BACKGROUND: Practical issues dealing with the administration of allergen immunotherapy (AIT) by European and US allergists are not well known. Several concerns are only partially covered by guidelines. OBJECTIVE: To survey AIT practice patterns among worldwide members of the American Academy of Allergy, Asthma and Immunology (AAAAI). METHODS: A web-based survey was conducted among AAAAI members on dosing, dose adjustment after missed doses, and duration of AIT. RESULTS: A total of 1,201 replies (24.7% response rate of which 10% of responses were from non-US and non-Canada members). A total of 57% to 65% of the US-Canadian dosing falls within the recommended Practice Parameter ranges (9.4%-19% too low). Dose adjustment after missed doses is based on time elapsed since the last administered dose by 77% of US-Canadian and 58% of non-US-Canadian allergists. Doses are reduced when a patient comes in more than 14 days for 5 weeks after the last administration and initial dosing restarted after more than 30 days for 12 weeks since last administration during the build-up or maintenance stage. After missing 1 to 3 doses, the dosing schedules were mostly followed (build-up phase: repeat last dose, reduce by 1 dose, reduce by 2doses; maintenance phase: reduce by 1 dose, reduce by 2 doses, reduce by 3 doses). AIT is prescribed for a median of 3 years by non-US-Canadian allergists but for a median of 5 years by 75% of US-Canadian allergists. Main reasons for continuing beyond 5 years were "after stopping, symptoms reappeared" or "patient afraid to relapse." CONCLUSION: Many patients receive less than recommended doses. Two areas in which to plan further research are establishment of an optimal dose-adjustment plan for missed applications and exploration of the maximum appropriate duration of immunotherapy.
BACKGROUND: Practical issues dealing with the administration of allergen immunotherapy (AIT) by European and US allergists are not well known. Several concerns are only partially covered by guidelines. OBJECTIVE: To survey AIT practice patterns among worldwide members of the American Academy of Allergy, Asthma and Immunology (AAAAI). METHODS: A web-based survey was conducted among AAAAI members on dosing, dose adjustment after missed doses, and duration of AIT. RESULTS: A total of 1,201 replies (24.7% response rate of which 10% of responses were from non-US and non-Canada members). A total of 57% to 65% of the US-Canadian dosing falls within the recommended Practice Parameter ranges (9.4%-19% too low). Dose adjustment after missed doses is based on time elapsed since the last administered dose by 77% of US-Canadian and 58% of non-US-Canadian allergists. Doses are reduced when a patient comes in more than 14 days for 5 weeks after the last administration and initial dosing restarted after more than 30 days for 12 weeks since last administration during the build-up or maintenance stage. After missing 1 to 3 doses, the dosing schedules were mostly followed (build-up phase: repeat last dose, reduce by 1 dose, reduce by 2doses; maintenance phase: reduce by 1 dose, reduce by 2 doses, reduce by 3 doses). AIT is prescribed for a median of 3 years by non-US-Canadian allergists but for a median of 5 years by 75% of US-Canadian allergists. Main reasons for continuing beyond 5 years were "after stopping, symptoms reappeared" or "patient afraid to relapse." CONCLUSION: Many patients receive less than recommended doses. Two areas in which to plan further research are establishment of an optimal dose-adjustment plan for missed applications and exploration of the maximum appropriate duration of immunotherapy.
Authors: Jay Portnoy; Jeffrey D Miller; P Brock Williams; Ginger L Chew; J David Miller; Fares Zaitoun; Wanda Phipatanakul; Kevin Kennedy; Charles Barnes; Carl Grimes; Désirée Larenas-Linnemann; James Sublett; David Bernstein; Joann Blessing-Moore; David Khan; David Lang; Richard Nicklas; John Oppenheimer; Christopher Randolph; Diane Schuller; Sheldon Spector; Stephen A Tilles; Dana Wallace Journal: Ann Allergy Asthma Immunol Date: 2013-12 Impact factor: 6.347
Authors: Désirée Larenas-Linnemann; Noel Rodríguez-Pérez; Jorge A Luna-Pech; Mónica Rodríguez-González; María Virginia Blandón-Vijil; Blanca E Del-Río-Navarro; María Del Carmen Costa-Domínguez; Elsy Maureen Navarrete-Rodríguez; Carlos Macouzet-Sánchez; José Antonio Ortega-Martell; César Fireth Pozo-Beltrán; Alan Estrada-Cardona; Alfredo Arias-Cruz; Karen Guadalupe Rodríguez Galván; Herson Brito-Díaz; María Del Rosario Canseco-Raymundo; Enrique Emanuel Castelán-Chávez; Alberto José Escalante-Domínguez; José Luis Gálvez-Romero; Javier Gómez-Vera; Sandra Nora González-Díaz; María Gracia Belinda Guerrero-Núñez; Dante Daniel Hernández-Colín; Alejandra Macías-Weinmann; David Alejandro Mendoza-Hernández; Néstor Alejandro Meneses-Sánchez; María Dolores Mogica-Martínez; Carol Vivian Moncayo-Coello; Juan Manuel Montiel-Herrera; Patricia María O'Farril-Romanillos; Ernesto Onuma-Takane; Margarita Ortega-Cisneros; Lorena Rangel-Garza; Héctor Stone-Aguilar; Carlos Torres-Lozano; Edna Venegas-Montoya; Guillermo Wakida-Kusunoki; Armando Partida-Gaytán; Aída Inés López-García; Ana Paola Macías-Robles; María de Jesús Ambriz-Moreno; Amyra Ali Azamar-Jácome; Claudia Yusdivia Beltrán-De Paz; Chrystopherson Caballero-López; Juan Carlos Fernández de Córdova-Aguirre; José Roberto Fernández-Soto; José Santos Lozano-Sáenz; José Joel Oyoqui-Flores; Roberto Efrain Osorio-Escamilla; Fernando Ramírez-Jiménez; Daniela Rivero-Yeverino; Eric Martínez Infante; Miguel Alejandro Medina-Ávalos Journal: World Allergy Organ J Date: 2020-08-21 Impact factor: 4.084