Erkka Valovirta - Academia.edu (original) (raw)

Papers by Erkka Valovirta

Research paper thumbnail of Requisitos para treinamento médico em alergia: Competências clínicas essenciais para o tratamento de pacientes com doenças alérgicas ou imunológicas: Declaração da posição provisória da World Allergy Organization (WAO)

Arquivos de Asma, Alergia e Imunologia, 2008

Research paper thumbnail of POSITION ARTICLE AND GUIDELINES Open Access EAACI: A European Declaration on Immunotherapy. Designing the future of allergen specific immunotherapy

Allergy today is a public health concern of pandemic proportions, affecting more than 150 million... more Allergy today is a public health concern of pandemic proportions, affecting more than 150 million people in Europe alone. In view of epidemiological trends, the European Academy of Allergy and Clinical Immunology (EAACI) predicts that within the next few decades, more than half of the European population may at some point in their lives experience some type of allergy. Not only do allergic patients suffer from a debilitating disease, with the potential for major impact on their quality of life, career progression, personal development and lifestyle choices, but they also constitute a significant burden on health economics and macroeconomics due to the days of lost productivity and underperformance. Given that allergy triggers, including urbanization, industrialization, pollution and climate change, are not expected to change in the foreseeable future, it is imperative that steps are taken to develop, strengthen and optimize preventive and treatment strategies. Allergen specific immu...

Research paper thumbnail of ARIA update 2008: allergic rhinitis and its effect on asthma

Allergologie, 2009

... LTT Lan; J Li; R Lockey; S Mavale; EO Meltzer; Y Mohammad; J Mullol; R Naclerio; R OHehir; K ... more ... LTT Lan; J Li; R Lockey; S Mavale; EO Meltzer; Y Mohammad; J Mullol; R Naclerio; R OHehir; K Ohta; S Ouedraogo; S Palkonen; N Papadopoulos; ... DY Wang; M Wickman; B Yawn; A Yorgancioglu; O Yusuf; H Zar. Title, ARIA update 2008: allergic rhinitis and its effect on asthma. ...

Research paper thumbnail of Gapp Survey Working Group. Unmet Needs in Asthma: Global Physician and Patient (Gapp) Survey: Global Adult Findings

Research paper thumbnail of ARIA‐EAACI care pathways for allergen immunotherapy in respiratory allergy

Clinical and Translational Allergy, 2021

This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Research paper thumbnail of Burden of allergic rhinitis and impact of MP-AzeFlu from the patient perspective: pan European patient survey

Current Medical Research and Opinion, 2021

Objective: The aims of this survey were to (1) assess the burden of allergic rhinitis (AR) from t... more Objective: The aims of this survey were to (1) assess the burden of allergic rhinitis (AR) from the patient perspective, (2) investigate MP-AzeFlu use in real life and its impact on patients' lives and (3) explore factors associated with treatment satisfaction. Methods: A cross-sectional, quantitative, online, questionnaire-based survey was conducted in seven European countries (March-June 2019). Questions explored AR burden and treatment satisfaction. Satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication 9-item (TSQM-9; max score ¼ 100). Participants (aged !18 years) had a doctor/healthcare provider confirmed AR diagnosis and used MP-AzeFlu within the last year. Results: Pre-MP-AzeFlu treatment, participants (n ¼ 1004) reported an average of 3.3 (SD:3.5) doctor visits/year, 8.1 (SD:11.0) days/year absenteeism and 15.8 (SD:18.9) days/year presenteeism due to AR. Only 48% of participants used MP-AzeFlu twice/day as recommended. Post-MP-AzeFlu 57% of participants reported better QoL, 47% reported fewer doctor visits and 52% discontinued polypharmacy. Absenteeism and presenteeism were reduced by 2.5 (SD 10.0) and 7.3 (SD:16.0) days/year, respectively. 70% of participants were more/much more satisfied with MP-AzeFlu versus previous AR treatment(s), and !70% were satisfied/extremely satisfied with its ability to prevent/treat AR, relieve symptoms and with its onset of action. Mean global, effectiveness and convenience TSQM-9 scores were 70.0 (SD:19.8), 68.3 (SD:21.6) and 72.7 (SD:20.4), respectively. Treatment satisfaction and effectiveness were significantly improved when MP-AzeFlu was taken as recommended. Conclusions: The impact of AR on patients' lives remains high. Real-life use of MP-AzeFlu reduces that impact and is associated with a high level of effectiveness, convenience and global satisfaction.

