The treatment and management of ocular allergy (OA) remains a major concern for different specialties, including allergists, ophthalmologists, primary care physicians, rhinologists, pediatricians, dermatologists, clinical immunologists and pharmacists. We performed a systematic review of all relevant publications in Medline, SCOPUS and WebScience including systematic reviews and meta-analysis. Publications were considered relevant if they addressed treatments, or management strategies of OA. A further wider systematic literature search was performed if no evidence or good quality evidence was found. There are effective drugs for the treatment of OA, however there is a lack an optimal treatment for the perennial and severe forms. Topical antihistamines, mast cell stabilizers or double action drugs are the first choice of treatment. All of them are effective in reducing signs and symptoms of OA. The safety and optimal dosing regimen of the most effective topical anti-inflammatory drugs, corticosteroids, is still a major concern. Topical calcineurine inhibitors may be used in steroid-dependent/resistant cases of severe allergic keratoconjunctivitis. Allergen specific immunotherapy may be considered in cases of failure of first line treatments or to modify the natural course of OA disease. Based on the current wealth of publications and on the collective experience, recommendations on management of OA have been proposed. This article is protected by copyright. All rights reserved.
ANTECEDENTES: La rinitis alérgica representa un problema de salud mundial que afecta a 10% a 20% de la población. La rinitis alérgica y su impacto sobre las directrices del Asma (ARIA) han sido ampliamente utilizados para el tratamiento de los pacientes, aproximadamente 500 millones de afectados en todo el mundo.
OBJETIVO: Desarrollar recomendaciones clínicas explícita, sin ambigüedades, y transparentes de forma sistemática para el tratamiento de la rinitis alérgica sobre la base de la mejor evidencia actual.
Métodos: Los autores actualizados recomendaciones clínicas ARIA en colaboración con global de la alergia y el asma Red Europea siguiendo el enfoque sugerido por la clasificación de las recomendaciones de la evaluación, el grupo de trabajo de desarrollo y evaluación.
RESULTADOS: En este artículo se presenta recomendaciones sobre la prevención de las enfermedades alérgicas, el uso de medicamentos orales y tópicos, la inmunoterapia específica con alergenos, y los tratamientos complementarios en pacientes con rinitis alérgica, así como los pacientes con rinitis alérgica y el asma. El panel de normas desarrollado perfiles de datos para cada recomendación y considera beneficios para la salud y los daños, carga, las preferencias del paciente, y el uso de los recursos, cuando sea apropiado, para formular recomendaciones para los pacientes, los médicos y otros profesionales de la salud.
Conclusión: Estos son los las recomendaciones más desarrolladas de forma sistemática y transparente sobre el tratamiento de la rinitis alérgica en adultos y niños más reciente y en la actualidad. Los pacientes, los médicos y los políticos se les anima a utilizar estas recomendaciones en su práctica diaria y para apoyar sus decisiones.
The treatment and management of ocular allergy (OA) remains a major concern for different specialties, including allergists, ophthalmologists, primary care physicians, rhinologists, pediatricians, dermatologists, clinical immunologists and pharmacists. We performed a systematic review of all relevant publications in Medline, SCOPUS and WebScience including systematic reviews and meta-analysis. Publications were considered relevant if they addressed treatments, or management strategies of OA. A further wider systematic literature search was performed if no evidence or good quality evidence was found. There are effective drugs for the treatment of OA, however there is a lack an optimal treatment for the perennial and severe forms. Topical antihistamines, mast cell stabilizers or double action drugs are the first choice of treatment. All of them are effective in reducing signs and symptoms of OA. The safety and optimal dosing regimen of the most effective topical anti-inflammatory drugs, corticosteroids, is still a major concern. Topical calcineurine inhibitors may be used in steroid-dependent/resistant cases of severe allergic keratoconjunctivitis. Allergen specific immunotherapy may be considered in cases of failure of first line treatments or to modify the natural course of OA disease. Based on the current wealth of publications and on the collective experience, recommendations on management of OA have been proposed. This article is protected by copyright. All rights reserved.
Síntesis amplia»Revisión panorámica de revisiones sistemáticas
