International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics

• Published in: Journal of allergy and clinical immunology Vol. 137; no. 2; pp. 358 - 368
• Main Authors: Jutel, Marek, MD, Agache, Ioana, MD, Bonini, Sergio, MD, Burks, A. Wesley, MD, Calderon, Moises, MD, Canonica, Walter, MD, Cox, Linda, MD, Demoly, Pascal, MD, Frew, Antony J., MD, FRCP, O'Hehir, Robyn, FRACP, PhD, Kleine-Tebbe, Jörg, MD, Muraro, Antonella, MD, PhD, Lack, Gideon, MD, Larenas, Désirée, MD, Levin, Michael, MD, Martin, Bryan L., MD, Nelson, Harald, MD, Pawankar, Ruby, MD, Pfaar, Oliver, MD, van Ree, Ronald, PhD, Sampson, Hugh, MD, Sublett, James L., MD, Sugita, Kazunari, MD, Du Toit, George, MD, Werfel, Thomas, MD, Gerth van Wijk, Roy, MD, Zhang, Luo, MD, Akdis, Mübeccel, MD, Akdis, Cezmi A., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2016; Elsevier Limited; Elsevier
• Subjects: allergen standardization; allergen vaccine; Allergens - administration & dosage; Allergens - immunology; Allergies; Allergology; allergy; Allergy and Immunology; Antigens; Asthma; Biomarkers; Consensus; Cost-Benefit Analysis; cost-effectiveness; Cytotoxicity; Desensitization, Immunologic - economics; Desensitization, Immunologic - methods; Desensitization, Immunologic - standards; Drug dosages; Economics, Pharmaceutical - legislation & jurisprudence; Humans; Hypersensitivity - immunology; Hypersensitivity - therapy; Immune Tolerance; Immunology; Immunotherapy; International consensus; Life Sciences; Lymphocytes; marketing authorization; mechanisms; Pharmacoeconomics; regulatory authorities; Rodents; Standardization; Studies; T cell receptors; Throat surgery; tolerance; unmet needs; Venom; VIT; ILC; Standard treatment; Breg; CUA; ILC2; allergen vaccine; allergen standardization; MA; Forkhead box protein 3; In-house reference preparation; EMA; Regulatory T; mechanisms; tolerance; Toll-like receptor; Incremental cost-effectiveness ratio; Dendritic cell; Subcutaneous immunotherapy; allergy; AIT; FOXP3; Regulatory B; EU; AS; QALY; IHRP; Innate lymphoid cell; Cost-utility analysis; NPP; immunotherapy; unmet needs; TLR; pharmacoeconomics; marketing authorization; SCIT; D50; cost-effectiveness; ST; Venom immunotherapy; regulatory authorities; SLIT; ICER; Treg; Named-patient product; Sublingual immunotherapy; European Union; Quality-adjusted life year; BAU; Type 2 innate lymphoid cell; Dilution of extract that on average produces a 50 mm erythema (sum of lengths and width); International consensus; Bioequivalent allergen units; Allergen immunotherapy; European Medicines Agency; DC
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2015.12.1300

This article continues the comprehensive international consensus (ICON) statement on allergen immunotherapy (AIT). The initial article also recently appeared in the Journal . The conclusions below focus on key mechanisms of AIT-triggered tolerance, requirements in allergen standardization, AIT cost-effectiveness, and regulatory guidance. Potential barriers to and facilitators of the use of AIT are described in addition to future directions. International allergy specialists representing the European Academy of Allergy and Clinical Immunology; the American Academy of Allergy, Asthma & Immunology; the American College of Allergy, Asthma and Immunology; and the World Allergy Organization critically reviewed the existing literature and prepared this summary of recommendations for best AIT practice. The authors contributed equally and reached consensus on the statements presented herein.