Research paper thumbnail of ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice

Allergy, 2020

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Research paper thumbnail of Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence

Journal of Allergy and Clinical Immunology, 2019

Background: In all societies, the burden and cost of allergic and chronic respiratory diseases ar... more Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Nextgeneration guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.

Research paper thumbnail of Contraindications to immunotherapy: a global approach

Clinical and Translational Allergy, 2019

Background Recommendations on contraindications to allergen immunotherapy (AIT) have been indepen... more Background Recommendations on contraindications to allergen immunotherapy (AIT) have been independently developed by National and International Societies/Academies. AIT contraindications are mainly based on case reports, case-series, or experts’ opinion, while evidence-based information is limited. The aim of the present review was to describe existing guidelines on contraindications to AIT and to highlight differences between them. Main body An extended review of the literature regarding contraindications to AIT for respiratory allergy and venom hypersensitivity was performed. Furthermore, Societies and Academies registered in the World Allergy Organization and EAACI databases, were asked for additional information. Only AIT guidelines published under official auspicies were included. A large heterogeneity among the various recommendations on contraindications was registered. Common contraindications to most of the guidelines were: lack of adherence, pregnancy before the start of A...

Research paper thumbnail of Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Clinical and Translational Allergy, 2019

BackgroundIn all societies, the burden and cost of allergic and chronic respiratory diseases are ... more BackgroundIn all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.Main bodyAs an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by phar...

Research paper thumbnail of Birch pollen allergy in Europe

Allergy, 2019

Birch and other related trees of the families Betulaceae and Fagaceae (alder, hazel, oak, hornbea... more Birch and other related trees of the families Betulaceae and Fagaceae (alder, hazel, oak, hornbeam, chestnut, and beech) constitute the birch homologous group. This grouping is primarily based on the extensive IgE cross-reactivity of allergen homologs to the major birch allergen Bet v 1. Birch pollen is the most dominant tree pollen in Northern and Central Europe and is a major cause of allergic rhinitis and, possibly, asthma symptoms. Over the last few decades, levels of birch pollen have risen and the period of exposure has increased due to climate changes. Subsequently, the prevalence of birch pollen sensitization has also increased. The cross-reactivity and sequential pollen seasons within the birch homologous group create a prolonged symptomatic allergy period beyond birch pollen alone. Furthermore, many plant food allergens contain homologs to Bet v 1, meaning that the majority of patients with birch pollen allergy suffer from secondary pollen food syndrome (PFS). As a result, the negative impact on health-related quality of life (HRQoL) in patients allergic to birch pollen is significant. The purpose of this manuscript was to narratively review topics of interest such as taxonomy, cross-reactivity, prevalence, clinical relevance, PFS, and HRQoL with regard to birch pollen allergy from a European perspective.

Research paper thumbnail of The SQ tree SLIT-tablet is highly effective and well tolerated: Results from a randomized, double-blind, placebo-controlled phase III trial

Journal of Allergy and Clinical Immunology, 2019

placebo treatment. The primary end point was the average daily ARC total combined score (TCS) dur... more placebo treatment. The primary end point was the average daily ARC total combined score (TCS) during the birch pollen season (BPS) analyzed for subjects with diary data during the BPS. Secondary end points included average daily symptom scores (DSS) during the BPS, average TCS and DSS during the tree pollen season (TPS), and average daily medication scores (DMS) in the BPS and TPS. Results: The primary and key secondary end points demonstrated statistically significant and clinically relevant effects of the SQ tree SLIT-tablet compared with placebo. For the BPS, absolute (relative) differences from placebo were 3.02 (40%) for TCS, 1.32 (37%) for DSS, and 1.58 (49%) for DMS (all P < .0001). For the TPS, absolute (relative) differences from placebo were 2.27 (37%) for TCS, 0.99 (33%) for DSS, and 1.20 (47%) for DMS (all P < .0001). Treatment was well tolerated. The most frequently reported treatment-related adverse events were mild or moderate local reactions related to sublingual administration. Conclusion: The trial demonstrated the efficacy and safety of the SQ tree SLIT-tablet compared with placebo during the BPS and TPS in adolescents and adults with birch pollen-induced

