Hvorfor allergen immunterapi

Hankin CS, Cox L, Lang D, Bronstone A, Fass P, Leatherman B, et al. Allergen immunotherapy and health care cost benefits for children with allergic rhinitis: a large-scale, retrospective, matched cohort study. Ann Allergy Asthma Immunol. 2010;104(1):79-85.

Hankin CS, Cox L, Bronstone A, Wang Z. Allergy immunotherapy: reduced health care costs in adults and children with allergic rhinitis. J Allergy Clin Immunol. 2013;131(4):1084-91.

Petersen KD, Gyrd-Hansen D, Dahl R. Health-economic analyses of subcutaneous specific immunotherapy for grass pollen and mite allergy. Allergol Immunopathol (Madr). 2005;33(6):296-302.

Keiding H, Jorgensen KP. A cost-effectiveness analysis of immunotherapy with SQ allergen extract for patients with seasonal allergic rhinoconjunctivitis in selected European countries. Curr Med Res Opin. 2007;23(5):1113-20.

Bachert C, Vestenbaek U, Christensen J, Griffiths UK, Poulsen PB. Costeffectiveness of grass allergen tablet (GRAZAX) for the prevention of seasonal grass pollen induced rhinoconjunctivitis - a Northern European perspective. Clin Exp Allergy. 2007;37(5):772-9.

Mekanismer for allergen immunterapi og SCIT eller SLIT

Epstein TG, Liss GM, Murphy-Berendts K, Bernstein DI. Risk factors for fatal and nonfatal reactions to subcutaneous immunotherapy: National surveillance study on allergen immunotherapy (2008-2013). Ann Allergy Asthma Immunol. 2016;116(4):354-359.

Epstein TG, Liss GM, Berendts KM, Bernstein DI. AAAAI/ACAAI Subcutaneous Immunotherapy Surveillance Study (2013-2017): Fatalities, Infections, Delayed Reactions, and Use of Epinephrine Autoinjectors. J Allergy Clin Immunol Pract. 2019;7(6):1996-2003.

Calderon MA, Vidal C, Del Rodriguez RP, et al. European Survey on Adverse Systemic Reactions in Allergen Immunotherapy (EASSI): a real-life clinical assessment. Allergy. 2017;72:462-472

Rodriguez RP, Vidal C, Just J, et al. The European Survey on Adverse Systemic Reactions in Allergen Immunotherapy (EASSI): a paediatric assessment. Pediatr Allergy Immunol. 2017;28:60-70

Field K, Blaiss MS. Sublingual Versus Subcutaneous Immunotherapy for Allergic Rhinitis: What Are the Important Therapeutic and Real-World Considerations?. Curr Allergy Asthma Rep. 2020;20(9):45.

Quirino T, Iemoli E, Siciliani E, Parmiani S, Milazzo F. Sublingual versus injective immunotherapy in grass pollen allergic patients: a double blind (double dummy) study. Clin Exp Allergy. 1996;26(11):1253-1261.

Khinchi MS, Poulsen LK, Carat F, André C, Hansen AB, Malling HJ. Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy: a randomized, placebo-controlled, double-blind, double-dummy study. Allergy. 2004;59(1):45-53. 

Durham SR, Penagos M. Sublingual or subcutaneous immunotherapy for allergic rhinitis?. J Allergy Clin Immunol. 2016;137(2):339-349.

Di Bona D, Plaia A, Leto-Barone MS, La Piana S, Di Lorenzo G. Efficacy of subcutaneous and sublingual immunotherapy with grass allergens for seasonal allergic rhinitis: a meta-analysis-based comparison. J Allergy Clin Immunol. 2012;130(5):1097-1107.

Dhami S, Kakourou A, Asamoah F, et al. Allergen immunotherapy for allergic asthma: A systematic review and meta-analysis. Allergy. 2017;72(12):1825-1848. 

Roberts G, Pfaar O, Akdis CA, et al. EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. Allergy. 2018;73(4):765-798. 

Asaria M, Dhami S, van Ree R, Gerth van Wijk R, Muraro A, Roberts G, Sheikh A. Health economic analysis of allergen immunotherapy for the management of allergic rhinitis, asthma, food allergy and venom allergy: A systematic overview. Allergy. 2018 Feb;73(2):269-283. 

Alvaro-Lozano M, Akdis CA, Akdis M, Alviani C, Angier E, Arasi S, Arzt-Gradwohl L, Barber D, Bazire R, Cavkaytar O, Comberiati P, Dramburg S, Durham SR, Eifan AO, Forchert L, Halken S, Kirtland M, Kucuksezer UC, Layhadi JA, Matricardi PM, Muraro A, Ozdemir C, Pajno GB, Pfaar O, Potapova E, Riggioni C, Roberts G, Rodríguez Del Río P, Shamji MH, Sturm GJ, Vazquez-Ortiz M. EAACI Allergen Immunotherapy User’s Guide. Pediatr Allergy Immunol. 2020 May;31 Suppl 25(Suppl 25):1-101. 

