In: Muraro , A , Fokkens , W J , Pietikainen , S , Borrelli , D , Agache , I , Bousquet , J , Costigliola , V , Joos , G , Lund , V J , Poulsen , L K , Price , D , Rolland , C , Zuberbier , T & Hellings , P W 2016 , ' European Symposium on Precision Medicine in Allergy and Airways Diseases : Report of the European Union Parliament Symposium (October 14, 2015) ' , Allergy: European Journal of Allergy and Clinical Immunology , vol. 71 , no. 5 , pp. 583-587 . https://doi.org/10.1111/all.12819
The European Academy of Allergy and Clinical Immunology (EAACI), the European Rhinologic Society (ERS), and the European Medical Association (EMA) organized, on October 14, 2015, a symposium in the European Parliament in Brussels on Precision Medicine in Allergy and Airways Diseases, hosted by MEP David Borrelli, and with active participation of the EU Commissioner for Health and Food Safety Vytenis Andriukaitis, MEP Sirpa Pietikainen, Chair of the European Parliament Interest Group on Allergy and Asthma, the European Respiratory Society (ERS), the European Federations of Allergy and Airways Diseases Patients Associations (EFA), the Global Allergy and Asthma European Network (Ga2len), Allergic Rhinitis and Its Impact on Asthma (ARIA), and the Respiratory Effectiveness Group (REG). The socioeconomic impact of allergies and chronic airways diseases cannot be underestimated, as they represent the most frequently diagnosed chronic noncommunicable diseases in the EU; 30% of the total European population is suffering from allergies and asthma, and more than half are deprived from adequate diagnosis and treatment. Precision medicine represents a novel approach, embracing four key features: personalized care based on molecular, immunologic, and functional endotyping of the disease, with participation of the patient in the decision-making process of therapeutic actions, and considering predictive and preventive aspects of the treatment. Implementation of precision medicine into clinical practice may help to achieve the arrest of the epidemic of allergies and chronic airways diseases. Participants underscored the need for optimal patient care in Europe, supporting joint action plans for disease prevention, patient empowerment, and cost-effective treatment strategies.
In: Bonertz , A , Roberts , G , Slater , J E , Bridgewater , J , Rabin , R L , Hoefnagel , M , Timon , M , Pini , C , Pfaar , O , Sheikh , A , Ryan , D , Akdis , C , Goldstein , J , Poulsen , L K , van Ree , R , Rhyner , C , Barber , D , Palomares , O , Pawankar , R , Hamerlijnk , D , Klimek , L , Agache , I , Angier , E , Casale , T , Fernandez-Rivas , M , Halken , S , Jutel , M , Lau , S , Pajno , G , Sturm , G , Varga , E M , van Wijk , R G , Bonini , S , Muraro , A & Vieths , S 2018 , ' Allergen manufacturing and quality aspects for allergen immunotherapy in Europe and the United States : An analysis from the EAACI AIT Guidelines Project ' , Allergy: European Journal of Allergy and Clinical Immunology , vol. 73 , no. 4 , pp. 816-826 . https://doi.org/10.1111/all.13357
Adequate quality is essential for any medicinal product to be eligible for marketing. Quality includes verification of the identity, content and purity of a medicinal product in combination with a specified production process and its control. Allergen products derived from natural sources require particular considerations to ensure adequate quality. Here, we describe key aspects of the documentation on manufacturing and quality aspects for allergen immunotherapy products in the European Union and the United States. In some key parts, requirements in these areas are harmonized while other fields are regulated separately between both regions. Essential differences are found in the use of Reference Preparations, or the requirement to apply standardized assays for potency determination. As the types of products available are different in specific regions, regulatory guidance for such products may also be available in one specific region only, such as for allergoids in the European Union. Region-specific issues and priorities are a result of this. As allergen products derived from natural sources are inherently variable in their qualitative and quantitative composition, these products present special challenges to balance the variability and ensuring batch-to-batch consistency. Advancements in scientific knowledge on specific allergens and their role in allergic disease will consequentially find representation in future regulatory guidelines.
In: Bonertz , A , Roberts , G C , Hoefnagel , M , Timon , M , Slater , J E , Rabin , R L , Bridgewater , J , Pini , C , Pfaar , O , Akdis , C , Goldstein , J , Poulsen , L K , van Ree , R , Rhyner , C , Barber , D , Palomares , O , Sheikh , A , Pawankar , R , Hamerlijnk , D , Klimek , L , Agache , I , Angier , E , Casale , T , Fernandez-Rivas , M , Halken , S , Jutel , M , Lau , S , Pajno , G , Sturm , G , Varga , E M , Gerth van Wijk , R , Bonini , S , Muraro , A & Vieths , S 2018 , ' Challenges in the implementation of EAACI guidelines on allergen immunotherapy : A global perspective on the regulation of allergen products ' , Allergy: European Journal of Allergy and Clinical Immunology , vol. 73 , no. 1 , pp. 64–76 . https://doi.org/10.1111/all.13266
Regulatory approaches for allergen immunotherapy (AIT) products and the availability of high-quality AIT products are inherently linked to each other. While allergen products are available in many countries across the globe, their regulation is very heterogeneous. First, we describe the regulatory systems applicable for AIT products in the European Union (EU) and in the United States (US). For Europe, a depiction of the different types of relevant procedures, as well as the committees involved, is provided and the fundamental role of national agencies of the EU member states in this complex and unique network is highlighted. Furthermore, the regulatory agencies from Australia, Canada, Japan, Russia, and Switzerland provided information on the system implemented in their countries for the regulation of allergen products. While AIT products are commonly classified as biological medicinal products, they are made available by varying types of procedures, most commonly either by obtaining a marketing authorization or by being distributed as named patient products. Exemptions from marketing authorizations in exceptional cases, as well as import of allergen products from other countries, are additional tools applied by countries to ensure availability of needed AIT products. Several challenges for AIT products are apparent from this analysis and will require further consideration.