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Stephen R Durham - One of the best experts on this subject based on the ideXlab platform.
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Sublingual Immunotherapy world allergy organization position paper 2013 update
World Allergy Organization Journal, 2014Co-Authors: George Walter Canonica, Moises A. Calderon, Jean Bousquet, Linda Cox, Ruby Pawankar, Carlos E Baenacagnani, Michael S Blaiss, S Bonini, Enrico Compalati, Stephen R DurhamAbstract:We have prepared this document, “Sublingual Immunotherapy: World Allergy Organization Position Paper 2013 Update”, according to the evidence-based criteria, revising and updating chapters of the originally published paper, “Sublingual Immunotherapy: World Allergy Organization Position Paper 2009”, available at http://www.waojournal.org. Namely, these comprise: “Mechanisms of Sublingual Immunotherapy;” “Clinical efficacy of Sublingual Immunotherapy” – reporting all the data of all controlled trials published after 2009; “Safety of Sublingual Immunotherapy” – with the recently published Grading System for adverse reactions; “Impact of Sublingual Immunotherapy on the natural history of respiratory allergy” – with the relevant evidences published since 2009; “Efficacy of SLIT in children” – with detailed analysis of all the studies; “Definition of SLIT patient selection” – reporting the criteria for eligibility to Sublingual Immunotherapy; “The future of Immunotherapy in the community care setting”; “Methodology of clinical trials according to the current scientific and regulatory standards”; and “Guideline development: from evidence-based medicine to patients' views” – including the evolution of the methods to make clinical recommendations.
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systematic reviews of Sublingual Immunotherapy slit
Allergy, 2011Co-Authors: Suzana Radulovic, Moises A. Calderon, D Wilson, Stephen R DurhamAbstract:To cite this article: Radulovic S, Wilson D, Calderon M, Durham S. Systematic reviews of Sublingual Immunotherapy (SLIT). Allergy 2011; 66: 740–752. Abstract Allergic rhinitis is common worldwide, with significant morbidity and impact on quality of life. In patients who don’t respond adequately to anti-allergic drugs. Subcutaneous allergen Immunotherapy is effective although requires specialist administration. Sublingual Immunotherapy may represent an effective and safer alternative. This Cochrane systematic review is an update of one published in 2003. We searched Cochrane ENT Group Trials Register, Central, PubMed, EMBASE, CINAHL, Web of Science, Biosis Previews, Cambridge Scientific Abstarcts, mRCT and additional sources. We included randomised, double-blind, placebo- controlled trials of Sublingual Immunotherapy in adults and children. Two authors selected studies and assessed them for quality. Data were put into RevMan 5.0 for a statistical analysis. We used standardised mean difference (SMD), with a random effect model to combine data. Sixty studies were included, with 49 suitable for meta-analysis. We found significant reductions in symptoms (SMD −0.49; 95%CI (−0.64 to −0.34, P < 0.00001)) and medication requirements (SMD −0.32; 95%CI (−0.43 to −0.21, P < 0.00001)) compared with placebo. None of the trials reported severe systemic reactions, anaphylaxis or use of Adrenaline. This updated review reinforces the conclusion of the original 2003 Cochrane Review that Sublingual Immunotherapy is effective for allergic rhinitis and appears a safe route of administration.
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Systematic reviews of Sublingual Immunotherapy (SLIT)
Allergy, 2011Co-Authors: Suzana Radulovic, Moises A. Calderon, D Wilson, Stephen R DurhamAbstract:To cite this article: Radulovic S, Wilson D, Calderon M, Durham S. Systematic reviews of Sublingual Immunotherapy (SLIT). Allergy 2011; 66: 740–752. Abstract Allergic rhinitis is common worldwide, with significant morbidity and impact on quality of life. In patients who don’t respond adequately to anti-allergic drugs. Subcutaneous allergen Immunotherapy is effective although requires specialist administration. Sublingual Immunotherapy may represent an effective and safer alternative. This Cochrane systematic review is an update of one published in 2003. We searched Cochrane ENT Group Trials Register, Central, PubMed, EMBASE, CINAHL, Web of Science, Biosis Previews, Cambridge Scientific Abstarcts, mRCT and additional sources. We included randomised, double-blind, placebo- controlled trials of Sublingual Immunotherapy in adults and children. Two authors selected studies and assessed them for quality. Data were put into RevMan 5.0 for a statistical analysis. We used standardised mean difference (SMD), with a random effect model to combine data. Sixty studies were included, with 49 suitable for meta-analysis. We found significant reductions in symptoms (SMD −0.49; 95%CI (−0.64 to −0.34, P
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Mechanisms of Sublingual Immunotherapy.
