Efficacy and safety of immunotherapy for allergies to Alternaria alternata in children

Kuna, Piotr; Kaczmarek, Jadwiga; Kupczyk, Maciej

doi:10.1016/j.jaci.2010.11.036

Cited by 90 publications

(96 citation statements)

References 42 publications

(28 reference statements)

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“…The primary diagnosis was asthma in 7 studies, 6,7,[11][12][13][14][15] rhinoconjunctivitis in 1 study, 16 and asthma with rhinitis/rhinoconjunctivitis in 5 studies. 8,9,[17][18][19] The majority of studies used a single allergen for SCIT. Dust mites were evaluated in 8 of the 13 studies.…”

Section: Resultsmentioning

confidence: 99%

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Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Kim¹,

Lin²,

et al. 2013

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BACKGROUND AND OBJECTIVE: Subcutaneous immunotherapy (SCIT) is approved in the United States for the treatment of pediatric asthma and rhinitis; sublingual immunotherapy (SLIT) does not have regulatory approval but is used in clinical practice. The objective of this study was to systematically review the evidence regarding the efficacy and safety of SCIT and SLIT for the treatment of pediatric asthma and allergic rhinoconjunctivitis. METHODS:Two independent reviewers selected articles for inclusion, extracted data, and graded the strength of evidence for each clinical outcome. All studies were randomized controlled trials of children with allergic asthma or rhinoconjunctivitis treated with SCIT or an aqueous formulation of SLIT. Data sources were Medline, Embase, LILACS, CENTRAL, and the Cochrane Central Register of Controlled Trials through May 2012. RESULTS:In 13 trials, 920 children received SCIT or usual care; in 18 studies, 1583 children received SLIT or usual care. Three studies compared SCIT with SLIT head-to-head in 135 children. The strength of evidence is moderate that SCIT improves asthma and rhinitis symptoms and low that SCIT improves conjunctivitis symptoms and asthma medication scores. Strength of evidence is high that SLIT improves asthma symptoms and moderate that SLIT improves rhinitis and conjunctivitis symptoms and decreases medication usage. The evidence is low to support SCIT over SLIT for improving asthma or rhinitis symptoms or medication usage. Local reactions were frequent with SCIT and SLIT. There was 1 report of anaphylaxis with SCIT.CONCLUSIONS: Evidence supports the efficacy of both SCIT and SLIT for the treatment of asthma and rhinitis in children. Pediatrics

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Section: Resultsmentioning

confidence: 99%

“…Six RCTs with 550 subjects evaluated SCIT for control of asthma symptoms relative to placebo 11,15,18,19 or pharmacotherapy 13,17 (Table 1; Supplemental Appendix Table 4). Four studies evaluated a single allergen 11,13,18,19 and 2 used multiple allergens.…”

Section: Asthmamentioning

confidence: 99%

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Kim¹,

Lin²,

et al. 2013

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“…Children having allergic rhinitis/ asthma allergic to Alternaria utilized mold AIT or placebo for 3 years in a study by Kuna et al Symptom and medication scores were notably decreased in the AIT group following the 2nd and 3rd years, with a decline in the symptom scores by 63% after AIT. The AIT group had a significant decline in symptoms after a single dose nasal allergen challenge compared to their baseline and to the placebo group one year after completion of the 3 year AIT [15].…”

Section: Subcutaneous Allergen Immunotherapy (Sc-ait) For Alternaria mentioning

confidence: 90%

“…There is an absence of commercial extracts for many of the frequent fungi due to not growing on artificial media [26]. Published studies have also major limitations, including lack of placebo control, open design, utilization of unstandardized extracts, short follow-up time, or not have of a baseline observation periods [15].…”

Section: Limitations To Immunotherapymentioning

confidence: 99%

“…The concerns raised by the EAACI included not only the lack of efficacy but also safety issues. A limited number of AIT studies performed in Europe with extracts of Cladosporium and Alternaria have demonstrated therapeutic efficacy [15]. Cochrane reviews included just 2 out of 88 AIT trials with Cladosporium in its meta-analysis [29][30][31].…”

Section: Limitations To Immunotherapymentioning

confidence: 99%

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Mold Allergy, Its Prevention and Therapy - Part 2

Özdemir¹

2015

MOJI

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In the current treatment of mold allergy, there are two modalities: Preventive and therapeutic approaches. Preventive approaches include measurements against indoor as well as outdoor molds. Relative humidity is suggested to maintain at <50% indoor environments. Windows are kept closed in warm months and air-conditioning ought to be used. Indoor plants, as a possible cause of allergen, should be exposed to direct sunlight from time to time.Visible molds are cleaned and mold-infested resources are should be discarded from houses. Washable surfaces must be cleaned with 5% bleach and detergent solution. Damp carpets are ought to dried out quickly and to think taking them away if humidity is not immediately goes away. In bathrooms, curtains and tile should be regularly checked and mended to keep waterproof. Firewood or newspaper piles or old books are regularly scrutinized and thrown away as necessary. Drip pans for fridges, garages and basements at homes should be regularly checked and cleaned. Water leaks in dwellings should be fixed swiftly.In outdoor environment, intense exposure to moldy plants must be avoided. A well-fitted particulate mask when functioning with moldy objects ought to be used. Air-conditioned vehicles should be utilized. Therapeutic approaches mentioned here for fungal allergy is specifically mold allergen immunotherapy in addition to pharmacotherapy against the effects of mold allergy. Mold allergen immunotherapy, as a specific therapy of fungal allergy, is previously hindered by the poor quality of most of the commercial extracts. There have been only several studies evaluating the efficacy of allergen immunotherapy with Alternaria extracts in patients with respiratory mold allergy.A meta-analysis demonstrated that clinical efficacy of allergen immunotherapy with mold extracts was revealed in 79 actively treated cases in 4 controlled trials, with only 2 mold species, namely Alternaria alternate and Cladosporium herbarium. Recently the American Academy of Allergy, Asthma & Immunology concluded that immunotherapy might be effective for mold allergy. In near future, diagnosis and therapy for mold allergy will be more decisive and effective with newly developed production techniques and methods.

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International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Wise

Damask

Roland

et al. 2023

Int Forum Allergy Rhinol

151

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Background In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR‐Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR‐Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence‐based findings and recommendation from the full document. Methods ICAR‐Allergic Rhinitis 2023 employed established evidence‐based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. Results ICAR‐Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. Conclusion The ICAR‐Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.

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Efficacy and safety of immunotherapy for allergies to Alternaria alternata in children

Cited by 90 publications

References 42 publications

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Mold Allergy, Its Prevention and Therapy - Part 2

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

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