耳鼻喉科Pubmed文献追踪每日 14:00 同步
← 返回全部文献
Article record

世界过敏组织舌下免疫治疗立场文件:2026年更新:关于疗效、安全性、疾病修饰与实施的全球专家共识。

World Allergy Organization Sublingual Immunotherapy Position Paper: 2026 update: Global expert consensus on efficacy, safety, disease modification, and implementation.

指南共识鼻科IF 4.8Q2

文献信息

中文摘要

背景: 舌下免疫治疗(SLIT)是一种成熟的过敏原免疫治疗形式,在IgE介导的过敏性疾病中,尤其是在过敏性鼻炎和过敏性哮喘中,已证明具有疗效和良好的安全性。自世界过敏组织(WAO)既往立场文件发布以来,不断积累的证据和扩大的全球临床经验使得更新、国际协调的框架成为必要,以指导SLIT在不同医疗环境中的适当使用。
方法: 一个国际专家小组采用结构化德尔菲共识方法制定了更新的SLIT立场文件。声明基于对科学文献的目标性综述和专家临床经验制定,涵盖适应证、患者选择、安全性、治疗持续时间、依从性、生物标志物、疾病修饰和实施等领域。进行了两轮匿名电子投票。共识预先定义为≥70%同意(5点Likert量表评分4-5分)。
结果: 邀请了代表所有WAO地区的83位专家,其中78位参与了德尔菲过程。在核心原则方面达成了高度共识,包括SLIT有效性、安全性、适当患者选择的重要性、至少3年的治疗持续时间、首剂监督给药后居家治疗,以及依从性和定期随访的核心作用。关于疾病修饰效应的共识在儿童和青少年中强于成人。在区域过敏原相关主题上观察到较低的共识,可能受到过敏原暴露、产品可及性、临床经验和监管背景差异的影响;然而,未进行正式的按区域分层分析。
结论: 本WAO立场文件建立了一个全球适用、基于证据的共识框架,用于SLIT的定位和实施。通过清晰界定高度一致的领域以及有条件或情境依赖性证据的领域,它为全球公平和可持续地整合SLIT提供了临床参考和战略路线图。

英文摘要

BACKGROUND: Sublingual immunotherapy (SLIT) is a well-established form of allergen immunotherapy with demonstrated efficacy and a favorable safety profile in IgE-mediated allergic diseases, particularly in allergic rhinitis and allergic asthma. Since the publication of previous World Allergy Organization (WAO) position papers, accumulating evidence and expanding global clinical experience has justified an updated, internationally harmonized framework to guide the appropriate use of SLIT across diverse healthcare settings.
METHODS: An international panel of experts developed an updated Position Paper on SLIT using a structured Delphi consensus methodology. Statements were formulated based on a targeted review of the scientific literature and expert clinical experience, addressing indications, patient selection, safety, treatment duration, adherence, biomarkers, disease modification, and implementation domains. Two rounds of anonymous electronic voting were conducted. Consensus was predefined as ≥70% agreement (scores 4-5 on a 5-point Likert scale).
RESULTS: Eighty-three experts representing all WAO regions were invited, and seventy-eight of them participated in the Delphi process. High levels of consensus were achieved for core principles, including SLIT effectiveness, safety, the importance of appropriate patient selection, a minimum treatment duration of 3 years, supervised administration of the first dose followed by home-based treatment, and the central role of adherence and regular follow-up. Consensus regarding disease-modifying effects was stronger for children and adolescents than for adults. Lower consensus was observed on topics related to regional allergens, likely influenced by differences in allergen exposure, product availability, clinical experience, and regulatory contexts; however, formal region-stratified analyses were not performed.
CONCLUSIONS: This WAO Position Paper establishes a globally applicable, evidence-informed consensus framework for the positioning and implementation of SLIT. By clearly delineating areas of strong agreement and domains of conditional or context-dependent evidence, it provides both a clinical reference and a strategic roadmap for equitable and sustainable SLIT integration worldwide.