Immunology and allergy clinics of North America, 2011Co-Authors: Guy W. Scadding, Stephen R DurhamAbstract:Sublingual Immunotherapy (SLIT) has been shown to be effective in the treatment of seasonal allergic rhinoconjunctivitis. Despite comparable clinical efficacy to traditional subcutaneous Immunotherapy, the mechanisms of SLIT have yet to be fully established. This article considers the role of the local oral mucosa and regional lymphoid tissues in the processing of allergen during SLIT and the subsequent effects on T-cell and B-cell immune compartments and at mucosal sites. The likely time course of events and the evidence for long-lasting tolerance following SLIT are discussed.
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The Cochrane Library - Sublingual Immunotherapy for allergic rhinitis
The Cochrane database of systematic reviews, 2010Co-Authors: Suzana Radulovic, Moises A. Calderon, Duncan R. Wilson, Stephen R DurhamAbstract:This is an update of a Cochrane Review first published in The Cochrane Library in Issue 2, 2003.Allergic rhinitis is a common condition which can significantly impair quality of life. Immunotherapy by injection can significantly reduce symptoms and medication use but its use is limited by the possibility of severe systemic adverse reactions. Immunotherapy by the Sublingual route is therefore of considerable interest. To evaluate the efficacy and safety of Sublingual Immunotherapy for allergic rhinitis in adults and children. We searched the Cochrane ENT Group Trials Register; CENTRAL (2010, Issue 3); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; mRCT and additional sources for published and unpublished trials. The date of the most recent search was 14 August 2009. Randomised, double-blind, placebo-controlled trials of Sublingual Immunotherapy in adults or children. Primary outcome measures were symptom and medication scores. We also collected adverse event data. Two independent authors selected studies and assessed risk of bias. One author extracted data which was rechecked by two other authors. We used the standardised mean difference (SMD) with a random-effects model to combine data. We included a total of 60 randomised controlled trials in the review. Forty-nine were suitable for pooling in meta-analyses (2333 SLIT, 2256 placebo participants). Overall, we found a significant reduction in symptoms (SMD -0.49; 95% confidence interval (CI) -0.64 to -0.34, P < 0.00001) and medication requirements (SMD -0.32; 95% CI -0.43 to -0.21, P < 0.00001) in participants receiving Sublingual Immunotherapy compared to placebo. None of the trials included in this review reported severe systemic reactions or anaphylaxis, and none of the systemic reactions reported required the use of adrenaline. This updated review reinforces the conclusion of the original 2003 Cochrane Review that Sublingual Immunotherapy is effective for allergic rhinitis and has been proven to be a safe route of administration.
George Walter Canonica - One of the best experts on this subject based on the ideXlab platform.
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Sublingual Immunotherapy world allergy organization position paper 2013 update
World Allergy Organization Journal, 2014Co-Authors: George Walter Canonica, Moises A. Calderon, Jean Bousquet, Linda Cox, Ruby Pawankar, Carlos E Baenacagnani, Michael S Blaiss, S Bonini, Enrico Compalati, Stephen R DurhamAbstract:We have prepared this document, “Sublingual Immunotherapy: World Allergy Organization Position Paper 2013 Update”, according to the evidence-based criteria, revising and updating chapters of the originally published paper, “Sublingual Immunotherapy: World Allergy Organization Position Paper 2009”, available at http://www.waojournal.org. Namely, these comprise: “Mechanisms of Sublingual Immunotherapy;” “Clinical efficacy of Sublingual Immunotherapy” – reporting all the data of all controlled trials published after 2009; “Safety of Sublingual Immunotherapy” – with the recently published Grading System for adverse reactions; “Impact of Sublingual Immunotherapy on the natural history of respiratory allergy” – with the relevant evidences published since 2009; “Efficacy of SLIT in children” – with detailed analysis of all the studies; “Definition of SLIT patient selection” – reporting the criteria for eligibility to Sublingual Immunotherapy; “The future of Immunotherapy in the community care setting”; “Methodology of clinical trials according to the current scientific and regulatory standards”; and “Guideline development: from evidence-based medicine to patients' views” – including the evolution of the methods to make clinical recommendations.
