EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

被引：580

作者：

Roberts, G. ^{[1
,2
,3
,4
]}

Pfaar, O. ^{[5
,6
]}

Akdis, C. A. ^{[7
,8
]}

Ansotegui, I. J. ^{[9
]}

Durham, S. R. ^{[10
]}

van Wijk, R. Gerth ^{[11
]}

Halken, S. ^{[12
]}

Larenas-Linnemann, D. ^{[13
]}

Pawankar, R. ^{[14
]}

Pitsios, C. ^{[15
]}

Sheikh, A. ^{[16
]}

Worm, M. ^{[17
]}

Arasi, S. ^{[18
,19
]}

Calderon, M. A. ^{[10
]}

Cingi, C. ^{[20
]}

Dhami, S. ^{[21
]}

Fauquert, J. L. ^{[22
]}

Hamelmann, E. ^{[23
]}

Hellings, P. ^{[24
,25
]}

Jacobsen, L. ^{[26
]}

Knol, E. F. ^{[27
,28
]}

Lin, S. Y. ^{[29
]}

Maggina, P. ^{[30
]}

Moesges, R. ^{[31
]}

Elberink, J. N. G. Oude ^{[32
,33
]}

Pajno, G. B. ^{[18
]}

Pastorello, E. A. ^{[34
]}

Penagos, M. ^{[10
]}

Rotiroti, G. ^{[35
]}

Schmidt-Weber, C. B. ^{[36
,37
]}

Timmermans, F. ^{[38
]}

Tsilochristou, O. ^{[39
]}

Varga, E. -M. ^{[40
]}

Wilkinson, J. N. ^{[41
]}

Williams, A. ^{[42
]}

Zhang, L. ^{[43
]}

Agache, I. ^{[44
]}

Angier, E. ^{[45
]}

Fernandez-Rivas, M. ^{[46
]}

Jutel, M. ^{[47
,48
]}

Lau, S. ^{[49
]}

van Ree, R. ^{[50
,51
]}

Ryan, D. ^{[52
]}

Sturm, G. J. ^{[53
,54
]}

Muraro, A. ^{[55
]}

机构：

[1] St Marys Hosp, David Hide Asthma & Allergy Res Ctr, Newport, Wight, England

[2] Univ Hosp Southampton NHS Fdn Trust, NIHR Biomed Res Ctr, Southampton, Hants, England

[3] Univ Southampton, Fac Med, Clin & Expt Sci Unit, Southampton, Hants, England

[4] Univ Southampton, Fac Med, Human Dev Hlth Acad Unit, Southampton, Hants, England

[5] Heidelberg Univ, Univ Med Mannheim, Dept Otorhinolaryngol Head & Neck Surg, Mannheim, Germany

[6] Ctr Rhinol & Allergol, Wiesbaden, Germany

[7] Univ Zurich, Swiss Inst Allergy & Asthma Res SIAF, Davos, Switzerland

[8] Christine Kuhne Ctr Allergy Res & Educ, Davos, Switzerland

[9] Hosp Quironsalud Bizkaia, Dept Allergy & Immunol, Bilbao, Spain

[10] Imperial Coll London, Natl Heart & Lung Inst, Allergy & Clin Immunol, London, England

[11] Erasmus MC, Sect Allergol, Dept Internal Med, Rotterdam, Netherlands

[12] Odense Univ Hosp, Hans Christian Andersen Childrens Hosp, Odense, Denmark

[13] Hosp Med Sur, Ctr Excellence Asthma & Allergy, Mexico City, DF, Mexico

[14] Nippon Med Sch, Dept Pediat, Tokyo, Japan

[15] Univ Cyprus, Sch Med, Nicosia, Cyprus

[16] Univ Edinburgh, Asthma UK Ctr Appl Res, Usher Inst Populat Hlth Sci & Informat, Edinburgh, Midlothian, Scotland

[17] Univ Med Berlin, Dept Dermatol & Allergy, Charite Campus Mitte, Berlin, Germany

[18] Univ Messina, Dept Pediat, Allergy Unit, Messina, Italy

[19] Charite, Mol Allergol & Immunomodulat, Dept Pediat Pneumol & Immunol, Berlin, Germany

