Allergen Immunotherapy in combination with biologicals for inhalant allergy: what do we really know?

Auszug

Allergen immunotherapy is highly effective in treating patients with IgE-mediated allergic rhinitis and asthma, with proven long-term benefits that may persist for years after discontinuation. Subcutaneous immunotherapy remains the gold standard whereas sublingual immunotherapy represents an effective alternative for self-administration. Nonetheless, limitations with SCIT include the need for specialist supervision and the risk of systemic side-effects, particularly in asthmatics. For sublingual therapy there is a restricted spectrum of available vaccines and ensuring adherence to treatment may be a particular problem. Whereas modified allergens and virus like particles as adjuvants have shown early promise, use of alternative routes such as intradermal, epicutaneous and intralymphatic immunotherapy and peptide therapy targeting selected T cell or B cell epitopes have so far been unsuccessful in phase 3 trials. There remains a clear need to improve immunotherapy to achieve greater efficacy, safety, and adherence to therapy and to achieve more durable long-term tolerance. …