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Allergen-specific immunotherapy in asthma

In a lot of people, asthma is closely linked to an allergy. Their asthma attacks are mainly triggered by allergy-causing substances such as pollen, dust mites or animal fur. Allergen-specific immunotherapy might be considered as a treatment for this kind of asthma.The aim of this treatment is to prevent asthma attacks by making the body less sensitive to the allergy-causing substances. It is also known as desensitization or hyposensitization.In allergen-specific immunotherapy (SIT), people are repeatedly given small amounts of the substances that they are allergic to. This is meant to gradually make them less oversensitive to the substances. Allergen-specific immunotherapy is only possible if extracts of the allergen (the substance that triggers the allergy) are available for the treatment. This is currently the case for things like animal hair, dust mites, pollen, mold and the poison in insect stings.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 26, 2014

Antigen‐specific active immunotherapy for ovarian cancer

Ovarian cancer is the leading cause of death from gynaecological cancers. Standard therapy consists of surgery and chemotherapy. Responses to chemotherapy are generally good, however, the majority of women will relapse, for which no curative treatment is available. The presence of certain immune cells in tumours is associated with longer survival. This suggests that stimulation of anti‐tumour immune responses, i.e. immunotherapy, might be a useful approach to improve outcome for women with ovarian cancer.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Hay fever and dust mite allergies: Allergen-specific immunotherapy

People who have hay fever or a dust mite allergy sneeze a lot, and have a runny or stuffy nose. Many of those who have very severe and bothersome symptoms try out allergen-specific immunotherapy. This treatment aims to make the immune system “get used to” the substances triggering the allergy, so that it no longer reacts as strongly to them.The goal of allergen-specific immunotherapy is to reduce allergy symptoms in the medium to long term. It has to be repeated regularly and takes quite a long time to start working. In the past this treatment was commonly called "desensitization" or "hyposensitization." These terms describe what it aims to do: make the immune system less sensitive. In people who are allergic to something, their body is oversensitive or hypersensitive to an allergen (the substance that causes their allergic reaction). Their body produces antibodies to fight the allergen, even though the allergen is harmless. These antibodies are part of a chain reaction that leads to allergy symptoms. In allergen-specific immunotherapy, people are given allergen extracts to try to train their body to react differently: It is a bit like being “vaccinated” against your own allergy.Allergen-specific immunotherapy (SIT) cannot be used for every allergy. It is called "specific" because the allergen extract has to be tailored to the individual person's allergic response. There are still no suitable SIT extracts for some substances that cause allergies. But there are extracts for many of the common allergens found in the air, for mold, for animal allergens, and for some toxic substances (like the poison in bee stings).

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 4, 2014

Allergen immunotherapy for the treatment of chronic asthma

Injecting allergens under the skin (allergen specific immunotherapy) can reduce asthma and use of medication and improve the sensitivity of the lungs, but with a risk of severe reactions. Asthma attacks can be caused by allergies, pollens, cigarette smoke or air pollution and can be fatal. An allergen is a substance that causes an allergic reaction in a person sensitive to it. Allergen specific immunotherapy involves having injections of increasing amounts of the allergen under the skin. It is also called hyposensitisation or desensitisation, and there is a risk of severe allergic reactions. The review of trials found that immunotherapy can reduce asthma symptoms, the need for medications and the risk of severe asthma attacks after future exposure to the allergen. It is possibly as effective as inhaled steroids. However, there is an increased risk of a lump at the injection site, rash, wheezing, breathlessness and very rarely a fatal allergic reaction.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Immunotherapy by allergen injections for seasonal allergic rhinitis ('hay fever')

Seasonal allergic rhinitis ('hay fever') is a global health problem and its prevalence has increased considerably in the last two decades. Treatment includes allergen avoidance, drugs such as antihistamine tablets and nasal sprays, and immunotherapy (vaccination). For those patients whose symptoms remain uncontrolled despite drug treatment, specific allergen immunotherapy (SIT) is advised.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Oral immunotherapy for the treatment of peanut allergy

Allergy to peanut can result in potentially life‐threatening reactions and, on occasions, death. Unlike many other forms of food allergy, allergy to peanut is typically life‐long. There is currently no cure for peanut allergy and people with this allergy must constantly be careful to avoid accidentally eating peanut or peanut‐containing foods.  If a person with a peanut allergy accidentally ingests peanut, he or she may develop serious allergic reactions necessitating emergency treatment with epinephrine (adrenaline).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Specific allergy immunotherapy for the treatment of atopic eczema

At least one in seven children and one in 50 adults suffer from atopic eczema, a skin condition characterised by an itchy red rash. People with atopic eczema are allergic to things in the environment, such as house dust mites, and exposure to what they are allergic to may make their eczema worse. Specific allergen immunotherapy is a treatment that involves a course of injections or drops under the tongue containing the substance to which a person is allergic. The treatment can reduce the severity of a person's allergy and may therefore be able to reduce symptoms of atopic eczema. We evaluated whether specific allergen immunotherapy was better or worse than a standard treatment or placebo at improving disease severity and symptoms as assessed by participants, parents, or investigators.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Sublingual and Injectable Customized Allergy Immunotherapy: Clinical and Cost-Effectiveness and Guidelines [Internet]

The purpose of this Rapid Response report is to review the evidence of comparative clinical effectiveness and cost-effectiveness of subcutaneous (or injectable) immunotherapy (SCIT), sublingual immunotherapy (SLIT), and oral antihistamines in patients with allergies, and to identify published, evidence-based guidelines on the use of SCIT or SLIT for allergies.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: May 31, 2016
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A systematic review and economic evaluation of subcutaneous and sublingual allergen immunotherapy in adults and children with seasonal allergic rhinitis

Severe allergic rhinitis uncontrolled by conventional medication can substantially affect quality of life. Immunotherapy involves administering increasing doses of a specific allergen, with the aim of reducing sensitivity and symptomatic reactions. Recent meta-analyses have concluded that both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are more effective than placebo in reducing symptoms. It is uncertain which route of administration is more effective and whether or not treatment is cost-effective.