Cox L, Larenas-Linnemann D, Lockey RF, Passalacqua G. Speaking the same language: The World Allergy Organization Subcutaneous Immunotherapy Systemic Reaction Grading System. J Allergy Clin Immunol. 2010;125(3):569-574.

Indikasjoner og Kontraindikasjoner

Sturm GJ, Varga EM, Roberts G, Mosbech H, Bilò MB, Akdis CA, Antolín-Amérigo D, Cichocka-Jarosz E, Gawlik R, Jakob T, Kosnik M, Lange J, Mingomataj E, Mitsias DI, Ollert M, Oude Elberink JNG, Pfaar O, Pitsios C, Pravettoni V, Ruëff F, Sin BA, Agache I, Angier E, Arasi S, Calderón MA, Fernandez-Rivas M, Halken S, Jutel M, Lau S, Pajno GB, van Ree R, Ryan D, Spranger O, van Wijk RG, Dhami S, Zaman H, Sheikh A, Muraro A. EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy. Allergy. 2018 Apr;73(4):744-764

Roberts G, Pfaar O, Akdis CA, Ansotegui IJ, Durham SR, Gerth van Wijk R, et al. EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. Allergy. 2018;73(4):765-98

Alvaro-Lozano M, Akdis CA, Akdis M, Alviani C, Angier E, Arasi S, Arzt-Gradwohl L, Barber D, Bazire R, Cavkaytar O, Comberiati P, Dramburg S, Durham SR, Eifan AO, Forchert L, Halken S, Kirtland M, Kucuksezer UC, Layhadi JA, Matricardi PM, Muraro A, Ozdemir C, Pajno GB, Pfaar O, Potapova E, Riggioni C, Roberts G, Rodríguez Del Río P, Shamji MH, Sturm GJ, Vazquez-Ortiz M. EAACI Allergen Immunotherapy User’s Guide. Pediatr Allergy Immunol. 2020 May;31 Suppl 25(Suppl 25):1-101

Worm M, Francuzik W, Renaudin JM, Bilo MB, Cardona V, Scherer Hofmeier K, Köhli A, Bauer A, Christoff G, Cichocka-Jarosz E, Hawranek T, Hourihane JO', Lange L, Mahler V, Muraro A, Papadopoulos NG, Pföhler C, Poziomkowska-Gęsicka I, Ruëff F, Spindler T, Treudler R, Fernandez-Rivas M, Dölle S. Factors increasing the risk for a severe reaction in anaphylaxis: An analysis of data from The European Anaphylaxis Registry. Allergy. 2018 Jun;73(6):1322-1330

Turner PJ, Jerschow E, Umasunthar T, Lin R, Campbell DE, Boyle RJ. Fatal Anaphylaxis: Mortality Rate and Risk Factors. J Allergy Clin Immunol Pract. 2017 Sep-Oct;5(5):1169-1178

Stoevesandt J, Sturm GJ, Bonadonna P, Oude Elberink JNG, Trautmann A. Risk factors and indicators of severe systemic insect sting reactions. Allergy. 2020 Mar;75(3):535-545

Golden DB, Kelly D, Hamilton RG, Craig TJ. Venom immunotherapy reduces large local reactions to insect stings. J Allergy Clin Immunol. 2009;123(6):1371-1375

Om optimal farmakoterapi

Bousquet J, Pfaar O, Togias A, Schünemann HJ, et al. ARIA Working Group. 2019 ARIA Care pathways for allergen immunotherapy. Allergy. 2019 Nov;74(11):2087-2102

Bédard, A., Basagaña, X., Anto, J.M. et al. Treatment of allergic rhinitis during and outside the pollen season using mobile technology. A MASK study. Clin Transl Allergy 10, 62 (2020) 

Pediatriveileder fra norsk barnelegeforening. 2017 - Helsebibiloteket.no

Scadding, GK, Kariyawasam, HH, Scadding, G, et al. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007). Clin Exp Allergy. 2017; 47: 856- 889 https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.12953 
 
SPC-preparatomtale - legemiddelsok.no 

www.koble.info

Utredning

https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf

https://www.helsebiblioteket.no/innhold/retningslinjer/pediatri/generell-veileder-i-pediatri/7.ovre-og-nedre-luftveier/7.8.2-astma-bronkiale-barn-og-ungdom-i-alder-618-ar 

Nolte M, Barber D, Maloney J, Li Z, Kaur A, Galan A, Andersen JS, Nolte H. Timothy specific IgE levels are associated with efficacy and safety of timothy grass sublingual immunotherapy tablet. Ann Allergy Asthma Immunol. 2015 Dec;115(6):509-515.e2. doi: 10.1016/j.anai.2015.09.018. Epub 2015 Oct 21. PMID: 26507709.

