SLIT: dealing with trouble, doing it right. Giovanni B Pajno MD Professor of Pediatrics Department of Pediatrics – Allergy Unit University of Messina Italy.

Slides:

Advertisements

Similar presentations

Prevention of asthma in childhood

Advertisements

Decreasing the burden of allergy

Addressing the burden of allergies and asthma in childhood Philippe Eigenmann Pediatric Allergy.

Asthma and Inhalant Allergens

Food Allergy Update Thomas Flaim, M.D.. Prevalence of Food Allergy Prevalence rate is 6% in children < 3 years of age; 4% in adults Prevalence rate is.

Bret Haymore, MD FAAAAI, FACAAI

Food Allergy Highlights of the past 3 years Adam Fox Paediatric Study Day Cheltenham June 2004 Dr Adam Fox.

Why immunotherapy fails ? Stephen Durham Imperial College and Royal Brompton Hospital, London UK.

Allergen Immunotherapy: From Shots to Tablets Susan Waserman MSc MDCM FRCPC Professor of Medicine Division of Clinical Allergy and Immunology Life and.

Subject: Introdução à Medicina Long-term preventive effects of allergen specific immunotherapy: a systematic review and meta-analysis.

Canadian Asthma Primary Prevention Study (CAPPS) Chris Carlsten, MD MPH University of British Columbia Chris Carlsten University of British Columbia Genesis.

Dr Narayana pradeep Consultant Pulmonologist Carewell hospital KasaragodKERALA.

Agency for Healthcare Research and Quality (AHRQ)

CURRENT STATUS OF SUBLINGUAL IMMUNOTHERAPY IN THE U.S. Michael S. Blaiss, MD Clinical Professor of Pediatrics and Medicine University of Tennessee Health.

Use of Multiple Allergen Mixes in Immunotherapy Harold S. Nelson, MD Professor of Medicine National Jewish Health University of Colorado Denver School.

Diagnostic approach to the allergic patient. Allergic conditions in Israel.

T-cell Immunoregulation and the Response to Immunotherapy Harold S. Nelson. MD Professor of Medicine National Jewish Health and University of Colorado.

Allergy Symptom Response Following Conversion from Injection Immunotherapy to Sublingual Immunotherapy CDR Timothy Clenney, MD, MPH Naval Medical Center.

Anti-IgE in Asthma and Other Allergic Diseases Harold S. Nelson. MD Professor of Medicine National Jewish Health And University of Colorado School of Medicine.

Rush and Cluster Immunotherapy Harold S. Nelson, MD Professor of Medicine National Jewish Health University of Colorado Health Science Center Denver, Colorado.

Greg Rex Department of Pediatrics, Division of Allergy IWK Health Centre Immunology and Allergy Update.

EVALUATION OF THREE ALLERGEN SPECIFIC IMMUNOTHERAPY METHODS Standard Injection RUSH Injection Sublingual Abstract# 54 Richard Herrscher M.D. FACAAI Clinical.

Anti-IgE Use in Allergy

Which Patients for Subcutaneous Immunotherapy? Harold S. Nelson. MD Professor of Medicine National Jewish Heath University of Colorado Denver School of.

SLIT and Atopic Dermatitis George F. Kroker, MD ©2008 Allergychoices, Inc. All Rights Reserved.

The prevalence of allergic diseases and the overall pattern of sensitization among years old adolescents in two Danish birth cohorts 14 years apart.

Treatment Philosophy for Inhalant Allergy— Key Concepts George F. Kroker MD FACAAI.

Vincent S. Beltrani, MD, FAAAAI Board Certified by American Academy of Dermatology American Academy Allergy, Asthma & Immunology Associate Clinical Professor.

Food and Drug Administration Division of Pulmonary and Allergy Drug Products Summary Comments - Orally Inhaled and Intranasal Budesonide and Fluticasone.

SUBLINGUAL IMMUNOTHERAPY Giovanni Passalacqua Allergy & Respiratory Diseases Dept.Internal Medicine- University of Genoa ITALY.

Monotherapy for the polysensitized patient Noel Rodriguez-Perez, MD Professor of pediatrics State University of Tamaulipas, Mexico.

RHINOVIRUS-ASSOCIATED WHEEZING IN INFANCY: SIMILARITIES AND DIFFERENCES WITH RESPIRATORY SYNCYTIAL VIRUS BRONCHIOLITIS Kotaniemi-Syrjänen A, 1 Korppi M,

Dr Mazen Qusaibaty MD, DIS / Head Pulmonary and Internist Department Ibnalnafisse Hospital Ministry of Syrian health – Dr Mazen.

Catherine M. Bettcher, M.D. CME Director & Assistant Professor, Department of Family Medicine, University of Michigan No Nuts Allowed: Food Allergies in.

UNIT 7: SEASONAL ALLERGIES & ASTHMA SC330 Immunology.

Sublingual Allergy Treatment. Sublingual Immunotherapy Immunotherapy is widely used by allergy specialists because it treats the underlying cause of allergic.

Sublingual immunotherapy in allergic conjuctivitis with house dust and dust mite allergies DR VIPUL SHAH.

Immunotherapy for Allergic Rhinitis

Sublingual Immunotherapy

Management of Food Allergies: Beyond avoidance, what does the future hold? Stanley Fineman, MD, MBA Adjunct Associate Professor, Department of Pediatrics.

The Journal of Allergy and Clinical Immunology: In Practice

Fadhel Saleh 1, Rabab A. Hussain 2, Fadheela A. Saleh 2

ALLERGEN SPECIFIC IMMUNOTHERAPY: EFFICACY & NEW DEVELOPMENTS

HATSJOE Study Symptomatic treatment of pollen-related allergic rhinoconjunctivitis in children: a randomized controlled trial.