Health Technology Assessment - NIHR Journals Library.

Version: July 2013
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Standardized Allergenic Extract, Timothy grass (Phleum pratense) (GRASTEK) (sublingual tablet 2,800 BAU) [Internet]

The objective is to conduct a systematic review of the beneficial and harmful effects of Timothy grass (Phleum pratense) standardized allergenic extract (PPAE; brand name Grastek) 2,800 BAU, for the treatment of Timothy and related grass pollen–induced allergic rhinitis (AR), with or without conjunctivitis, in adults and children aged five years and older.

Common Drug Review - Canadian Agency for Drugs and Technologies in Health.

Version: December 2014
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Oral and sublingual immunotherapy (giving people small amounts of things they are allergic to via their mouth or under their tongue) for fruit allergy

We reviewed the evidence about the effect of oral and sublingual immunotherapy in people with a food allergy to fruit. Food allergy is an abnormal response to a food, usually after eating it. The main treatment for food allergy is to avoid the food, but in people with food allergy, accidentally eating the food can cause severe reactions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

[Efficacy of allergen-specific immunotherapy for atopic dermatitis: a systematic review and meta-analysis of randomized controlled trials]

Bibliographic details: Pereira AM.  [Efficacy of allergen-specific immunotherapy for atopic dermatitis: a systematic review and meta-analysis of randomized controlled trials]. Revista Portuguesa de Imunoalergologia 2013; 21(3): 215-216 Available from: http://rpia.spaic.pt/arquivos/?imr=8&fmo=artigo&ia=1&ano=2013&edicao=639&id_pub=1&opcao=2013

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Specific immunotherapy using Hymenoptera venom: systematic review

CONTEXT AND OBJECTIVE: The only effective treatment for patients who have severe reactions after Hymenoptera stings is venom immunotherapy. The aim of this study was to review the literature to assess the effects of venom immunotherapy among patients presenting severe reactions after Hymenoptera stings.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Specific immunotherapy in the treatment of atopic dermatitis: a systematic review using the GRADE system

BACKGROUND: Controversy exists regarding the potential role of specific immunotherapy (SIT) as a therapeutic intervention for patients with atopic dermatitis (AD) and aeroallergen sensitivity.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Allergen-specific immunotherapy for pediatric asthma and rhinoconjunctivitis: a systematic review

BACKGROUND AND OBJECTIVE: Subcutaneous immunotherapy (SCIT) is approved in the United States for the treatment of pediatric asthma and rhinitis; sublingual immunotherapy (SLIT) does not have regulatory approval but is used in clinical practice. The objective of this study was to systematically review the evidence regarding the efficacy and safety of SCIT and SLIT for the treatment of pediatric asthma and allergic rhinoconjunctivitis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Efficacy of allergen-specific immunotherapy for atopic dermatitis: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Allergen-specific immunotherapy (allergen-SIT) is the only treatment directed at the cause of IgE-mediated allergic diseases. However, there is controversy over the use of SIT for patients with atopic dermatitis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

IgE-mediated allergy: a rare cause of chronic spontaneous urticarial with allergen-specific immunotherapy as treatment option - a systematic review with meta-analysis from China

BACKGROUND: Allergen-specific immunotherapy (SIT) has long been a controversial treatment for chronic urticaria (CU), although SIT has been used in patients with allergic diseases for more than 90 years.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Evidences of efficacy of allergen immunotherapy in atopic dermatitis: an updated review

PURPOSE OF REVIEW: To update and assess the quality of the evidence concerning the efficacy of allergen immunotherapy for atopic eczema. Desensitization for eczema as a clinical manifestation of food allergy was not a target of this review.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Specific immunotherapy (SIT) in the treatment of allergic rhinitis

SCIENTIFIC BACKGROUND: Allergic rhinitis (AR) exhibits a prevalence of approx. 20% in Germany and causes enormous costs in the health care system. Specific immunotherapy (SIT) is considered to be the only potentially causal therapy for AR and mainly administered by two routes, subcutaneous (SCIT) and sublinguale (SLIT). SIT promises a reduction of symptoms and the need for medication in patients with AR.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Pregnancy and birth: Asthma in pregnancy

Many pregnant women who have asthma worry that their medication might harm their child. But most asthma medications are considered to be safe in pregnancy too. Untreated asthma, on the other hand, can have serious consequences.It is estimated that about 1 out of 5 pregnant women with asthma need treatment for asthma attacks. But good asthma control, particularly with the regular use of inhaled corticosteroids, can prevent these attacks. And there are a number of things you can do to avoid possible triggers of asthma attacks.In many women who have asthma, being pregnant does not affect their symptoms. Their symptoms sometimes even get better at first. But the physical changes that happen during pregnancy make asthma worse in 1 out of 3 women. Towards the end of pregnancy it often becomes increasingly difficult to stay physically active. Carrying the extra weight around can even make women who do not have asthma feel out of breath. Many cannot sleep properly, and feel tired and exhausted.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 26, 2014

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