Decision-making for pediatric allergy immunotherapy for aeroallergens: a narrative review
Por:
Tortajada-Girbés M, Mesa Del Castillo M, Larramona H, Lucas JM, Álvaro Lozano M, Tabar AI, Soler López B and Martínez-Cañavate A
Publicada:
1 dic 2019
Ahead of Print:
14 ago 2019
Categoría:
Pediatrics, perinatology and child health
Resumen:
There has been exciting progress in diagnosis and in the treatment of allergic patients. The objective of this review is to summarize the most relevant contributions in the past 10 years with a special focus on the pediatric population allergic to aeroallergens and provide the most relevant references and practical issues for the decision-making. Current guidelines on allergy diagnosis recommend a thorough clinical history as the first step, followed by allergen extract testing using an in vivo prick test and/or an in vitro specific IgE test. Molecular diagnosis is recommended when previous tests are inconclusive. In practice, the most important factors to decide the AIT treatment are the actual intensity and duration of the patient's symptoms and the availability of appropriate AIT products for the patient's sensitization profile at high allergen concentrations and with confirmed efficacy and safety from clinical trials. This document summarizes outstanding references for allergic immunotherapy decision-making and provides summary tables and figures analyzing the most important factors related to the decision for allergen immunotherapy and the safety risks related. The experts concluded that AIT is efficacious and safe for the treatment of allergic patients that is available for the most frequent aeroallergens.What is Known:center dot The prevalence of allergic asthma and rhinitis in children has increased in recent decades.center dot The efficacy and safety of allergen immunotherapy has been shown in multiple studies and systematic reviews.What is New:center dot This document summarizes outstanding references for allergic immunotherapy decision-making and provides summary tables and figures analyzing the most important factors related to the decision for allergen immunotherapy and the safety risks related. Recommendations of expert authors for the decision of the patients more suitable for allergen immunotherapy are included.
Filiaciones:
:
Paediatric Allergology and Pulmonology Unit, Dr. Peset University Hospital, Fundación IVI, Valencia, Spain
Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain
Mesa Del Castillo M:
Paediatric Allergology and Neumology Unit, Hospital El Escorial, Madrid, Spain
Larramona H:
Paediatric Allergology and Pulmonology Unit, Department of Paediatrics, University Autonoma of Barcelona, and Corporacio Sanitaria Parc Tauli, Hospital of Sabadell, Barcelona, Spain
Lucas JM:
Pediatric Allergy and Immunology Unit, Virgen Arrixaca Clinic Universitary Hospital, Murcia, Spain
Álvaro Lozano M:
Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Tabar AI:
Complejo Hospitalario de Navarra
IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
Soler López B:
Medical Department, E-C-BIO, S.L., c/ Rosa de Lima, 1, Edificio ALBA, Office 016, Las Rozas, 28230, Madrid, Spain.
Martínez-Cañavate A:
Paediatric Allergology and Neumology Unit, Complejo Hospitalario Universitario de Granada, Coordinator of the SEICAP Immunotherapy Working Group, Granada, Spain
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