International Clinical Practice Guidelines: 2018 Midyear Review

John Anello; Brian Feinberg; John Heinegg; Yonah Korngold; Richard Lindsey; Cristina Wojdylo; Olivia Wong, DO


July 10, 2018

In This Article

Allergy Immunotherapy

European Academy of Allergy and Clinical Immunology

A 3-year course of allergen immunotherapy (AIT) (subcutaneous immunotherapy [SCIT] or sublingual immunotherapy [SLIT]) can be considered in children with moderate to severe allergic rhinitis (AR) and grass/birch pollen allergy that are not sufficiently controlled with optimal pharmacotherapy, for short-term (ie, up to 2 years post- treatment) and possibly long-term prevention of asthma symptoms in addition to improving the control of AR.

Venom immunotherapy (VIT) is indicated in venom-allergic individuals following moderate to severe systemic reactions. Pretreatment with H1 antihistamines should be used to prevent large local reactions.

A 12-week maintenance injection interval can be recommended in lifelong VIT.

Food allergy allergen immunotherapy (FA-AIT) should be considered for children from around 4-5 years of age with a persistent IgE-mediated food allergy to cow’s milk, hen’s egg, or peanut to increase the threshold of reactivity while on therapy. A benefit postdiscontinuation is suggested but not confirmed.

AIT should be considered in patients with AR, with or without conjunctivitis; evidence of IgE sensitization to one or more clinically relevant allergens; and moderate to severe symptoms despite regular and/or avoidance strategies.



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