Research paper thumbnail of The Finnish Allergy Programme 2008–2018 works

European Respiratory Journal, 2017

Health allocated €60 000-65 000 annually for educational and coordinating work, which was organis... more Health allocated €60 000-65 000 annually for educational and coordinating work, which was organised by the Finnish Lung Health Association (Filha), an expert non-governmental organisation. Filha raised private funds of €50 000-100 000 per year to carry out the education for more than 20 000 healthcare professionals in 2008-2016. For patient education and public communication, three non-governmental patient organisations together received, between 2011 and 2014, an annual payment of €200 000 from Finland's Slot Machine Association (RAY). The main purpose of the government-regulated RAY is to raise funds to promote health and welfare in Finland through gaming operations. Funding information for this article has been deposited with the Crossref Funder Registry.

Research paper thumbnail of Results from the 5-year SQ grass sublingual immunotherapy tablet asthma prevention (GAP) trial in children with grass pollen allergy

Journal of Allergy and Clinical Immunology, 2017

The following work is licensed under a Creative Commons: Attribution-NonCommercial-NoDerivatives ... more The following work is licensed under a Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License.

Research paper thumbnail of Novel approaches and perspectives in allergen immunotherapy

Allergy, 2017

In this review, we report on relevant current topics in allergen immunotherapy (AIT) which were b... more In this review, we report on relevant current topics in allergen immunotherapy (AIT) which were broadly discussed during the first Aarhus Immunotherapy Symposium (Aarhus, Denmark) in December 2015 by leading clinicians, scientists and industry representatives in the field. The aim of this symposium was to highlight AIT-related aspects of public health, clinical efficacy evaluation, mechanisms, development of new biomarkers and an overview of novel therapeutic approaches. Allergy is a public health issue of high socioeconomic relevance, and development of evidence-based action plans to address allergy as a public health issue ought to be on national and regional agendas. The underlying mechanisms are in the focus of current research that lays the ground for innovative therapies. Standardization and harmonization of clinical endpoints in AIT trials as well as current knowledge about potential biomarkers have substantiated proof of effectiveness of this disease-modifying therapeutic option. Novel treatments such as peptide immunotherapy, intralymphatic immunotherapy and use of recombinant allergens herald a new age in which AIT may address treatment of allergy as a public health issue by reaching a large fraction of patients. Allergies have become a public health concern of pandemic proportions that affect >150 million Europeans. More alarming, their prevalence and impact are on the rise. It has been predicted that within the next few decades, up to half of the European population may at some point in their lives experience some type of allergy (1). Allergen immunotherapy (AIT) is the only Abbreviations AEC, allergen exposure chamber; AIT, allergen immunotherapy; AR, allergic rhinitis; CSMS, combined symptom and medication score; DC,

Research paper thumbnail of MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis

The Journal of allergy and clinical immunology, Aug 23, 2016

The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several fact... more The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assessment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control. Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). A CDSS is currently being developed to optimize AR control. An algorithm develo...

Research paper thumbnail of Efficacy of MP-AzeFlu in children with seasonal allergic rhinitis: Importance of paediatric symptom assessment

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2016

This study aimed to assess the efficacy of MP-AzeFlu (a novel intranasal formulation of azelastin... more This study aimed to assess the efficacy of MP-AzeFlu (a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate in a single spray) in children with seasonal allergic rhinitis (SAR) and explore the importance of child symptom severity assessment in paediatric allergic rhinitis (AR) trials. A total of 348 children (4-11 years) with moderate/severe SAR were randomized into a double-blind, placebo-controlled, 14-day, parallel-group trial. Efficacy was assessed by changes from baseline in reflective total nasal symptom score (rTNSS), reflective total ocular symptom score (rTOSS) and individual symptom scores over 14 days (children 6-11 years; n = 304), recorded by either children or caregivers. To determine whether a by-proxy effect existed, efficacy outcomes were assessed according to degree of child/caregiver rating. Moreover, total Paediatric Rhinitis Quality of Life Questionnaire (PRQLQ) score was compared between the groups. A statistically superior, clin...

