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• W4299608029 abstract "Given the preponderance of evidence that demonstrates the effectiveness of allergen immunotherapy, the major question that needs to be addressed is not whether immunotherapy should be implemented in the treatment of allergic rhinitis and allergic asthma but rather at what point during the course of disease should it be initiated. One of the earliest studies indicated that children with allergic rhinitis treated with immunotherapy had significantly reduced chances of later developing asthma.22 A more recent study conducted in Europe confirmed this observation as allergen immunotherapy was found to significantly reduce the incidence of asthma.21 These studies support the concept that early treatment intervention with allergen immunotherapy in patients with allergic rhinitis or mild allergic asthma will down-modulate inflammatory responses and lessen the severity of future disease.21, 22 Recent investigations also found that early intervention by an allergy subspecialist (including immunotherapy) in the management of allergic rhinitis and asthma is more effective in improving clinical outcomes while reducing overall resource utilization and net costs to treat these diseases, compared with care provided by a general internist.7,48 Expert care encompasses specialized clinical, pharmaceutical, and immunologic skills including allergen immunotherapy. Although the optimal time to implement immunotherapy remains an unsettled question, logically it should be administered early on in the course of disease if the same rationale for early introduction of inhaled anti-inflammatory agents for the treatment of asthma to reduce disease severity and improve clinical outcomes is applied.5, 26 In summary, allergen immunotherapy has been demonstrated to be effective in the treatment of allergic rhinitis and mild asthma. The critical decision for management of patients with allergic rhinitis and allergic asthma is whether to rely on avoidance measures and medications for suppression of disease related symptoms or to combine them with allergen immunotherapy in an attempt to gradually reduce the need for chronic medication by attenuating the inflammatory events responsible for clinical disease. If the clinical situation suggests the necessity for long-term treatment and the patient is a candidate for allergen immunotherapy, treatment should be initiated early on in the course of disease to prevent disease progression and severity. Further outcome studies are necessary to determine more precisely the cost-effectiveness of allergen immunotherapy compared with medication and avoidance measures, taking into account indirect costs, such as quality of life. In the past, such studies have been difficult to implement because allergic rhinitis and allergic asthma have variable courses for each individual. Costeffectiveness analysis studies using “construction and analysis of references case” methods may prove useful for demonstrating the beneficial pharmacoeconomic impact of allergen immunotherapy in the treatment of allergic diseases.40, 42, 49" @default.
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• W4299608029 date "2000-08-01" @default.
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• W4299608029 title "COST-BENEFIT ANALYSIS FOR ALLERGEN IMMUNOTHERAPY" @default.
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• W4299608029 doi "https://doi.org/10.1016/s0033-8389(22)00109-9" @default.
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