ALERGIE Supplementum 1/2020
Editorial
Vít Petrů ............................................................................. 1
Ester Seberová .................................................................. 2
Doporučené postupy ARIA 2019:
Doporučení péče o pacienty s alergickou rýmou
v České republice
Lokální koordinátor: Ester Seberová
Autoři: Claus Bachert, Wytske J. Fokkens,
Tori Haahtela, Peter W. Hellings, Ludgar Klimek,
Nicolaos G. Papadopoulos, Oliver Pfaar, Holger J.
Schunemann, Dana Wallace, Arunas Valiulis,
Maria Teresa Ventura, Gabrielle L. Onorato,
Anna Bedbrook, Wienczyslawa Czarlewski,
Jean Bousquet ................................................................... 5
Úvod .................................................................................. 6
1. Situace v České republice ............................ ............... 7
1.1 .................................................................................. 7
1.2 Zdravotní systém ..................................................... 7
1.3 ARIA v ČR ............................................................... 7
2. Nová generace ARIA-GRADE doporučení ................... 7
2.1 Důkazy použité při návrhu ARIA ICPs .................... 8
2.1.1 MASK algoritmus pro farmakoterapii AR ...... 8
2.1.2 ARIA 2010, 2016 a postup doporučovaný
v USA 2017 ................................................... 9
2.1.3 Rychlost nástupu účinku léků ........................ 9
2.1.4 Reálné výsledky s užitím mobilní
technologie .................................................... 9
2.2 Nová generace ARIA–GRADE doporučení
pro léčbu dospělých a adolescentů ........................ 10
3. AIT u pacientů s respirační alergií
dle doporučení ARIA 2019 .......................................... 11
3.1 Alergeny doporučené k AIT ................................... 11
3.2 Bezpečnost AIT ...................................................... 11
3.2.1 Subkutánní imunoterapie (SCIT) ................... 11
3.2.2 Sublinguální imunoterapie (SLIT) .................. 11
3.3 Spolupráce při AIT .................................................. 11
3.3.1 Spolupráce s pacientem ................................ 11
3.3.2 Spolupráce s farmaceuty ............................... 12
3.3.3 Spolupráce s praktickými lékaři ..................... 12
3.4 Praktický přístup pro výběr pacientů k léčbě AIT .... 12
3.4.1 Výběr alergického pacienta pro AIT ............... 12
3.4.2 AIT u pacientů s alergickou rýmou ................. 12
3.4.3 AIT u pacientů s astmatem
(adolescentů a dospělých) ............................. 12
3.4.4 AIT u polymorbidních pacientů ...................... 14
3.4.5 AIT u dětí ....................................................... 14
3.4.6 AIT u pacientů vyšších věkových skupin ....... 14
3.5 Využití mobilních technologií (mHealth)
v léčbě AIT .............................................................. 14
Literatura .......................................................................... 14
Předplatné ........................................................................ 19
POKYNY AUTORŮM ....................................................... 20
Editorial
Vít Petrů ............................................................................. 1
Ester Seberová .................................................................. 2
Clinical practice 2019 ARIA: Care pathways
for allergic rhinitis – Czech Republic
Local co-ordinator: Ester Seberová
Authors: Claus Bachert, Wytske J. Fokkens,
Tori Haahtela, Peter W. Hellings, Ludgar Klimek,
Nicolaos G. Papadopoulos, Oliver Pfaar, Holger
J. Schunemann, Dana Wallace, Arunas Valiulis,
Maria Teresa Ventura, Gabrielle L. Onorato,
Anna Bedbrook, Wienczyslawa Czarlewski,
Jean Bousquet ................................................................... 5
Introduction ........................................................................ 6
1. Czech Republic – state of art ......................................... 7
1.1 AR in Czech Republic ............................................... 7
1.2 Health system ........................................................... 7
1.3 ARIA in the Czech Republic ..................................... 7
2. Next generation ARIA-GRADE guidelines .................... 7
2.1 Evidence considered for the development
of ARIA ICPs ............................................................ 8
2.1.1 MASK algorithm for AR
pharmacologic treatment .......................................... 8
2.1.2 ARIA 2010, 2016 and USA 2017
guidelines ................................................................. 9
2.1.3 Speed of action of medications ....................... 9
2.1.4 Real-world evidence using
mobile technology .................................................... 9
2.2 Next generation ARIA-GRADE guidelines ............. 10
3. 2019 ARIA care pathways for allergen
immunotherapy (AIT) ...................................................... 11
3.1 Allergens to be used .............................................. 11
3.2 Safety of AIT .......................................................... 11
3.2.1 Subcutaneous imunoterapie (SCIT) .............. 11
3.2.2 Sublingual imunoterapie (SLIT) ..................... 11
3.3 Co-operation in AIT ................................................. 11
3.1 Co-operation with patient ........................................ 11
3.2 Co-operation with pharmacists ............................... 12
3.3 Co-operation with GPs ........................................... 12
3.4 Practical approach for patient stratification
in AIT ............................................................................ 12
3.4.1 Stratification of allergic patients for AIT .......... 12
3.4.2 AIT in allergic rhinitis patients ......................... 12
3.4.3 AIT in bronchial asthmatic patients
(adolescents and adults) .......................................... 12
3.4.4 AIT in polymorbid patients .............................. 14
3.4.5 AIT in children ................................................. 14
3.4.6 AIT in the elderly patients ............................... 14
3.5 mHealth in the AIT precision medicine approach ...... 14
References ...................................................................... 14
Subscription ..................................................................... 19
INSTRUCTION FOR AUTHORS ..................................... 20
