European Survey on Adverse Systemic Reactions in Allergen Immunotherapy (EASSI): a real-life clinical assessment

Calderón, Moisés A.; Vidal, Carmen; Río, Pablo Rodríguez del; Just, Jocelyne; Pfaar, Oliver; Tabar, A. I.; Sánchez‐Machín, Inmaculada; Bubel, Petra; Borja, J.; Eberle, Peter; Reiber, Rainer; Bouvier, Michel; Lepelliez, A.; Klimek, L.; Demoly, Pascal

doi:10.1111/all.13066

Cited by 83 publications

(92 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…11,14,196,197,198 Severe SRs with SLIT appear to be much less likely than with SCIT although the overall rate of any adverse reactions is similar in both SCIT and SLIT 14,184 (see Tables S2 and S3 in online supplement for details of classification 123,199 ). In a review of 66 SLIT studies (over 4000 patients who received over a million doses), there was 1 SR for approximately every 4 years of treatment and only 1 severe SR per 384 treatment years.…”

Section: Slitmentioning

confidence: 99%

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

Roberts

Pfaar

Akdiş

et al. 2017

Allergy

Self Cite

593

705

View full text Add to dashboard Cite

drawn on data from a systematic review of the literature, more recent published studies and multistakeholder expert clinical opinion. This Guideline is aimed at healthcare professionals who are encouraged to take the recommendations into account in the context of delivering clinical care. This Guideline is not a substitute for professional clinical judgment, which professionals need to exercise in the context of delivering personalised healthcare. AbstractAllergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of life; pharmacotherapy may also induce some side-effects. Allergen immunotherapy (AIT) represents the only currently available treatment that targets the underlying pathophysiology, and it may have a disease-modifying effect. Either the subcutaneous (SCIT) or sublingual (SLIT) routes may be used. This Guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on AIT for AR and is part of the EAACI presidential project "EAACI Guidelines on Allergen Immunotherapy." It aims to provide evidence-based clinical recommendations and has been informed by a formal systematic review and meta-analysis. Its generation has followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach.The process included involvement of the full range of stakeholders. In general, broad evidence for the clinical efficacy of AIT for AR exists but a product-specific evaluation of evidence is recommended. In general, SCIT and SLIT are recommended for both seasonal and perennial AR for its short-term benefit. The strongest evidence for long-term benefit is documented for grass AIT (especially for the grass 766 | ROBERTS, PFAAR ET AL. tablets) where long-term benefit is seen. To achieve long-term efficacy, it is recommended that a minimum of 3 years of therapy is used. Many gaps in the evidence base exist, particularly around long-term benefit and use in children. | ME TH ODOLOGYThis Guideline was produced using the Appraisal of Guidelines forResearch & Evaluation (AGREE II) approach, 17,18 a structured approach to guideline production (see Table S1). This is designed to ensure appropriate representation of the full range of stakeholders, a careful search for and critical appraisal of the relevant literature, a systematic approach to the formulation and presentation of recommendations and steps to ensure that the risk of bias is minimized at each step of the process. The process started on April 2015 beginning with detailed face-to-face discussions agreeing on the process and the key clinical areas to address, followed by face-to-face meetings, and regular web conferences in which professional and lay representatives participated. | Clarifying the scope and purpose of the guidelinesThe scope of this EAACI Guideline is multifaceted...

show abstract

Section: Slitmentioning

confidence: 99%

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

Roberts

Pfaar

Akdiş

et al. 2017

Allergy

Self Cite

593

705

View full text Add to dashboard Cite

show abstract

“…In a recent meta‐analysis about the efficacy of grass pollen SLIT tablet by Di Bona et al., 7 treatment‐related adverse events requiring adrenaline were reported in the SLIT RCTs; however, no episode of anaphylaxis was reported. In recent real‐life clinical studies of AIT, less severe systemic reactions were reported with SLIT than with SCIT, although the overall rate of adverse reactions is similar in SCIT and SCIT . The safety profile for the present purpose is not regarded as being different from AIT for the treatment of AR.…”

Section: Ait For Prevention: Evidence and Clinical Recommendationsmentioning

confidence: 99%

EAACI guidelines on allergen immunotherapy: Prevention of allergy

Halken

Larenas‐Linnemann

Roberts

et al. 2017

Pediatric Allergy Immunology

197

173

View full text Add to dashboard Cite

Allergic diseases are common and frequently coexist. Allergen immunotherapy (AIT) is a disease-modifying treatment for IgE-mediated allergic disease with effects beyond cessation of AIT that may include important preventive effects. The European Academy of Allergy and Clinical Immunology (EAACI) has developed a clinical practice guideline to provide evidence-based recommendations for AIT for the prevention of (i) development of allergic comorbidities in those with established allergic diseases, (ii) development of first allergic condition, and (iii) allergic sensitization. This guideline has been developed using the Appraisal of Guidelines for Research & Evaluation (AGREE II) framework, which involved a multidisciplinary expert working group, a systematic review of the underpinning evidence, and external peer-review of draft recommendations. Our key recommendation is that a 3-year course of subcutaneous or sublingual AIT can be recommended for children and adolescents with moderate-to-severe allergic rhinitis (AR) triggered by grass/birch pollen allergy to prevent asthma for up to 2 years post-AIT in addition to its sustained effect on AR symptoms and medication. Some trial data even suggest a preventive effect on asthma symptoms and medication more than 2 years post-AIT. We need more evidence concerning AIT for prevention in individuals with AR triggered by house dust mites or other allergens and for the prevention of allergic sensitization, the first allergic disease, or for the prevention of allergic comorbidities in those with other allergic conditions. Evidence for the preventive potential of AIT as disease-modifying treatment exists but there is an urgent need for more high-quality clinical trials.

show abstract

“…Yet, a wide spectrum of side effects may occur due to the application of SCIT, ranging from mild local reactions to severe systemic anaphylactic reactions, potentially limiting its practical application . Concerning adult patients, multiple studies show diverging rates of systemic reactions, ranging from 2.4% to 50% of all patients and approximately 0.2% of all injections . The rare studies investigating systemic side effects in children indicate lower rates of <4% of all patients, respectively, <0.1% of all injections .…”

Section: Introductionmentioning

confidence: 99%

Side effects during subcutaneous immunotherapy in children with allergic diseases

Tophof

Hermanns

Adelt³

et al. 2018

Pediatric Allergy Immunology

View full text Add to dashboard Cite

Subcutaneous immunotherapy is a safe form of therapy in pediatric patients, with similar rates of local side effects compared to adult patients and low rates of severe systemic side effects. However, local and systemic reactions occurring later than 30 minutes after injection were observed more often than expected, which makes it essential to be attentive on behalf of pediatricians, patients, and parents.

show abstract

European Survey on Adverse Systemic Reactions in Allergen Immunotherapy (EASSI): a real-life clinical assessment

Abstract: AIT for respiratory allergy is safe, with a low number of SRs observed in real-life clinical practice. A personalized analysis of risk factors could be used to minimize SRs.

Cited by 83 publications

References 36 publications

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

EAACI guidelines on allergen immunotherapy: Prevention of allergy

Side effects during subcutaneous immunotherapy in children with allergic diseases

Contact Info

Product

Resources

About