2016 Section 5 Green Book

II.

Allergic and Immunologic Disorders A. Allergy 1. Immunology 2. New diagnostics 3. Treatment of allergic rhinitis a. SLIT/SCIT

Lin SY, Erekosima N, Kim JM, et al. Sublingual immunotherapy for the treatment of allergic rhinoconjunctivitis and asthma: a systematic review. JAMA . 2013; 309(12):1278-1288. EBM level 1a.........................................................................183-193 Summary : Sublingual immunotherapy (SLIT) provides a moderate-grade level of evidence to support effectiveness for the treatment of allergic rhinitis and asthma when combined. In the asthma group, the evidence was high in support of SLIT for improving symptoms. In the rhinitis group, the evidence was rated moderate in support of SLIT for rhinitis symptoms. b. Pharmaceuticals Li JT, Bernstein DI, Calderon MA, et al. Sublingual grass and ragweed immunotherapy: clinical considerations-a PRACTALL consensus report. J Allergy Clin Immunol . 2016; 137(2):369-376. EBM level 1a...............................................................................194-201 Summary : Sublingual allergen immunotherapy has been widely used and studied throughout Europe. Sublingual grass and ragweed immunotherapy tablets, used for allergic rhinitis, have proven efficacy studied through large multi-institutional trials. Sublingual immunotherapy (SLIT) is indicated for IgE atopy confirmed by positive skin test or in vitro testing. Most SLIT- induced local reactions occur soon after the beginning of treatment and cease within 2 weeks without intervention. SLIT is extremely safe. Based on the European experience, no SLIT related fatalities have occurred.

B. Asthma

1. Unified airway Mener DJ, Lin SY. Improvement and prevention of asthma with concomitant treatment of allergic rhinitis and allergen-specific therapy. Int Forum Allergy Rhinol . 2015; 5 Suppl 1:S45-S50. EBM level 4................................................................................................202-207

Summary : This article is an expert review on the impact of management of allergic rhinitis on asthma treatment and prevention.

Stachler RJ. Comorbidities of asthma and the unified airway. Int Forum Allergy Rhinol . 2015; 5 Suppl 1:S17-S22. EBM level 4.........................................................................208-213

Summary : This article is a review of the current literature, studying asthma as a comorbidity of respiratory diseases such as allergic rhinitis.