Barber D, Diaz-Perales A, Escribese MM, Kleine-Tebbe J, Matricardi PM, Ollert M, Santos AF, Sastre J. Molecular allergology and its impact in specific allergy diagnosis and therapy. Allergy. 2021 Dec;76(12):3642-3658. doi: 10.1111/all.14969. Epub 2021 Jun 22. PMID: 34057744.

Astma og AIT

Agache I, Lau S, Akdis CA, Smolinska S, Bonini M, Cavkaytar O, Flood B, Gajdanowicz P, Izuhara K, Kalayci O, Mosges R, Palomares O, Papadopoulos NG, Sokolowska M, Angier E, Fernandez-Rivas M, Pajno G, Pfaar O, Roberts GC, Ryan D, Sturm GJ, van Ree R, Varga EM, van Wijk RG, Yepes-Nuñez JJ, Jutel M. EAACI Guidelines on Allergen Immunotherapy: House dust mite‐driven allergic asthma Allergy. 2019 May;74(5):855-873

Jacobsen, L et al. Immunotherapy with partially purified and standardized tree pollen extracts. IV. Results from long-term (6-year) follow-up. Allergy vol. 52,9 (1997): 914-20

Alvaro-Lozano, M., Akdis, C. A., Akdis, M., Alviani, C., Angier, E., Arasi, S., Vazquez-Ortiz, M. (2020). EAACI Allergen Immunotherapy User's Guide. [Review]. Pediatric Allergy & Immunology, 31 Suppl 25, 1-101

Halken S, Larenas-Linnemann D, Roberts G, Calderón MA, Angier E, Pfaar O, Ryan D, Agache I, Ansotegui IJ, Arasi S, Du Toit G, Fernandez-Rivas M, Geerth van Wijk R, Jutel M, Kleine-Tebbe J, Lau S, Matricardi PM, Pajno GB, Papadopoulos NG, Penagos M, Santos AF, Sturm GJ, Timmermans F, van Ree R, Varga EM, Wahn U, Kristiansen M, Dhami S, Sheikh A, Muraro A. EAACI guidelines on allergen immunotherapy: Prevention of allergy. Pediatr Allergy Immunol. 2017 Dec;28(8):728-745 

Dhami S, Kakourou A, Asamoah F, Agache I, Lau S, Jutel M, et al. Allergen immunotherapy for allergic asthma: A systematic review and meta-analysis. Allergy. 2017;72(12):1825-48 

Lin SY, Azar A, Suarez-Cuervo C, Diette GB, Brigham E, Rice J, Ramanathan M Jr, Robinson KA. Role of sublingual immunotherapy in the treatment of asthma: An updated systematic review. Int Forum Allergy Rhinol. 2018 Sep;8(9):982-992 

Xu K, Deng Z, Li D, Yuan H, Liu C, Chen Z, Zhu L. Efficacy of add-on sublingual immunotherapy for adults with asthma. A meta-analysis and systematic review. Ann Allergy Asthma Immunol. 2018 Aug;121(2):186-194. doi: 10.1016/j.anai.2018.05.019

Fortescue R, Kew KM, Leung MST. Sublingual immunotherapy for asthma. Cochrane Database Syst Rev. 2020 Sep 14;9(9):CD011293

https://ginasthma.org/wp-content/uploads/2021/05/GINA-Main-Report-2021-V2-WMS.pdf

Mosbech H, Deckelmann R, de Blay F, Pastorello EA, Trebas-Pietras E, Andres LP, Malcus I, Ljørring C, Canonica GW. Standardized quality (SQ) house dust mite sublingual immunotherapy tablet (ALK) reduces inhaled corticosteroid use while maintaining asthma control: A randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol. 2014 Sep;134(3):568-575.e7

Virchow JC, Backer V, Kuna P, Prieto L, Nolte H, Villesen HH, et al. Efficacy of a House Dust Mite Sublingual Allergen Immunotherapy Tablet in Adults With Allergic Asthma: A Randomized Clinical Trial. Jama. 2016;315(16):1715-25

Organisering av behandlingen

https://lovdata.no/dokument/NL/lov/1999-07-02-64

https://www.legeforeningen.no/jus-og-arbeidsliv/rettigheter-og-plikter-for-lege-og-pasient/krav-til-faglig-forsvarlighet/#20025 

Allergenekstrakter tilgjengelige i Norge

https://legemiddelverket.no/godkjenningsfritak/godkjenningsfritak-for-legemidler-til-mennesker

https://www.legemiddelhandboka.no/L9.5.1/Allergenekstrakter

https://www.alk.no/

https://www.stallergenesgreer.com

Praktisk gjennomføring av sublingual immunterapi (SLIT)