Efficacy and safety of birch pollen immunotherapy for local allergic rhinitis Andrzej Bożek, MD, PhD, Krzysztof Kołodziejczyk, MD, PhD, Jerzy Jarząb,

Figure 2. Systematic review: chronological presentation of allergic reaction rates in recipients (n) of equine botulinum antitoxin (BAT) products by study,

Innate microbial sensors and their relevance to allergy

Practical aspects Of SLIT

Clinical Developments in Allergen Immunotherapy

Efficacy of subcutaneous and sublingual immunotherapy with grass allergens for seasonal allergic rhinitis: A meta-analysis–based comparison Danilo Di.

Implementing Best Practices in the Management of Allergic Diseases

The Future of House Dust Mite Allergy

In-Depth Discussion of Key Data on Immunotherapy for Allergic Diseases

T lymphocytes in asthma: Bronchial versus peripheral responses

Noninjection routes for immunotherapy

Hendrik Nolte, MD, PhD, David I

Practice Notes from the AAAAI

House Dust Mite Respiratory Allergy: An Overview of Current Therapeutic Strategies Moisés A. Calderón, MD, PhD, Jörg Kleine-Tebbe, MD, Allan Linneberg,

Linda S. Cox, MD, Cheryl Hankin, PhD, Richard Lockey, MD

Children's compliance with allergen immunotherapy according to administration routes Giovanni Battista Pajno, MD, Daniela Vita, MD, Lucia Caminiti, MD,

Sublingual immunotherapy with once-daily grass allergen tablets: A randomized controlled trial in seasonal allergic rhinoconjunctivitis Stephen R. Durham,

Mohamed H. Shamji, PhD, FAAAI, Stephen R. Durham, MD, FRCP

Sublingual immunotherapy in mite-sensitized children with atopic dermatitis: A randomized, double-blind, placebo-controlled study Giovanni B. Pajno,

Sublingual grass allergen tablet immunotherapy provides sustained clinical benefit with progressive immunologic changes over 2 years Ronald Dahl, MD,

Sustained 3-year efficacy of pre- and coseasonal 5-grass-pollen sublingual immunotherapy tablets in patients with grass pollen–induced rhinoconjunctivitis

Long-lasting effects of sublingual immunotherapy according to its duration: A 15-year prospective study Maurizio Marogna, MD, Igino Spadolini, MD, Alessandro.

Presentation transcript:

SLIT: dealing with trouble, doing it right. Giovanni B Pajno MD Professor of Pediatrics Department of Pediatrics – Allergy Unit University of Messina Italy Allergy School An Insight into Allergy and Allergen Immunotherapy 11 – 13 September 2014 Athens, Greece

FDA Committee Votes to Approve SLIT Treatments Last month, the Allergenic Products Advisory Committee (APAC) of the Food and Drug Administration (FDA) met and voted that the available safety and efficacy data support approval of two sublingual allergy immunotherapy (AIT) products. One is a grass pollen AIT tablet developed by Stallergenes and the other is Merck’s grass pollen AIT tablet. The APAC voted 9-1 regarding approval of the Stallergenes tablet and 9-0 regarding the Merck tablet. The FDA will need to give final approval, but it usually follows the advice of its advisory committees. AAAAI President Linda Cox, MD, FAAAAI, said in an to members: “There are no FDA-approved forms of sublingual AIT currently available here in the United States, so these products would be the first licensed therapies of their kind. It’s worth noting that the committee felt very strongly about including language in the prescribing instructions for both products that recommended the patient has autoinjectable epinephrine in the event of a severe allergic reaction." Dr. Cox also discusses the news in this month's President's Message.President's Message More information, including a webcast of the meetings, is available from the FDA websiteFDA website

1. Early intervention 2. Long lasting effect 3. Adherence SLIT

1. Early intervention 2. Long lasting effect 3. Adherence SLIT

Increasing post-natal age Birth SLITSLIT Hampering the progression and worsening of IgE mediated disorders Allergens Exposure Food Allergens Inhalant Allergens TH2 polarized Immunity Persistent Wheeze Atopic Dermatitis Hay Fever Food Allergy Persistent Allergic Diseases J Allergy Clin Immunol 2007;119: G.B. Pajno

(Di Rienzo V et al. Clin Exp Allergy 2003;33: )

Figure 1. Percentage of children in the immunotherapy and control groups who developed asthma after 3 years, in the 3 available trials. In the study by Marogna et al,37 the development of persistent asthma was assessed37 Specific immunotherapy: beyond the clinical scores Passalacqua G Annals of Allergy 2011;107:

1. Early intervention 2. Long lasting effect 3. Adherence SLIT

- SLIT

1. Early intervention 2. Long lasting effect 3. Adherence SLIT

J Allergy Clin Immunol. 2005;116:1380-1

Allergen immunotherapy practice parameter, JACI 2010

Discontinuation 52% three y. old 18% four y. " 13% five y. "

CONCLUSION

Table 1. Comparison between SCIT and SLIT: Similarities and Diversities SharedEffective for both allergic rhino-conjunctivitis and allergic asthma. Disease modifying. - Possible prevention of new sensitivities in patients (mostly children) who are monosensitized to house dust mite. -Persistence of benefit for several years after discontinuation. -Possible prevention of allergic asthma? Immunological mechanisms of action. DifferingSeverity of systemic reactions (favours SLIT) Effectiveness of multiple allergen extracts (favours SCIT) Adherence to therapy (favours SCIT) Treatment of young allergic children (favours SLIT) Exp Review Clin Immunol in press Pajno G et al.