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An update on allergen immunotherapy and asthma.
MedLine Citation:
PMID:  24296688     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: The aim is to review recent literature up to July 2013 concerning the effect of allergen-specific immunotherapy (AIT) on asthma. AIT, effective in combined allergic rhinitis and asthma, was previously described as a convenient approach able to improve clinical outcomes and reduce bronchial hyperresponsiveness. In addition, long-term and preventive effects on the onset of new sensitizations and progression from allergic rhinitis to asthma have been shown.
RECENT FINDINGS: Recent investigations, mainly based on observational or small open trials, confirmed previous findings, showing improvement in asthma control, symptoms and medication usage and steroid-sparing effects, sometimes inconsistent with changes in lung function. Some meta-analyses support the clinical benefit on adult and paediatric asthma. Only few trials, however, were specifically designed to explore asthma endpoints.
SUMMARY: Clinical studies primarily have focused on AIT, and research on asthma endpoints is scarce; however, the evidence of beneficial effect of AIT for the treatment of adults and children affected by allergic rhinitis with or without asthma suggests that this treatment can favourably affect asthma. In children, sublingual AIT has been more extensively investigated than injective. Confirmatory, adequately powered trials are needed to reinforce the evidence of efficacy for individual AIT products. The main drawback in using injective AIT for asthma is the risk of serious adverse reactions and uncontrolled asthma. The sublingual route is better tolerated and does not appear inferior. As standard controller pharmacotherapy seems unable to affect the natural course of asthma, the potentially disease-modifying effect of AIT represents an appealing perspective that requires further investigation.
Authors:
Enrico Compalati; Fulvio Braido; Giorgio W Canonica
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in pulmonary medicine     Volume:  20     ISSN:  1531-6971     ISO Abbreviation:  Curr Opin Pulm Med     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2013-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503765     Medline TA:  Curr Opin Pulm Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  109-17     Citation Subset:  IM    
Affiliation:
Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
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