Plamena Novakova1, Angelica Tiotiu2,3,4, Ilaria Baiardini5, Borislava Krusheva6, Herberto Chong-Neto7, Silviya Novakova8. 1. Clinic of Clinical Allergy, Medical University Sofia, Sofia, Bulgaria. 2. Department of Pulmonology, University Hospital of Nancy, Nancy, France. 3. EA3450 DevAH - Development, Adaptation and Disadvantage. Cardio-Respiratory Regulations and Motor Control, University of Lorraine, Nancy, France. 4. Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK. 5. Department of Biomedical Sciences, Humanitas University, Milan, Italy. 6. Department of Allergology and Asthma, Aleksandrovska University Hospital, Sofia, Bulgaria. 7. Division of Allergy and Immunology, Department of Pediatrics, Federal University of Paraná, Curitiba, Brazil. 8. Allergy Unit, Internal Consulting Department, University Hospital "St. George", Plovdiv, Bulgaria.
Abstract
Background: Allergic asthma is the predominant phenotype in clinical practice. Allergen immunotherapy is the only curative and specific approach for the treatment of allergies with clinical benefits for several years after its discontinuation. Despite advances, the use of allergen immunotherapy in allergic asthma is still suboptimal and controversial.Objective: The purpose of this article is to review the published data about the impact of allergen immunotherapy with the most commonly used allergen extracts on allergic asthma outcomes, including both clinical parameters and patients' subjective experience (quality of life). Methods: As data sources several databases were used, including PubMed, Scopus, Web of Science (2002-2019) and search in English and Spanish languages was performed using the following terms: "allergen immunotherapy" and "asthma" in combination with "house dust mite", "birch pollen", "grass pollen", "olive tree pollen", "molds", "pets" and "asthma quality of life". Randomised control trials and meta-analysis from reviewed publications were selected. Results: Emerging data relating to the positive impact on asthma outcomes of allergen immunotherapy allows the addition of this treatment as a therapeutic option in mild to moderate asthmatics sensitized to house dust mite and pollens. Limited data are available for patients sensitized to molds and pets, as well in severe allergic asthma population. Conclusion: Allergen immunotherapy remains a potential therapeutic option for some patients with allergic asthma. Further research is needed to define the optimal period of treatment, the possible therapeutic role in the treatment of severe allergic asthma, and the cost-effectiveness of allergen immunotherapy in asthmatic patients.
Background: Allergic asthma is the predominant phenotype in clinical practice. Allergen immunotherapy is the only curative and specific approach for the treatment of allergies with clinical benefits for several years after its discontinuation. Despite advances, the use of allergen immunotherapy in allergic asthma is still suboptimal and controversial.Objective: The purpose of this article is to review the published data about the impact of allergen immunotherapy with the most commonly used allergen extracts on allergic asthma outcomes, including both clinical parameters and patients' subjective experience (quality of life). Methods: As data sources several databases were used, including PubMed, Scopus, Web of Science (2002-2019) and search in English and Spanish languages was performed using the following terms: "allergen immunotherapy" and "asthma" in combination with "house dust mite", "birch pollen", "grass pollen", "olive tree pollen", "molds", "pets" and "asthma quality of life". Randomised control trials and meta-analysis from reviewed publications were selected. Results: Emerging data relating to the positive impact on asthma outcomes of allergen immunotherapy allows the addition of this treatment as a therapeutic option in mild to moderate asthmatics sensitized to house dust mite and pollens. Limited data are available for patients sensitized to molds and pets, as well in severe allergic asthma population. Conclusion: Allergen immunotherapy remains a potential therapeutic option for some patients with allergic asthma. Further research is needed to define the optimal period of treatment, the possible therapeutic role in the treatment of severe allergic asthma, and the cost-effectiveness of allergen immunotherapy in asthmatic patients.
Entities:
Keywords:
Allergy; quality of life; recommendations; sensitization; treatment
Authors: José Fernando Florido-López; Carmen Andreu-Balaguer; Carmelo Escudero; Marta Seoane-Rodríguez; Mercedes Hernández; Luis Ángel Navarro-Seisdedos; Miguel Torrecillas-Toro; Mónica Anton-Girones; Leticia Herrero-Lifona; Dorimar Brugaletta; Jesús Macías; Rafael Pineda; Maria Ángeles Lara; Julián López-Caballero; Maria José Rojas Journal: World Allergy Organ J Date: 2020-12-18 Impact factor: 4.084