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Sublingual Immunotherapy: other indications.
Immunology and allergy clinics of North America, 2011Co-Authors: Giovanni Passalacqua, Enrico Compalati, George Walter CanonicaAbstract:Sublingual Immunotherapy (SLIT) represents a significant advance and it seems particularly suitable in pediatric patients. There are favorable results for food allergy in controlled trials. For latex allergy, the results of several trials are encouraging. For atopic dermatitis, previous experience with subcutaneous Immunotherapy and some earlier trials suggest the possible application of SLIT in children with mild to moderate dermatitis and sensitization to dust mite, but this recommendation is considered insufficiently evidence based. In hymenoptera allergy, the only trial available is a proof-of-concept study in large local reactions that needs to be confirmed in well-controlled studies.
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Emerging Sublingual Immunotherapy drugs
Expert opinion on pharmacotherapy, 2010Co-Authors: Enrico Compalati, Giovanni Passalacqua, Anthi Rogkakou, Elisa Villa, George Walter CanonicaAbstract:Importance of the field: There is epidemiological evidence that respiratory allergy has reached epidemic proportions; owing to the related socio-economic impact, this topic deserves particular attention. An integrated approach involving pharmacotherapy and the immunomodulatory effect of Immunotherapy is expected to optimize the management of respiratory allergy, reducing its clinical and economic burdens. Sublingual Immunotherapy (SLIT) has gained increasing interest for its efficacy comparable to traditional subcutaneous Immunotherapy and its good safety profile. Areas covered in this review: A review of the up-to-date state of the art concerning the key aspects of SLIT is provided; the critical issues are discussed in the light of the comprehensive revision of the recent World Allergy Organization position paper and the subsequent literature, paying particular attention to efficacy, safety, additional effects, adherence and clinical developments. What the reader will gain: The overview of current certai...
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Recommendations for appropriate Sublingual Immunotherapy clinical trials
The Journal of allergy and clinical immunology, 2009Co-Authors: Thomas B. Casale, George Walter Canonica, Harold S. Nelson, Jean Bousquet, Linda Cox, Richard F. Lockey, Giovanni PassalacquaAbstract:Sublingual Immunotherapy is gaining widespread attention as a viable alternative to subcutaneous Immunotherapy for the treatment of allergic rhinoconjunctivitis. In addition, Sublingual Immunotherapy has been studied in other allergic disorders including asthma. However, a review of published studies indicates that there are deficiencies and considerable heterogeneity in both design and data interpretation of Sublingual Immunotherapy studies. These deficiencies have made it somewhat difficult to assess the appropriate place of Sublingual Immunotherapy in guidelines for the therapy of allergic diseases. Moreover, several unpublished oral and Sublingual Immunotherapy studies in the United States failed to meet primary endpoints. This article reviews data from Sublingual Immunotherapy trials and makes recommendations about appropriate designs of future Sublingual Immunotherapy studies. It is hoped that these recommendations will result in more adequately designed Sublingual Immunotherapy trials to facilitate the appropriate placement of this therapy to treat patients with allergic rhinoconjunctivitis and other allergic diseases.
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Sublingual Immunotherapy: update 2006.
