| Allergen immunotherapy practice in the United States: guidelines, measures, and outcomes. | |
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MedLine Citation:
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PMID: 21962088 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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To discuss recent issues pertinent to allergen immunotherapy practice in the United States. Allergen extract preparation guidelines, updated allergen immunotherapy practice parameter (AIPP) guidelines, and evolving trends in how immunotherapy outcomes will be measured and assessed. Allergen extract preparation guidelines have been established by 2 entities: the US Pharmacopeia and an American Academy of Allergy, Asthma, and Immunology/American College of Allergy, Asthma, and Immunology/Joint Council of Allergy, Asthma, and Immunology Joint Task Force. Minor differences exist between these guidelines, but both focus on aseptic techniques and require that compounding personnel pass a written examination and annual media fill test. The AIPP third update provides new dosing recommendations for Bermuda grass, imported fire ant, and nonstandardized extracts distinguishing between pollen (0.5 mL of a 1:100 or 1:200 vol/vol) and mold/fungi or cockroach (highest tolerated dose) extracts. Because of limited and sometimes conflicting data on high and low proteolytic-containing extract compatibility, the AIPP continues to recommend against mixing these together. Although the AIPP does not specifically recommend a specific diluent, recent evidence suggests normal saline may not be as effective a stabilizer for extract dilutions as glycerin or human serum albumin. Currently, immunotherapy efficacy is determined with subjective assessments that rely on patient reporting, but this may change as health care reform evolves. It will likely become more important for US allergy/immunology practices to demonstrate immunotherapy comparative-effectiveness and report quality measures. Recent comparative-effectiveness studies have demonstrated the cost-effectiveness of immunotherapy compared with symptomatic drug treatment. |
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Authors:
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Linda Cox; Robert E Esch; Mark Corbett; Cheryl Hankin; Michael Nelson; Greg Plunkett |
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Publication Detail:
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Type: Journal Article Date: 2011-07-31 |
Journal Detail:
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Title: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology Volume: 107 ISSN: 1534-4436 ISO Abbreviation: Ann. Allergy Asthma Immunol. Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-03 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9503580 Medline TA: Ann Allergy Asthma Immunol Country: United States |
Other Details:
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Languages: eng Pagination: 289-99 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Nova Southeastern University, Ft Lauderdale, Florida. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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