Duration of allergen immunotherapy for long-term efficacy in allergic rhinoconjunctivitis
Author(s)
Penagos, Martin
Eifan, Aarif O
Durham, Stephen R
Scadding, Guy W
Type
Journal Article
Abstract
Rationale
Subcutaneous and sublingual immunotherapy are effective for allergic rhinitis. An important question is whether allergen immunotherapy provides a sustained clinical effect after treatment cessation. In view of potential side effects, cost and the necessary patient commitment, long-term benefit is an important consideration for the recommendation of immunotherapy over standard pharmacotherapy.
Purpose of review
In this review, we analyse the existing evidence for long-term effects of both routes of administration in the context of double-blind, placebo-controlled, randomised clinical trials that included a follow-up phase of at least 1 year after treatment cessation.
Recent findings
Overall, evidence suggests that 3 years of either subcutaneous or sublingual immunotherapy result in clinical benefit and immunological changes consistent with allergen-specific tolerance sustained for at least 2–3 years after treatment cessation.
Summary
The data presented here support recommendations in international guidelines that both routes of administration should be continued for a minimum of 3 years. Gaps in the evidence remain regarding the long-term efficacy of immunotherapy for perennial rhinitis and studies performed in children.
Subcutaneous and sublingual immunotherapy are effective for allergic rhinitis. An important question is whether allergen immunotherapy provides a sustained clinical effect after treatment cessation. In view of potential side effects, cost and the necessary patient commitment, long-term benefit is an important consideration for the recommendation of immunotherapy over standard pharmacotherapy.
Purpose of review
In this review, we analyse the existing evidence for long-term effects of both routes of administration in the context of double-blind, placebo-controlled, randomised clinical trials that included a follow-up phase of at least 1 year after treatment cessation.
Recent findings
Overall, evidence suggests that 3 years of either subcutaneous or sublingual immunotherapy result in clinical benefit and immunological changes consistent with allergen-specific tolerance sustained for at least 2–3 years after treatment cessation.
Summary
The data presented here support recommendations in international guidelines that both routes of administration should be continued for a minimum of 3 years. Gaps in the evidence remain regarding the long-term efficacy of immunotherapy for perennial rhinitis and studies performed in children.
Editor(s)
Cox, Linda
Date Issued
2018-09-01
Date Acceptance
2018-06-14
Citation
Current Treatment Options in Allergy, 2018, 5 (3), pp.275-290
ISSN
2196-3053
Publisher
Springer Verlag
Start Page
275
End Page
290
Journal / Book Title
Current Treatment Options in Allergy
Volume
5
Issue
3
Copyright Statement
© The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Subjects
Allergen immunotherapy
Allergic rhinitis
Biomarkers
Long term efficacy
Mechanisms
Subcutaneous
Sublingual
Coverage Spatial
United Kingdom
Date Publish Online
2018-08-31