Current opinion in allergy and clinical immunology, 2006Co-Authors: Giovanni Passalacqua, George Walter CanonicaAbstract:PURPOSE OF REVIEW Sublingual Immunotherapy is currently accepted as a viable therapeutic option, and is widely used in many European countries. In the past 2 years, new data concerning clinical, immunological and practical aspects of Sublingual Immunotherapy have been published, and many critical points have been addressed. RECENT FINDINGS In addition to the new data on clinical efficacy, the most recent studies have shown that, similar to the injection route, Sublingual Immunotherapy can also prevent the onset of new sensitizations and the onset of asthma. Moreover, several postmarketing surveys have confirmed the satisfactory safety profile, even in very young children, and compliance has been measured. The good safety profile has also suggested the possibility of using Sublingual Immunotherapy without the updosing phase. Finally, the mechanisms of action have been systematically investigated and the biodistribution of Sublingual allergens has been further clarified. SUMMARY More new data on Sublingual Immunotherapy are rapidly appearing in the international literature. These data consistently confirm the value of this treatment and show that Sublingual Immunotherapy is a viable and useful form of Immunotherapy.
Giovanni Passalacqua - One of the best experts on this subject based on the ideXlab platform.
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Sublingual Immunotherapy: other indications.
Immunology and allergy clinics of North America, 2011Co-Authors: Giovanni Passalacqua, Enrico Compalati, George Walter CanonicaAbstract:Sublingual Immunotherapy (SLIT) represents a significant advance and it seems particularly suitable in pediatric patients. There are favorable results for food allergy in controlled trials. For latex allergy, the results of several trials are encouraging. For atopic dermatitis, previous experience with subcutaneous Immunotherapy and some earlier trials suggest the possible application of SLIT in children with mild to moderate dermatitis and sensitization to dust mite, but this recommendation is considered insufficiently evidence based. In hymenoptera allergy, the only trial available is a proof-of-concept study in large local reactions that needs to be confirmed in well-controlled studies.
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Emerging Sublingual Immunotherapy drugs
Expert opinion on pharmacotherapy, 2010Co-Authors: Enrico Compalati, Giovanni Passalacqua, Anthi Rogkakou, Elisa Villa, George Walter CanonicaAbstract:Importance of the field: There is epidemiological evidence that respiratory allergy has reached epidemic proportions; owing to the related socio-economic impact, this topic deserves particular attention. An integrated approach involving pharmacotherapy and the immunomodulatory effect of Immunotherapy is expected to optimize the management of respiratory allergy, reducing its clinical and economic burdens. Sublingual Immunotherapy (SLIT) has gained increasing interest for its efficacy comparable to traditional subcutaneous Immunotherapy and its good safety profile. Areas covered in this review: A review of the up-to-date state of the art concerning the key aspects of SLIT is provided; the critical issues are discussed in the light of the comprehensive revision of the recent World Allergy Organization position paper and the subsequent literature, paying particular attention to efficacy, safety, additional effects, adherence and clinical developments. What the reader will gain: The overview of current certai...
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Recommendations for appropriate Sublingual Immunotherapy clinical trials
The Journal of allergy and clinical immunology, 2009Co-Authors: Thomas B. Casale, George Walter Canonica, Harold S. Nelson, Jean Bousquet, Linda Cox, Richard F. Lockey, Giovanni PassalacquaAbstract:Sublingual Immunotherapy is gaining widespread attention as a viable alternative to subcutaneous Immunotherapy for the treatment of allergic rhinoconjunctivitis. In addition, Sublingual Immunotherapy has been studied in other allergic disorders including asthma. However, a review of published studies indicates that there are deficiencies and considerable heterogeneity in both design and data interpretation of Sublingual Immunotherapy studies. These deficiencies have made it somewhat difficult to assess the appropriate place of Sublingual Immunotherapy in guidelines for the therapy of allergic diseases. Moreover, several unpublished oral and Sublingual Immunotherapy studies in the United States failed to meet primary endpoints. This article reviews data from Sublingual Immunotherapy trials and makes recommendations about appropriate designs of future Sublingual Immunotherapy studies. It is hoped that these recommendations will result in more adequately designed Sublingual Immunotherapy trials to facilitate the appropriate placement of this therapy to treat patients with allergic rhinoconjunctivitis and other allergic diseases.
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Sublingual Immunotherapy: update 2006.
