendrik
Section of Allergy and Clinical Immunology, Imperial College London-NHLI, London, United Kingdom.
Department of Medicine, McMaster University, Hamilton, ON, Canada.
J Allergy Clin Immunol Pract. 2020 Oct;8(9):2920-2936.e1. doi: 10.1016/j.jaip.2020.04.071. Epub 2020 May 16.
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.
变应原免疫疗法(AIT)可减轻与过敏性鼻炎相关的症状并减少药物使用,无论是否伴有结膜炎和过敏性哮喘。尽管已有多项AIT指南,但仍存在一些与日常实践相关的、尚未得到解答的关于AIT的问题。我们的目标是根据已发表的证据以及该领域国际专家的经验,编写一份基于证据的概述,阐述AIT在临床实践中的实际应用。涵盖的主题包括将临床试验数据解读并转化为日常临床实践(例如变应原剂量和治疗持续时间)、局部和全身过敏反应的风险评估与治疗、改进AIT指南的建议,以及确定寻求监管批准所需的适当数据等。随着产品和实践的发展,AIT实践中的许多信息空白需要进一步评估。