The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) recently released a clinical practice guideline (CPG) for the management of inhalant allergies with allergen immunotherapy (AIT).
The quality improvement guideline, published online in the March 2024 issue of Otolaryngology–Head and Neck Surgery, recommends that clinicians performing allergy skin testing or allergen immunotherapy be able to diagnose and manage anaphylaxis.
Richard K. Gurgel, MD, a professor of otolaryngology at the University of Utah School of Medicine in Salt Lake City, was a part of the guideline development group involved in publishing the new guideline.
“We hope this CPG will be a valuable resource to optimize patient care and reduce unnecessary and costly variation in AIT management,” Dr. Gurgel said.
The purpose of the guideline to identify quality improvement opportunities and provide trustworthy, evidence-based recommendations for the management of inhaled allergies with immunotherapy.
For patients with allergic rhinitis with or without allergic asthma, whose symptoms are inadequately controlled with medical therapy, allergen avoidance or both, or for those who prefer immunomodulation, the guideline recommends clinicians offer or refer to a clinician who can offer immunotherapy. For patients who are pregnant, have uncontrolled asthma or are unable to tolerate injectable epinephrine, the guideline recommends clinicians not initiate AIT.
Further, the new guideline recommends:
- Signs and symptoms of asthma should be evaluated before initiating AIT.
- Signs and symptoms of uncontrolled asthma should be assessed before administering subsequent AIT.
- Clinicians should educate patients regarding the potential benefits of AIT.
- Treatment should continue for a minimum of three years, with ongoing duration based on treatment response for patients experiencing symptomatic control from AIT.