Research paper thumbnail of Wymagania dotyczące kompetencji lekarzy w zakresie alergologii: Kluczowe umiejętności kliniczne konieczne do sprawowania opieki nad pacjentami chorymi na choroby alergiczne lub immunologiczne. Stanowisko Światowej Organizacji Alergii Requirements for Physician Competencies in Allergy: Key Clinica...

Research paper thumbnail of Allergy, living and learning: diagnosis and treatment of allergic respiratory diseases in Europe

Journal of investigational allergology & clinical immunology, 2012

Allergy Living and Learning (ALL) is a European initiative designed to increase knowledge and und... more Allergy Living and Learning (ALL) is a European initiative designed to increase knowledge and understanding of people living with allergies in order to improve respiratory allergy care. To investigate diagnostic and treatment patterns associated with respiratory allergies, patients' perception of their treatment, and restrictions on daily activities. Using a telephone-based randomized screening method, we recruited and analyzed 7004 patients (aged 16-60 years) with self-reported respiratory allergic disease from 10 European countries. Patients answered questions assessing their knowledge, experience, and perception of their condition and its treatment. Data analyses were descriptive. The most prevalent conditions were allergic rhinitis (66%) and asthma (26%), and the average duration of the symptoms of respiratory allergy was 14.5 years. Over 30% of patients had never had a specific diagnostic test. About 80% of patients used medication for their respiratory allergy, and 10% of ...

Research paper thumbnail of Requirements for Physician Competencies in Allergy: Key Clinical Competencies Appropriate for the Care of Patients With Allergic or Immunologic Diseases

World Allergy Organization Journal, 2008

With special recognition of the contribution of Karen Henley, staff liaison to Council 1 Some of ... more With special recognition of the contribution of Karen Henley, staff liaison to Council 1 Some of these skills should be at least taught and understood but may not be performed personally, in accordance with national guidelines and established practice parameters.

Research paper thumbnail of Requisitos para treinamento médico em alergia: Competências clínicas essenciais para o tratamento de pacientes com doenças alérgicas ou imunológicas: Declaração da posição provisória da World Allergy Organization (WAO)

Arquivos de Asma, Alergia e Imunologia, 2008

Research paper thumbnail of POSITION ARTICLE AND GUIDELINES Open Access EAACI: A European Declaration on Immunotherapy. Designing the future of allergen specific immunotherapy

Allergy today is a public health concern of pandemic proportions, affecting more than 150 million... more Allergy today is a public health concern of pandemic proportions, affecting more than 150 million people in Europe alone. In view of epidemiological trends, the European Academy of Allergy and Clinical Immunology (EAACI) predicts that within the next few decades, more than half of the European population may at some point in their lives experience some type of allergy. Not only do allergic patients suffer from a debilitating disease, with the potential for major impact on their quality of life, career progression, personal development and lifestyle choices, but they also constitute a significant burden on health economics and macroeconomics due to the days of lost productivity and underperformance. Given that allergy triggers, including urbanization, industrialization, pollution and climate change, are not expected to change in the foreseeable future, it is imperative that steps are taken to develop, strengthen and optimize preventive and treatment strategies. Allergen specific immu...

Research paper thumbnail of ARIA update 2008: allergic rhinitis and its effect on asthma

Allergologie, 2009

... LTT Lan; J Li; R Lockey; S Mavale; EO Meltzer; Y Mohammad; J Mullol; R Naclerio; R OHehir; K ... more ... LTT Lan; J Li; R Lockey; S Mavale; EO Meltzer; Y Mohammad; J Mullol; R Naclerio; R OHehir; K Ohta; S Ouedraogo; S Palkonen; N Papadopoulos; ... DY Wang; M Wickman; B Yawn; A Yorgancioglu; O Yusuf; H Zar. Title, ARIA update 2008: allergic rhinitis and its effect on asthma. ...