Current opinion in allergy and clinical immunology, 2006Co-Authors: Giovanni Passalacqua, George Walter CanonicaAbstract:PURPOSE OF REVIEW Sublingual Immunotherapy is currently accepted as a viable therapeutic option, and is widely used in many European countries. In the past 2 years, new data concerning clinical, immunological and practical aspects of Sublingual Immunotherapy have been published, and many critical points have been addressed. RECENT FINDINGS In addition to the new data on clinical efficacy, the most recent studies have shown that, similar to the injection route, Sublingual Immunotherapy can also prevent the onset of new sensitizations and the onset of asthma. Moreover, several postmarketing surveys have confirmed the satisfactory safety profile, even in very young children, and compliance has been measured. The good safety profile has also suggested the possibility of using Sublingual Immunotherapy without the updosing phase. Finally, the mechanisms of action have been systematically investigated and the biodistribution of Sublingual allergens has been further clarified. SUMMARY More new data on Sublingual Immunotherapy are rapidly appearing in the international literature. These data consistently confirm the value of this treatment and show that Sublingual Immunotherapy is a viable and useful form of Immunotherapy.
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Safety profile of Sublingual Immunotherapy.
Treatments in respiratory medicine, 2006Co-Authors: Giovanni Passalacqua, Laura Guerra, Federica Fumagalli, George Walter CanonicaAbstract:Sublingual Immunotherapy (SLIT) was proposed for clinical practice about 20 years ago with the main aim of improving the safety and avoiding the adverse effects of traditional treatment for allergic airways disease. To date, 32 randomized controlled trials and 6 postmarketing surveys have been published that provide a robust documentation of the safety profile of the treatment.
Moises A. Calderon - One of the best experts on this subject based on the ideXlab platform.
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Sublingual Immunotherapy for the Polyallergic Patient
The journal of allergy and clinical immunology. In practice, 2016Co-Authors: Amber N. Pepper, Moises A. Calderon, Thomas B. CasaleAbstract:Allergen Immunotherapy is the only disease-modifying treatment for allergic diseases. Sublingual Immunotherapy (SLIT) in liquid and tablet form has been used by clinicians in Europe for years, but has only recently gained popularity and approval in the United States. In 2014, the US Food and Drug Administration approved 3 SLIT tablets for the treatment of allergic rhinitis, with or without allergic conjunctivitis. Immunotherapy treatment strategies for the polysensitized patient vary between the United States and Europe. This variation hinges upon whether the polysensitized patient is truly polyallergic. Polysensitization is the positive response to 2 or more allergens on skin prick testing or in vitro specific-IgE testing. Polyallergy is the symptomatic clinical response to 2 or more allergens. In this review, we discuss the use of SLIT in the United States with a focus on treating the polyallergic patient with SLIT.
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Subcutaneous Immunotherapy and Sublingual Immunotherapy: Comparative Efficacy, Current and Potential Indications, and Warnings—United States Versus Europe
Immunology and allergy clinics of North America, 2016Co-Authors: Harold S. Nelson, Melina Makatsori, Moises A. CalderonAbstract:Subcutaneous Immunotherapy and Sublingual Immunotherapy are effective for allergic rhinitis and allergic asthma and with some support for use in selected patients with atopic dermatitis. The sequence of immunologic responses is the same, irrespective of the route of administration, and similar disease modification has been demonstrated. However, there are differences between the two approaches. The most important is the greatly reduced likelihood of Sublingual Immunotherapy producing systemic reactions. There are major drawbacks for Sublingual Immunotherapy in regard to dosing. Finally, there is the question of relative clinical efficacy, with the currently available data favoring subcutaneous Immunotherapy.
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Sublingual Immunotherapy world allergy organization position paper 2013 update
World Allergy Organization Journal, 2014Co-Authors: George Walter Canonica, Moises A. Calderon, Jean Bousquet, Linda Cox, Ruby Pawankar, Carlos E Baenacagnani, Michael S Blaiss, S Bonini, Enrico Compalati, Stephen R DurhamAbstract:We have prepared this document, “Sublingual Immunotherapy: World Allergy Organization Position Paper 2013 Update”, according to the evidence-based criteria, revising and updating chapters of the originally published paper, “Sublingual Immunotherapy: World Allergy Organization Position Paper 2009”, available at http://www.waojournal.org. Namely, these comprise: “Mechanisms of Sublingual Immunotherapy;” “Clinical efficacy of Sublingual Immunotherapy” – reporting all the data of all controlled trials published after 2009; “Safety of Sublingual Immunotherapy” – with the recently published Grading System for adverse reactions; “Impact of Sublingual Immunotherapy on the natural history of respiratory allergy” – with the relevant evidences published since 2009; “Efficacy of SLIT in children” – with detailed analysis of all the studies; “Definition of SLIT patient selection” – reporting the criteria for eligibility to Sublingual Immunotherapy; “The future of Immunotherapy in the community care setting”; “Methodology of clinical trials according to the current scientific and regulatory standards”; and “Guideline development: from evidence-based medicine to patients' views” – including the evolution of the methods to make clinical recommendations.