[20] Eskisehir Osmangazi Univ, Dept Otorhinolaryngol, Med Fac, Eskisehir, Turkey

[21] Evidence Based Hlth Care Ltd, Edinburgh, Midlothian, Scotland

[22] CHU Clermont Ferrand Univ Hosp CHU Estaing, Unite Allergol Enfant, Clermont Ferrand, France

[23] Bielefeld Univ, Childrens Hosp Bethel, EvKB, Bielefeld, Germany

[24] Univ Hosp Leuven, Dept Otorhinolaryngol, Leuven, Belgium

[25] Acad Med Ctr Amsterdam, Dept Otorhinolaryngol, Amsterdam, Netherlands

[26] Allergy Learning & Consulting, Copenhagen, Denmark

[27] Univ Med Ctr Utrecht, Dept Immunol & Dermatol, Dept Immunol & Dermatol, Utrecht, Netherlands

[28] Univ Med Ctr Utrecht, Dept Allergol, Utrecht, Netherlands

[29] Johns Hopkins Dept Otolaryngol Head & Neck Surg, Baltimore, MD USA

[30] NKUA Athens Univ, Allergy & Clin Immunol Unit, Dept Pediat 2, Athens, Greece

[31] Clin Res Int Ltd, Hamburg, Germany

[32] Univ Groningen, Univ Med Ctr Groningen, Dept Allergol, Groningen, Netherlands

[33] Univ Groningen, Univ Med Ctr Groningen, GRIAC Res Inst, Groningen, Netherlands

[34] Univ Milan, Dept Allergy & Immunol, Asst Grande Osped Metropolitano Niguarda, Milan, Italy

[35] Univ Coll Hosp, Dept Allergy & Med Rhinol, Royal Natl Throat Nose & Ear Hosp, London, England

[36] Helmholtz Ctr Munich, Ctr Allergy & Environm ZAUM, Munich, Germany

[37] Helmholtz Ctr Munich, Inst Allergy Res, Munich, Germany

[38] Nederlands Anafylaxis Netwerk, European Anaphylaxis Taskforce, Dordrecht, Netherlands

[39] Kings Coll London, Guys & St Thomas Natl Hlth Serv Fdn Trust, Childrens Allergy Serv, Div Asthma Allergy & Lung Biol,Dept Paediat Aller, London, England

[40] Med Univ Graz, Resp & Allerg Dis Div, Dept Paediat & Adolescent Med, Graz, Austria

[41] European Union, Pharmaceut Grp, Brussels, Belgium

[42] Guys & St Thomas NHS Fdn Trust, Dept Allergy, London, England

[43] Capital Med Univ, Dept Otolaryngol Head & Neck Surg, Beijing TongRen Hosp, Beijing, Peoples R China

[44] Transylvania Univ Brasov, Fac Med, Dept Allergy & Clin Immunol, Brasov, Romania

[45] Northern Gen Hosp, Dept Clin Immunol & Allergy, Sheffield, S Yorkshire, England

[46] Hosp Clin San Carlos, Dept Allergy, IdISSC, Madrid, Spain

[47] ALL MED Med Res Inst, Wroclaw, Poland

[48] Wroclaw Med Univ, Wroclaw, Poland

[49] Charite, Dept Pediat Pneumol & Immunol, Berlin, Germany

[50] Univ Amsterdam, Acad Med Ctr, Dept Expt Immunol, Amsterdam, Netherlands

来源：

ALLERGY | 2018年 / 73卷 / 04期

关键词：

allergen immunotherapy; allergic conjunctivitis; allergic rhinitis; allergy; rhinoconjunctivitis; HOUSE-DUST-MITE; SUBLINGUAL-SWALLOW IMMUNOTHERAPY; GRASS-POLLEN IMMUNOTHERAPY; RANDOMIZED CONTROLLED-TRIAL; PERSISTENT SUBCUTANEOUS NODULES; COST-EFFECTIVENESS ANALYSIS; ADVERSE SYSTEMIC REACTIONS; SHORT-TERM IMMUNOTHERAPY; DOUBLE-BLIND; STANDARDIZED GRASS;

D O I：

10.1111/all.13317

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

Allergic 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 tablets) where long-term benefit is seen. To achieve long-term efficacy, it is recommended that a minimum of 3years of therapy is used. Many gaps in the evidence base exist, particularly around long-term benefit and use in children.

引用

页码：765 / 798

页数：34

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