Research paper thumbnail of Gapp Survey Working Group. Unmet Needs in Asthma: Global Physician and Patient (Gapp) Survey: Global Adult Findings

Research paper thumbnail of ARIA‐EAACI care pathways for allergen immunotherapy in respiratory allergy

Clinical and Translational Allergy, 2021

This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Research paper thumbnail of Burden of allergic rhinitis and impact of MP-AzeFlu from the patient perspective: pan European patient survey

Current Medical Research and Opinion, 2021

Objective: The aims of this survey were to (1) assess the burden of allergic rhinitis (AR) from t... more Objective: The aims of this survey were to (1) assess the burden of allergic rhinitis (AR) from the patient perspective, (2) investigate MP-AzeFlu use in real life and its impact on patients' lives and (3) explore factors associated with treatment satisfaction. Methods: A cross-sectional, quantitative, online, questionnaire-based survey was conducted in seven European countries (March-June 2019). Questions explored AR burden and treatment satisfaction. Satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication 9-item (TSQM-9; max score ¼ 100). Participants (aged !18 years) had a doctor/healthcare provider confirmed AR diagnosis and used MP-AzeFlu within the last year. Results: Pre-MP-AzeFlu treatment, participants (n ¼ 1004) reported an average of 3.3 (SD:3.5) doctor visits/year, 8.1 (SD:11.0) days/year absenteeism and 15.8 (SD:18.9) days/year presenteeism due to AR. Only 48% of participants used MP-AzeFlu twice/day as recommended. Post-MP-AzeFlu 57% of participants reported better QoL, 47% reported fewer doctor visits and 52% discontinued polypharmacy. Absenteeism and presenteeism were reduced by 2.5 (SD 10.0) and 7.3 (SD:16.0) days/year, respectively. 70% of participants were more/much more satisfied with MP-AzeFlu versus previous AR treatment(s), and !70% were satisfied/extremely satisfied with its ability to prevent/treat AR, relieve symptoms and with its onset of action. Mean global, effectiveness and convenience TSQM-9 scores were 70.0 (SD:19.8), 68.3 (SD:21.6) and 72.7 (SD:20.4), respectively. Treatment satisfaction and effectiveness were significantly improved when MP-AzeFlu was taken as recommended. Conclusions: The impact of AR on patients' lives remains high. Real-life use of MP-AzeFlu reduces that impact and is associated with a high level of effectiveness, convenience and global satisfaction.

Research paper thumbnail of ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice

Allergy, 2020

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Research paper thumbnail of Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence

Journal of Allergy and Clinical Immunology, 2019

Background: In all societies, the burden and cost of allergic and chronic respiratory diseases ar... more Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Nextgeneration guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.

Research paper thumbnail of Contraindications to immunotherapy: a global approach

Clinical and Translational Allergy, 2019

Background Recommendations on contraindications to allergen immunotherapy (AIT) have been indepen... more Background Recommendations on contraindications to allergen immunotherapy (AIT) have been independently developed by National and International Societies/Academies. AIT contraindications are mainly based on case reports, case-series, or experts’ opinion, while evidence-based information is limited. The aim of the present review was to describe existing guidelines on contraindications to AIT and to highlight differences between them. Main body An extended review of the literature regarding contraindications to AIT for respiratory allergy and venom hypersensitivity was performed. Furthermore, Societies and Academies registered in the World Allergy Organization and EAACI databases, were asked for additional information. Only AIT guidelines published under official auspicies were included. A large heterogeneity among the various recommendations on contraindications was registered. Common contraindications to most of the guidelines were: lack of adherence, pregnancy before the start of A...

Research paper thumbnail of Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Clinical and Translational Allergy, 2019

BackgroundIn all societies, the burden and cost of allergic and chronic respiratory diseases are ... more BackgroundIn all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.Main bodyAs an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by phar...

