Vnitr Lek 2025, 71(7):468-472 | DOI: 10.36290/vnl.2025.084

Evaluation of the effect of allergen immunotherapy for practice

Jiří Nevrlka
Farmakologický ústav LF MU Brno, Ústav laboratorní medicíny a Klinika nemocí plicních a tuberkulózy FN Brno, UPIRA s. r. o. (Úspěšná péče o imunitu, respiraci a alergie) Brno

Specific allergen immunotherapy represents an effective treatment modality for respiratory allergies with the potential for sustained effects persisting many years after cessation of therapy. To achieve this long-term benefit, it is administered continuously for a minimum of 3 years or repeatedly in pre/co-seasonal regimens. Proper and early evaluation of its efficacy after the first year or season of treatment is crucial for the identification of non-responders, optimization of care, and minimization of unnecessary costs. The assessment of allergen immunotherapy efficacy and its standardization are addressed in the European Academy of Allergy and Clinical Immunology (EAACI) recommendations from 2014 and 2023. Key methodologies include the Combined Symptom and Medication Score (CSMS), Visual Analog Scales (VAS), counting "good and bad days," and various validated questionnaires. In the case of asthma, the evaluation focuses on the number and severity of exacerbations, the possibility of reducing controller therapy, and incorporates pulmonary function testing (spirometry, FeNO). Provocation and exposure tests (nasal, conjunctival, bronchial) represent excellent parameters for assessing allergen immunotherapy efficacy; however, they are not available for routine clinical practice. Laboratory biomarkers such as specific IgG4 antibodies currently have only supportive significance. The most comprehensive assessment of allergen immunotherapy efficacy in treating respiratory allergies is provided by combining clinical scores, validated patient questionnaires, and selected objective tests.

Keywords: AIT evaluation, allergen immunotherapy, allergic rhinitis, bronchial asthma.

Accepted: October 16, 2025; Published: October 31, 2025  Show citation

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Nevrlka J. Evaluation of the effect of allergen immunotherapy for practice. Vnitr Lek. 2025;71(7):468-472. doi: 10.36290/vnl.2025.084.
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