What immunotherapy 2018

1. WHAT YOU SOULD HAVE READ BUT ………………… 2018
Immunotherapy
Attilio Boner
University of Verona, Italy
attilio.boner@univr.it

2. Selection of allergens

3. sottocutanea

4. Allergen immunotherapy for allergic asthma:
A systematic review and meta-analysis
S. Dhami, Allergy 2017;72:1825–1848
• Short-term symptom scores were
reduced but there was evidence
suggestive of publication bias.
• Short-term medication scores
were reduced, again with evidence
of potential publication bias.
98 studies

5. Allergen immunotherapy for allergic asthma:
A systematic review and meta-analysis
S. Dhami, Allergy 2017;72:1825–1848
• Subcutaneous immunotherapy
(SCIT) improved quality of life
and decreased allergen-specific
airway hyperreactivity (AHR),
but this was not the case for
sublingual immunotherapy (SLIT).
• There were no consistent
effects on asthma control,
exacerbations, lung function,
and nonspecific AHR.
98 studies

6. Allergen immunotherapy for allergic rhinoconjunctivitis:
A systematic review and meta-analysis
S Dhami, Allergy 2017;72:1597–1631
• AIT is effective in improving symptom,
medication, and combined symptom and
medication scores in patients with allergic
rhinoconjunctivitis while on treatment, and
• there is some evidence suggesting that
these benefits are maintained in relation
to symptom scores after discontinuation
of therapy.
 160 studies.

7. Meta-analysis of double-blind RCTs comparing symptom scores
between Subcutaneous immunotherapy (SCIT) and placebo groups
P<0.0001
Allergen immunotherapy for allergic rhinoconjunctivitis:
A systematic review and meta-analysis
S Dhami, Allergy 2017;72:1597–1631

8. Meta-analysis of double-blind
RCTs
comparing symptom scores
between Sublingual
immunotherapy (SLIT) and
placebo groups
P<0.0001
Allergen immunotherapy for allergic rhinoconjunctivitis:
A systematic review and meta-analysis
S Dhami, Allergy 2017;72:1597–1631

9. Sottocutanea
Effetti collaterali

10. • Food allergy
desensitisation
• L’ho messe nella
food allergy

11. sublinguale

12. epicutanea

13. Veleno di imenotteri

14. Preventive effects

15. Efficacy of allergen immunotherapy in reducing the
likelihood of developing new allergen sensitizations:
a systematic review. D Di Bona, Allergy 2017;72:691-704
• Low evidence supports the
position that AIT prevents
the onset of new allergen
sensitizations, with 10 of
18 studies reporting a
reduction in the onset
of new sensitizations
in patients treated with
AIT vs placebo.
 Risk difference in the onset
of new allergen
sensitizations between
patients treated with AIT
and pharmacotherapy.
 18 studies (1049 children,
10 057 adults)

16. Efficacy of allergen immunotherapy in reducing the
likelihood of developing new allergen sensitizations:
a systematic review. D Di Bona, Allergy 2017;72:691-704
• Low evidence supports the
position that AIT prevents
the onset of new allergen
sensitizations, with 10 of
18 studies reporting a
reduction in the onset
of new sensitizations
in patients treated with
AIT vs placebo.
 Risk difference in the onset
of new allergen
sensitizations between
patients treated with AIT
and pharmacotherapy.
 18 studies (1049 children,
10 057 adults)
Small studies and
studies with a
shorter follow-up
showed the highest
benefit of AIT.

17. Efficacy of allergen immunotherapy in reducing the
likelihood of developing new allergen sensitizations:
a systematic review. D Di Bona, Allergy 2017;72:691-704
• Low evidence supports the
position that AIT prevents
the onset of new allergen
sensitizations, with 10 of
18 studies reporting a
reduction in the onset
of new sensitizations
in patients treated with
AIT vs placebo.
 Risk difference in the onset
of new allergen
sensitizations between
patients treated with AIT
and pharmacotherapy.
 18 studies (1049 children,
10 057 adults)
The overall evidence
provides a low-grade
level of the evidence
supporting the efficacy
of AIT in preventing the
onset of new allergen
sensitizations,
but high-quality studies
could change this
estimate.

18. Future possibilities