Research paper thumbnail of Birch pollen allergy in Europe

Allergy, 2019

Birch and other related trees of the families Betulaceae and Fagaceae (alder, hazel, oak, hornbea... more Birch and other related trees of the families Betulaceae and Fagaceae (alder, hazel, oak, hornbeam, chestnut, and beech) constitute the birch homologous group. This grouping is primarily based on the extensive IgE cross-reactivity of allergen homologs to the major birch allergen Bet v 1. Birch pollen is the most dominant tree pollen in Northern and Central Europe and is a major cause of allergic rhinitis and, possibly, asthma symptoms. Over the last few decades, levels of birch pollen have risen and the period of exposure has increased due to climate changes. Subsequently, the prevalence of birch pollen sensitization has also increased. The cross-reactivity and sequential pollen seasons within the birch homologous group create a prolonged symptomatic allergy period beyond birch pollen alone. Furthermore, many plant food allergens contain homologs to Bet v 1, meaning that the majority of patients with birch pollen allergy suffer from secondary pollen food syndrome (PFS). As a result, the negative impact on health-related quality of life (HRQoL) in patients allergic to birch pollen is significant. The purpose of this manuscript was to narratively review topics of interest such as taxonomy, cross-reactivity, prevalence, clinical relevance, PFS, and HRQoL with regard to birch pollen allergy from a European perspective.

Research paper thumbnail of The SQ tree SLIT-tablet is highly effective and well tolerated: Results from a randomized, double-blind, placebo-controlled phase III trial

Journal of Allergy and Clinical Immunology, 2019

placebo treatment. The primary end point was the average daily ARC total combined score (TCS) dur... more placebo treatment. The primary end point was the average daily ARC total combined score (TCS) during the birch pollen season (BPS) analyzed for subjects with diary data during the BPS. Secondary end points included average daily symptom scores (DSS) during the BPS, average TCS and DSS during the tree pollen season (TPS), and average daily medication scores (DMS) in the BPS and TPS. Results: The primary and key secondary end points demonstrated statistically significant and clinically relevant effects of the SQ tree SLIT-tablet compared with placebo. For the BPS, absolute (relative) differences from placebo were 3.02 (40%) for TCS, 1.32 (37%) for DSS, and 1.58 (49%) for DMS (all P < .0001). For the TPS, absolute (relative) differences from placebo were 2.27 (37%) for TCS, 0.99 (33%) for DSS, and 1.20 (47%) for DMS (all P < .0001). Treatment was well tolerated. The most frequently reported treatment-related adverse events were mild or moderate local reactions related to sublingual administration. Conclusion: The trial demonstrated the efficacy and safety of the SQ tree SLIT-tablet compared with placebo during the BPS and TPS in adolescents and adults with birch pollen-induced

Research paper thumbnail of The Finnish Allergy Programme 2008–2018 works

European Respiratory Journal, 2017

Health allocated €60 000-65 000 annually for educational and coordinating work, which was organis... more Health allocated €60 000-65 000 annually for educational and coordinating work, which was organised by the Finnish Lung Health Association (Filha), an expert non-governmental organisation. Filha raised private funds of €50 000-100 000 per year to carry out the education for more than 20 000 healthcare professionals in 2008-2016. For patient education and public communication, three non-governmental patient organisations together received, between 2011 and 2014, an annual payment of €200 000 from Finland's Slot Machine Association (RAY). The main purpose of the government-regulated RAY is to raise funds to promote health and welfare in Finland through gaming operations. Funding information for this article has been deposited with the Crossref Funder Registry.

Research paper thumbnail of Results from the 5-year SQ grass sublingual immunotherapy tablet asthma prevention (GAP) trial in children with grass pollen allergy

Journal of Allergy and Clinical Immunology, 2017

The following work is licensed under a Creative Commons: Attribution-NonCommercial-NoDerivatives ... more The following work is licensed under a Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License.

Research paper thumbnail of Novel approaches and perspectives in allergen immunotherapy

