Allergen Immunotherapy (AIT) in Allergic Rhinitis: Long-Term Efficacy and the Development of Asthma. What Do We Know?

Allergy Immunotherapy is the only treatment able to modify the natural history of the respiratory allergic disease. It is indicated in IgE-mediated rhinoconjunctivitis and/or allergic asthma in both children and adults whenever more than occasional use of anti-inflammatory or controller medications is needed. Only well-standardized products should be used after precise diagnosis has been achieved. Efficacy of allergen immunotherapy (AIT) with mite and pollen extracts persist once treatment is discontinued, and for that AIT may be considered the only treatment able to change the natural history of the allergic disease. Key points 1. The strongest risk for developing asthma occurred in those patients with rhinitis and sensitization to several inhalant allergens, particularly house dust mites. 2. The role of allergen avoidance measures in the evolution of the respiratory disease is unknown. 3. AIT is indicated for rhinoconjunctivitis and/or asthma due to allergy to inhalants. In both cases, it is preferable to initiate the treatment as soon as possible, before chronic irreversible changes occur. 4. According to the European Medicines Agency (EMA), long-term efficacy can be defined as “the prolonged clinically relevant benefit that persists after stopping the treatment”. 5. Long-term efficacy of AIT has been demonstrated for both mite and pollen AIT in children and adults. © 2014, Springer International Publishing AG.