Update on Immunotherapy for the Treatment of Asthma

Giorgio W. Canonica; Diego Bagnasco; Giovanna Ferrantino; Matteo Ferrando; Giovanni Passalacqua

Disclosures

Curr Opin Pulm Med. 2016;22(1):18-24. 

In This Article

Abstract and Introduction

Abstract

Purpose of review Despite that specific immunotherapy can boast being more than a century old, there is still skepticism about its real effectiveness, and therefore it is still used too little in clinical practice. The purpose of this review was to analyze the most recent articles in the literature to highlight scientific evidence for the proper use of allergen immunotherapy (AIT).

Recent findings In the near future, the concept of medicine for trials will have to be revised and in certain cases abandoned in favor of a personalized medicine, able to use a drug more targeted for the individual patient and not for the disease.

Summary For AIT, it will become increasingly important to use products designed properly, standardized and with a well documented effectiveness in clinical studies. We must overcome the disputes of subcutaneous immunotherapy versus sublingual immunotherapy, arrive at the concept of personalized medicine regarding AIT, framing in different phenotypes of asthma patients to use the optimal preparation for each particular patient.

Introduction

The topic of allergen immunotherapy (AIT) has been recently addressed by our group in this journal.[1] Nonetheless, because of recent data, the relevant decisions of the regulatory authorities and the recent documents published by the Scientific Societies, we believe that updates need to be discussed.

Although AIT has been used for more than a century, nonetheless there is still some skepticism about its clinical effectiveness and safety, and as a consequence, AIT is still underused in asthma.[2,3] The aim of this article is to review the newest data to highlight the scientific evidence for a correct use of AIT in asthma.

One of the major criticisms in the past concerned the 'credibility' of the products used, that is, usually natural extracts without standardization. Currently, it is still true that different manufacturers' products with the potency indicated by means of in-house units that differ among the producers, can contain different amounts of major allergens. Unfortunately this 'old' phenomenon was insufficiently considered, when the AIT meta-analyses, many in the last decades, were performed.

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