Allergy, 2017

In this review, we report on relevant current topics in allergen immunotherapy (AIT) which were b... more In this review, we report on relevant current topics in allergen immunotherapy (AIT) which were broadly discussed during the first Aarhus Immunotherapy Symposium (Aarhus, Denmark) in December 2015 by leading clinicians, scientists and industry representatives in the field. The aim of this symposium was to highlight AIT-related aspects of public health, clinical efficacy evaluation, mechanisms, development of new biomarkers and an overview of novel therapeutic approaches. Allergy is a public health issue of high socioeconomic relevance, and development of evidence-based action plans to address allergy as a public health issue ought to be on national and regional agendas. The underlying mechanisms are in the focus of current research that lays the ground for innovative therapies. Standardization and harmonization of clinical endpoints in AIT trials as well as current knowledge about potential biomarkers have substantiated proof of effectiveness of this disease-modifying therapeutic option. Novel treatments such as peptide immunotherapy, intralymphatic immunotherapy and use of recombinant allergens herald a new age in which AIT may address treatment of allergy as a public health issue by reaching a large fraction of patients. Allergies have become a public health concern of pandemic proportions that affect >150 million Europeans. More alarming, their prevalence and impact are on the rise. It has been predicted that within the next few decades, up to half of the European population may at some point in their lives experience some type of allergy (1). Allergen immunotherapy (AIT) is the only Abbreviations AEC, allergen exposure chamber; AIT, allergen immunotherapy; AR, allergic rhinitis; CSMS, combined symptom and medication score; DC,

Research paper thumbnail of MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis

The Journal of allergy and clinical immunology, Aug 23, 2016

The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several fact... more The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assessment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control. Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). A CDSS is currently being developed to optimize AR control. An algorithm develo...

Research paper thumbnail of Efficacy of MP-AzeFlu in children with seasonal allergic rhinitis: Importance of paediatric symptom assessment

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2016

This study aimed to assess the efficacy of MP-AzeFlu (a novel intranasal formulation of azelastin... more This study aimed to assess the efficacy of MP-AzeFlu (a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate in a single spray) in children with seasonal allergic rhinitis (SAR) and explore the importance of child symptom severity assessment in paediatric allergic rhinitis (AR) trials. A total of 348 children (4-11 years) with moderate/severe SAR were randomized into a double-blind, placebo-controlled, 14-day, parallel-group trial. Efficacy was assessed by changes from baseline in reflective total nasal symptom score (rTNSS), reflective total ocular symptom score (rTOSS) and individual symptom scores over 14 days (children 6-11 years; n = 304), recorded by either children or caregivers. To determine whether a by-proxy effect existed, efficacy outcomes were assessed according to degree of child/caregiver rating. Moreover, total Paediatric Rhinitis Quality of Life Questionnaire (PRQLQ) score was compared between the groups. A statistically superior, clin...

Research paper thumbnail of Wymagania dotyczące kompetencji lekarzy w zakresie alergologii: Kluczowe umiejętności kliniczne konieczne do sprawowania opieki nad pacjentami chorymi na choroby alergiczne lub immunologiczne. Stanowisko Światowej Organizacji Alergii Requirements for Physician Competencies in Allergy: Key Clinica...

Research paper thumbnail of Allergy, living and learning: diagnosis and treatment of allergic respiratory diseases in Europe

Journal of investigational allergology & clinical immunology, 2012

Allergy Living and Learning (ALL) is a European initiative designed to increase knowledge and und... more Allergy Living and Learning (ALL) is a European initiative designed to increase knowledge and understanding of people living with allergies in order to improve respiratory allergy care. To investigate diagnostic and treatment patterns associated with respiratory allergies, patients' perception of their treatment, and restrictions on daily activities. Using a telephone-based randomized screening method, we recruited and analyzed 7004 patients (aged 16-60 years) with self-reported respiratory allergic disease from 10 European countries. Patients answered questions assessing their knowledge, experience, and perception of their condition and its treatment. Data analyses were descriptive. The most prevalent conditions were allergic rhinitis (66%) and asthma (26%), and the average duration of the symptoms of respiratory allergy was 14.5 years. Over 30% of patients had never had a specific diagnostic test. About 80% of patients used medication for their respiratory allergy, and 10% of ...

Research paper thumbnail of Requirements for Physician Competencies in Allergy: Key Clinical Competencies Appropriate for the Care of Patients With Allergic or Immunologic Diseases

World Allergy Organization Journal, 2008

With special recognition of the contribution of Karen Henley, staff liaison to Council 1 Some of ... more With special recognition of the contribution of Karen Henley, staff liaison to Council 1 Some of these skills should be at least taught and understood but may not be performed personally, in accordance with national guidelines and established practice parameters.