Monaldi Archives for Chest Disease (Feb 2016)
Practice parameters for sublingual immunotherapy
- C. Ortolani,
- F. Agostinis,
- S. Amoroso,
- R. Ariano,
- A. Barbato,
- M. Bassi,
- G. Cadario,
- P. Campi,
- F. Cardinale,
- G. Ciprandi,
- R. D’Anneo,
- M. Di Gioacchino,
- V. Di Rienzo,
- A. Fiocchi,
- M. Galimberti,
- E. Galli,
- M. Giovannini,
- C. Incorvaia,
- S. La Grutta,
- C. Lombardi,
- F. Marcucci,
- G. Marseglia,
- M. Minelli,
- A. Musarra,
- E. Nettis,
- E. Novembre,
- G. Pajno,
- G. Patriarca,
- F. Pezzuto,
- P. Piras,
- S. Pucci,
- A. Romano,
- C. Romano,
- O. Quercia,
- G. Scala,
- D. Schiavino,
- G. Sforza,
- M. Tosca,
- S. Tripodi,
- F. Frati
Affiliations
- C. Ortolani
- Casa di Cura Ambrosiana, Cesano Boscone, Milan
- F. Agostinis
- Allergy Consultant, Pediatrics Macedonio Melloni Hospital, Milan
- S. Amoroso
- Unità di Allergologia, Ospedale Civico, Palermo
- R. Ariano
- ASL 1 Imperiese, Allergology Department, Bordighera, Imperia
- A. Barbato
- University Department of Pediatrics, Padova
- M. Bassi
- Rho Hospital, Pediatrics, Rho
- G. Cadario
- Le Molinette Hospital, Torino
- P. Campi
- Allergology Department, ASL n. 10 FI, S. Giovanni di Dio Hospital, Firenze
- F. Cardinale
- III Clinica Pediatrica, Policlinico di Bari, Bari
- G. Ciprandi
- U.O. di Otorinolaringoiatria, S. Martino Hospital, Genova
- R. D’Anneo
- Pneumology Department, Regina Margherita Hospital, Messina
- M. Di Gioacchino
- Dipartimento di Medicina e Scienza dell’Invecchiamento, Immunologia e medicina del lavoro, G. D’Annunzio University, Chieti
- V. Di Rienzo
- Allergology Department, Poliambulatorio ASL FR, Frosinone
- A. Fiocchi
- Pediatric Department, Macedonio Melloni Hospital, Milan
- M. Galimberti
- Allergology Department, Novara Hospital, Novara
- E. Galli
- Pediatric Allergology, F.B.F. S. Pietro Hospital, Roma
- M. Giovannini
- Pneumology Department, Lugo Hospital, Ravenna
- C. Incorvaia
- Allergology/Pulmonary rehabilitation. Istituti Clinici di Perfezionamento, Milano
- S. La Grutta
- III Divisione di Pediatria, Sezione di Allergologia e Pneumologia, P.O.G. Di Cristina ARNAS Civico, Palermo
- C. Lombardi
- Divisione di Medicina, S. Orsola F.B.F., Brescia
- F. Marcucci
- Sezione di Terapia e Immuno-Allergologia Pediatrica, Dipartimento di Scienze Ginecologiche, Ostetriche e Pediatriche, Policlinico Monteluce, Perugia
- G. Marseglia
- Pediatric Allergology, S. Matteo Policlinico, Pavia
- M. Minelli
- Ambulatorio di Allergologia, U.O. Medicina Generale, Ospedale Campi Salentina, Lecce
- A. Musarra
- Ambulatorio di Allergologia, ASL Reggio Calabria
- E. Nettis
- Cattedra Allergologia e Immunologia Clinica, Policlinico di Bari
- E. Novembre
- Ambulatorio di Allergologia e Broncopneumologia, Dipartimento di Pediatria, Ospedale A. Meyer, Firenze
- G. Pajno
- Clinica Pediatrica, Policlinico di Messina
- G. Patriarca
- Allergology Department, Policlinico Gemelli, Università Cattolica, Roma
- F. Pezzuto
- Reparto di Allergologia e Immunologia, Ospedale Curteri, Mercato S. Severino, Salerno
- P. Piras
- Reparto di Otorinolaringoiatra - U.O. di Allergologia, Santissima Trinità Hospital, Cagliari
- S. Pucci
- U.O. di Allergologia, Ospedale Civile Civitanova Marche, ASL 8, Macerata
- A. Romano
- Allergology, Complesso Integrato Clinica Columbus, Roma
- C. Romano
- U.O.S. Pediatric Allergology, ASL NA n. 5, De Luca & Rossano Hospital, Napoli
- O. Quercia
- Allergology Department, Ospedale per gli Infermi, Faenza
- G. Scala
- Ambulatorio di Allergologia, Loreto Crispi Hospital, Napoli
- D. Schiavino
- Allergology Department, Policlinico Gemelli, Università Cattolica, Roma
- G. Sforza
- Allergology Department, ASL BA/1, Andria, Bari
- M. Tosca
- Pediatria Allergologica, Gaslini Hospital, Genova
- S. Tripodi
- Allergologia Pediatrica, Sandro Pertini Hospital, Roma
- F. Frati
- Scientific Department, Stallergénes, Milan
- DOI
- https://doi.org/10.4081/monaldi.2006.586
- Journal volume & issue
-
Vol. 65,
no. 1
Abstract
The efficacy and safety of sublingual immunotherapy (SLIT) are currently supported by clinical trials, metaanalysis and post-marketing surveys. Practice parameters for clinical use of SLIT are proposed here by a panel of Italian specialists, with reference to evidence based criteria. Indications to SLIT include allergic rhinoconjunctivitis, asthma, and isolated conjunctivitis (strength of recommendation: grade A). As to severity of the disease, SLIT is indicated in moderate/severe intermittent rhinitis, persistent rhinitis and mild to moderate asthma (grade D). SLIT may be safely prescribed also in children aged three to five years (grade B), and its use in subjects aged more than 60 years is not prevented when the indications and contraindication are ascertained (grade D). The choice of the allergen to be employed for SLIT should be made in accordance with the combination of clinical history and results of skin prick tests (grade D). Polysensitisation, i.e. the occurrence of multiple positive response does not exclude SLIT, which may be done with the clinically most important allergens (grade D). As to practical administration, co-seasonal, pre co-seasonal, and continuous schedules are available, being the latter recommended for perennial allergens or for pollens with particularly prolonged pollination, such as Parietaria (grade D). For pollens with relatively short pollination, such as grasses and trees (cypress, birch, alder, hazelnut, olive) the pre coseasonal and perennial schedules are preferred (grade C). The build-up phases suggested by manufacturers can be safely used (grade A), but they can be modified according to the patient’s tolerance (grade C). A duration of SLIT of 3-5 years is recommended to ensure a long-lasting clinical effect after the treatment has been terminated (grade C).
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