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systematic reviews of Sublingual Immunotherapy slit
Allergy, 2011Co-Authors: Suzana Radulovic, Moises A. Calderon, D Wilson, Stephen R DurhamAbstract:To cite this article: Radulovic S, Wilson D, Calderon M, Durham S. Systematic reviews of Sublingual Immunotherapy (SLIT). Allergy 2011; 66: 740–752. Abstract Allergic rhinitis is common worldwide, with significant morbidity and impact on quality of life. In patients who don’t respond adequately to anti-allergic drugs. Subcutaneous allergen Immunotherapy is effective although requires specialist administration. Sublingual Immunotherapy may represent an effective and safer alternative. This Cochrane systematic review is an update of one published in 2003. We searched Cochrane ENT Group Trials Register, Central, PubMed, EMBASE, CINAHL, Web of Science, Biosis Previews, Cambridge Scientific Abstarcts, mRCT and additional sources. We included randomised, double-blind, placebo- controlled trials of Sublingual Immunotherapy in adults and children. Two authors selected studies and assessed them for quality. Data were put into RevMan 5.0 for a statistical analysis. We used standardised mean difference (SMD), with a random effect model to combine data. Sixty studies were included, with 49 suitable for meta-analysis. We found significant reductions in symptoms (SMD −0.49; 95%CI (−0.64 to −0.34, P < 0.00001)) and medication requirements (SMD −0.32; 95%CI (−0.43 to −0.21, P < 0.00001)) compared with placebo. None of the trials reported severe systemic reactions, anaphylaxis or use of Adrenaline. This updated review reinforces the conclusion of the original 2003 Cochrane Review that Sublingual Immunotherapy is effective for allergic rhinitis and appears a safe route of administration.
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Systematic reviews of Sublingual Immunotherapy (SLIT)
Allergy, 2011Co-Authors: Suzana Radulovic, Moises A. Calderon, D Wilson, Stephen R DurhamAbstract:To cite this article: Radulovic S, Wilson D, Calderon M, Durham S. Systematic reviews of Sublingual Immunotherapy (SLIT). Allergy 2011; 66: 740–752. Abstract Allergic rhinitis is common worldwide, with significant morbidity and impact on quality of life. In patients who don’t respond adequately to anti-allergic drugs. Subcutaneous allergen Immunotherapy is effective although requires specialist administration. Sublingual Immunotherapy may represent an effective and safer alternative. This Cochrane systematic review is an update of one published in 2003. We searched Cochrane ENT Group Trials Register, Central, PubMed, EMBASE, CINAHL, Web of Science, Biosis Previews, Cambridge Scientific Abstarcts, mRCT and additional sources. We included randomised, double-blind, placebo- controlled trials of Sublingual Immunotherapy in adults and children. Two authors selected studies and assessed them for quality. Data were put into RevMan 5.0 for a statistical analysis. We used standardised mean difference (SMD), with a random effect model to combine data. Sixty studies were included, with 49 suitable for meta-analysis. We found significant reductions in symptoms (SMD −0.49; 95%CI (−0.64 to −0.34, P
Janice L. Stumpf - One of the best experts on this subject based on the ideXlab platform.
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House Dust Mite Sublingual Immunotherapy for Pediatric Patients With Allergic Asthma.
The Annals of pharmacotherapy, 2018Co-Authors: Jessika R Richards, Janice L. StumpfAbstract:Objective: To review the published literature evaluating administration of house dust mite (HDM) Sublingual Immunotherapy (SLIT) in pediatric patients with allergic asthma. Data Sources: PubMed dat...