Agache I, Lau S, Akdis CA, Smolinska S, Bonini M, Cavkaytar O, Flood B, Gajdanowicz P, Izuhara K, Kalayci O, Mosges R, Palomares O, Papadopoulos NG, Sokolowska M, Angier E, Fernandez-Rivas M, Pajno G, Pfaar O, Roberts GC, Ryan D, Sturm GJ, van Ree R, Varga EM, van Wijk RG, Yepes-Nuñez JJ, Jutel M. EAACI Guidelines on Allergen Immunotherapy: House dust mite‐driven allergic asthma Allergy. 2019 May;74(5):855-873

Alvaro-Lozano M, Akdis CA, Akdis M, et. al. EAACI Allergen Immunotherapy User’s Guide. Pediatr Allergy Immunol. 2020 May;31 Suppl 25(Suppl 25):1-101. 

Fortescue, R., Kew, K. M., & Leung, M. T. (2020). Sublingual immunotherapy for asthma. Cochrane Database of
Systematic Reviews (9). 

Roberts G, Pfaar O, Akdis CA, et al. EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. Allergy.
2018;73(4):765-798. 

Praktisk gjennomføring av subkutan immunterapi (SCIT)

Sturm GJ et al. EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy. Allergy 2018;73:744–764

UpToDate 15.06.21: SCIT: Standard schedules, administration techniques, adverse reactions, and monitoring. Author: Harold Nelson, Section Editor: Peter S Creticos, Deputy Editor: Anna M Feldweg

Tinkelman DG, Cole WQ. Tunno J. Immunotherapy: a one-year prospective study to evaluate risk factors of systemic reactions. J Allergy Clin Immunol 1995; 95:8

Lin MS, Tanner E, Lynn J, Friday GA. Nonfatal systemic allergic reactions induced by skin testing and immunotherapy. Ann Allergy 1993; 71:557

Cox L, Larenas-Linnemann D, Lockey RF, Passalacqua G. Speaking the same language: The World Allergy Organization Subcutaneous Immunotherapy Systemic Reaction Grading System. J Allergy Clin Immunol. 2010;125(3):569-574.e7. 
Dansk Selskab for Allergologis nationale behandlingsvejledning for allergen immunterapi. Godkendt 26.02.2019.

Avslutning av behandling

Roberts G, Pfaar O, Akdis CA, et al. EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. Allergy. 2018;73(4):765-798. 

Sturm GJ, Varga EM, Roberts G, et al. EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy. Allergy. 2018;73(4):744-764. 

Jacobsen L, Niggeman B, Dreborg S, et al. Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy. 2007;62:943–8. 

Durham, S R et al. “Long-term clinical efficacy of grass-pollen immunotherapy.” The New England journal of medicine vol. 341,7 (1999): 468-75.

Penagos, M., Eifan, A.O., Durham, S.R. et al. Duration of Allergen Immunotherapy for Long-Term Efficacy in Allergic Rhinoconjunctivitis. Curr Treat Options Allergy5, 275–290 (2018).

Valovirta E, Petersen TH, Piotrowska T, et al. Results from the 5-year SQ grass sublingual immunotherapy tablet asthma prevention (GAP) trial in children with grass pollen allergy. J Allergy Clin Immunol. 2018;141(2):529-538.e13

Agache I, Lau S, Akdis CA, et al. EAACI Guidelines on Allergen Immunotherapy: House dust mite-driven allergic asthma. Allergy. 2019;74(5):855-873. 

Golden DB, Kagey-Sobotka A, Norman PS, Hamilton RG, Lichtenstein LM. Outcomes of allergy to insect stings in children, with and without venom immunotherapy. N Engl J Med. 2004 Aug 12;351(7):668-74.

Lerch E, Müller UR. Long-term protection after stopping venom immuno- therapy: results of re-stings in 200 patients. J Allergy Clin Immunol 1998;101: 606-12. 

Golden DB, Kagey-Sobotka A, Lichtenstein LM. Survey of patients after discontinuing venom immunotherapy. J Allergy Clin Immunol 2000;105:385-90. 

Reisman RE. Duration of venom immunotherapy: relationship to the severity of symptoms of initial insect sting anaphylaxis. J Allergy Clin Immunol 1993;92: 831-6. 

Golden DB, Kwiterovich KA, Kagey-Sobotka A, Lichtenstein LM. Discontinuing venom immunotherapy: extended observations. J Allergy Clin Immunol 1998;101:298-305.

Vogelberg C, Brüggenjürgen B, Richter H, Jutel M. Real-World Adherence and Evidence of Subcutaneous and Sublingual Immunotherapy in Grass and Tree Pollen-Induced Allergic Rhinitis and Asthma. Patient Prefer Adherence. 2020 May 13;14:817-827.