Asthma Management with Immunotherapy
Allergen Immunotherapy
- The American Academy of Allergy, Asthma, and Immunology recommends considering subcutaneous allergen immunotherapy for patients with persistent allergic asthma when there is a clear relationship between asthma symptoms and unavoidable aeroallergen exposure with documented specific IgE antibodies 1, 2.
- Allergen immunotherapy is appropriate for patients who experience poor response to pharmacotherapy or avoidance measures, unacceptable medication side effects, desire to avoid long-term pharmacotherapy, coexisting allergic rhinitis, or long duration of symptoms 1, 2.
- In children with allergic rhinitis, allergen immunotherapy can potentially prevent asthma development and reduce new allergen sensitivities 1, 2.
Biologic Immunotherapy
- The American College of Allergy, Asthma, and Immunology recommends omalizumab for patients aged 12 years and older with severe persistent allergic asthma whose symptoms remain inadequately controlled despite high-dose inhaled corticosteroids plus long-acting beta-agonists 5, 6, 7, 8.
- Omalizumab prevents exacerbations, improves symptoms, and reduces inhaled steroid requirements in moderate-to-severe asthma 1, 2.
- The National Asthma Education and Prevention Program notes that biologics were not systematically reviewed, and specific recommendations for Steps 5-6 were not made 3, 4.
Clinical Outcomes with Specialist Care
- Specialist care, such as allergist-immunologist management, reduces asthma emergency department visits, hospitalizations, and improves asthma-related quality of life 1, 2.
- The American Academy of Allergy, Asthma, and Immunology recommends consultation with an asthma specialist for patients with Step 4 or higher required, Step 3, patients with potentially fatal asthma, patients requiring emergency department care for acute episodes, or uncontrolled asthma despite appropriate therapy 1, 3, 4, 5, 9.