Allergen Specific Immunotherapy
Allergen immunotherapy (AIT) has been used to treat allergic disease since the early 1900s. Despite numerous clinical trials and meta-analyses proving AIT efficacious, it remains underused and is estimated to be used in less than 10% of patients with allergic rhinitis or asthma worldwide. In addition, there are large differences between regions, which are not only due to socioeconomic status. There is practically no controversy about the use of AIT in the treatment of allergic rhinitis and allergic asthma, but for atopic dermatitis or food allergy, the indications for AIT are not well defined. The elaboration of a wider consensus is of utmost importance because AIT is the only treatment that can change the course of allergic disease by preventing the development of asthma and new allergen sensitizations and by inducing allergen-specific immune tolerance.
Part I published in the Journal of Allergy and Clinical Immunology 7 July 2015
Part II published in the Journal of Allergy and Clinical Immunology February 2016Last updated: 29 March 2017
Chronic rhinosinusitis (CRS) is a public health problem that has a significant socio-economic impact. The complexity of this disease due to its heterogeneous nature based on the underlying pathophysiology - leading to different disease variants - further complicates our understanding and directions for the most appropriate targeted treatment strategies. Several International/national guidelines/position papers and/or consensus documents are available that present the current knowledge and treatment strategies for CRS. Yet there are many challenges to the management of CRS especially in the case of the more severe and refractory forms of disease. Therefore, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), a collaboration between EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus (ICON) on Chronic Rhinosinusitis. The purpose of this ICON on CRS is to highlight the key common messages from the existing guidelines, the differences in recommendations as well as the gaps in our current knowledge of CRS, thus providing a concise reference.
Published in the World Allergy Organization Journal 2014, 7:25Last updated: 28 June 2018
The ICON: Anaphylaxis paper focuses on the principal anaphylaxis guidelines developed and published independently by the collaborating organisations from 2010 to 2014, other anaphylaxis-relevant guidelines and publications from these organisations, and more than 100 additional key publications that contribute to the evidence base for diagnosis, management, and prevention of anaphylaxis recurrences. In addition, it describes unmet needs in the diagnosis and treatment of anaphylaxis in high-, mid-, and low-resources countries and proposes an international agenda for anaphylaxis research.
ICON: International consensus on anaphylaxis (2014)Last updated: 29 March 2017
Drug hypersensitivity reactions (DHRs) comprise all drug reactions resembling allergy. DHRs constitute 15% of all adverse drug reactions affecting more than 7% of the general population. DHRs can be allergic or non-allergic with immunologically-mediated DHRs being named drug allergies. They are typically unpredictable, necessitate treatment changes and can potentially be life-threatening. A definitive diagnosis enabling the institution of adequate treatment options and proper preventive measures typically requires a complete drug allergy work up. Several guidelines and consensus statements on general or specific drug class-induced DHRs are available to support medical decisions on drug allergy; however, a standardized systematic approach for the diagnosis and management of DHRs is still a major challenge. The International Collaboration in Asthma, Allergy and Immunology (iCAALL), formed in 2012 by EAACI, AAAAI, ACAAI, and WAO, addresses this unmet need in this International Consensus on (ICON) Drug Allergy document. The purpose of this document is to:
• highlight the key messages that are common to many existing guidelines
• critically review and comment on differences, thus providing a concise reference
ICON: International consensus on drug allergy (2014)
See the summary of the ICON on drug allergy here.
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Last updated: 29 March 2017
Primary immunodeficiencies are intrinsic defects in the immune system that result in a predisposition to infection and are frequently accompanied by a propensity to autoimmunity and/or immunedysregulation. Primary immunodeficiencies can be divided into innate immunodeficiencies, phagocytic deficiencies, complement deficiencies, disorders of T cells and B cells (combined immunodeficiencies), antibody deficiencies and immunodeficiencies associated with syndromes. Diseases of immune dysregulation and autoinflammatory disorder are many times also included although the immunodeficiency in these disorders are often secondary to the autoimmunity or immune dysregulation and/or secondary immunosuppression used to control these disorders. Congenital primary immunodeficiencies typically manifest early in life although delayed onset are increasingly recognized. The early diagnosis of congenital immunodeficiencies is essential for optimal management and improved outcomes. In this International Consensus (ICON) document, we provide the salient features of the most common congenital immunodeficiencies.
ICON: International consensus on the early diagnosis of congenital immunodeficiencies (2014)Last updated: 15 October 2014