September 21, 2018

Duration of Allergen Immunotherapy for Long-Term Efficacy in Allergic Rhinoconjunctivitis

  • Martin Penagos 
  • Aarif O. Eifan 
  • Stephen R. Durham
  • Guy W. Scadding
  1. 1.
Open Access 
Specific Immunotherapy (L Cox, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Specific Immunotherapy
Abstract

Rationale

Subcutaneous and sublingual immunotherapy are effective for allergic rhinitis. An important question is whether allergen immunotherapy provides a sustained clinical effect after treatment cessation. In view of potential side effects, cost and the necessary patient commitment, long-term benefit is an important consideration for the recommendation of immunotherapy over standard pharmacotherapy.
Purpose of review
In this review, we analyse the existing evidence for long-term effects of both routes of administration in the context of double-blind, placebo-controlled, randomised clinical trials that included a follow-up phase of at least 1 year after treatment cessation.
Recent findings
Overall, evidence suggests that 3 years of either subcutaneous or sublingual immunotherapy result in clinical benefit and immunological changes consistent with allergen-specific tolerance sustained for at least 2–3 years after treatment cessation.
Summary
The data presented here support recommendations in international guidelines that both routes of administration should be continued for a minimum of 3 years. Gaps in the evidence remain regarding the long-term efficacy of immunotherapy for perennial rhinitis and studies performed in children.

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