Allergen Immunotherapy in House dust mite‐driven allergic asthma: EAACI Guidelines
The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline providing evidence‐based recommendations for the use of house dust mites (HDM) AIT as an add‐on treatment for HDM‐driven allergic asthma. Allergen immunotherapy (AIT) is a procedure of inducing tolerance to a specific allergen by repetitive administration of an allergen. It has been in use for the treatment of allergic disease for more than 100 years.
Asthma represents a major health burden globally. Patients with allergic asthma not adequately controlled on pharmacotherapy (including biologics) represent an unmet health need of Allergen immunotherapy. Assessing the role of allergic sensitization in asthma pathophysiology is an important step in disease workup because such patients might benefit from allergen immunotherapy (AIT) as an add‐on to pharmacological asthma therapy.
Major recommendations are _
• House dust mite (HDM) subcutaneous immunotherapy (SCIT) is recommended for children and adults with controlled HDM‐driven allergic asthma as an add‐on treatment to regular therapy to decrease symptoms and medication use.
• HDM SCIT is recommended for adults with controlled HDM‐driven allergic asthma as the add‐on treatment to regular therapy to decrease allergen‐specific airway hypersensitivity and to improve quality of life.
• HDM sublingual immunotherapy (SLIT) drops are recommended for children with controlled HDM‐driven allergic asthma as an add‐on treatment to decrease symptoms and medication use.
• HDM SLIT‐tablet is recommended for adults with controlled and partially controlled HDM‐driven allergic asthma as an add‐on treatment to regular therapy to decrease exacerbations and to improve asthma control.
Most of the clinical trials of AIT in asthma evaluated clinically relevant parameters such as symptom and medication scores. There is a clear need for better-designed studies of HDM AIT in HDM‐driven allergic asthma using harmonized and validated clinical outcomes. Respiratory physicians should be included in the trial design.
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