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Table 2 Items included in the questionnaire about “Allergy to mites, animal dander and moulds” (2A) and results (2B)

From: Diagnosis and allergen immunotherapy treatment of polysensitised patients with respiratory allergy in Spain: an Allergists’ Consensus

2A) 2B)
Items Mean Median % Panellists against IQ Result
Epidemiology
25- Knowledge of the predominant type of mites in a geographical area is useful in defining the composition of immunotherapy in an allergic patient. 7.98 8 3.23 2 A
26- The moulds with the most epidemiological importance in respiratory allergy are Aspergillus and Alternaria. 7.74 8 6.45 2 A
27- In patients with double sensitisation to mites and Alternaria, it is essential know if there is exposure to both sources 7.18 8 22.58 2 A
Clinical relevance
28- Skin-tests, by themselves, are sufficient for the diagnosis of mite allergy, epithelia and mould. 3.57 3 25 1.5 D
29- Skin-tests are sufficient for the immunotherapy prescription to mites, epithelium and mould. 3.43 3 26.67 2 D
30- Quantitation of specific IgE in serum against full mite extract adds additional value to the skin-test. 6.4 7 26.67 1.5 A
31- In order to know the true sensitisation profile of patients allergic to mites, molecular diagnosis is necessary. 6.13 7 38.33 2 NC
32- The specific IgE determination in serum against Der p 1 and Der p 2 is useful if these components have been quantified in the vaccine. 6.83 7 20 0.5 A
33- The IgE specific quantification to Dermatophagoides and/or Lepidoglyphus and/or Blomia helps to decide AIT composition. 6.65 7 16.67 0 A
34- Alt a1 determination as primary sensitiser to Alternaria is recommended before AIT prescription with this mould. 6.18 7 35 2 NC
35- Clinical relevance of double sensitisation to Alternaria and mites may be improved by symptom’s calendar. 6.2 7 40 2 NC
Therapeutic strategy (AIT for mite sensitised patients)
36-Given the high cross-reactivity between Dermatophagoides pteronyssinus and farinae, the choice of the species present in the vaccine is irrelevant. 6.45 7 26.67 2 A
37- Quantification of major molecular components (Der p 1 and Der p 2) in the vaccine is mandatory 6.92 8 22.58 1 A
38- In case of sensitisation to Lepidoglyphus or Blomia in a patient allergic to Dermatophagoides, only after proving clinical relevance of these minor mites should a vaccine be indicated. 7.47 8 14.52 1 A
39- Vaccines containing minor mites should not be used until efficacy has been proven. 5.97 7 40 3 NC
40- In case of true allergy to both a minor mite and Dermatophagoides, a vaccine containing both allergens could be used as a 50% mixture. 6.25 7 30 2 A
41- It is not advisable to mix mites with any other different allergenic source due to their proteolytic activity 6.37 7 28.33 3 A
Therapeutic strategy (patient allergic to moulds (one or more) and with/without mite allergy)
42- Patients allergic to Alternaria only should receive a vaccine containing this allergenic source. 7.69 8 11.29 2 A
43- Alternaria vaccine must have its major allergen quantified (Alt a 1) 7.95 8 11.29 2 A
44- Immunotherapy with mould mixtures is not indicated. 7.15 7 23.33 1 A
Therapeutic strategy (Regarding patients allergic to epithelia with/without other sensitivities)
45- There is not sufficient scientific evidence in immunotherapy to epithelia different from cat and dog 5.02 6 86.67 4 NC
46- Studies with cat epithelium vaccine have shown clinical efficacy 7.76 8 9.68 2 A
47- In case of mite and epithelia sensitisation, both clinically relevant when animal avoidance is not possible, a mixture of both would be advisable. 3.24 3 25.81 2 D
48- In case of mite and epithelia sensitisation, both clinically relevant when animal avoidance is not possible, two vaccines should be used 6.74 7.2 32.26 2 A
49- In the same situation as previously described, the use of a vaccine containing one allergen could be recommended followed by the consideration for a second AIT 7.37 8 19.35 2 A
50- In patients allergic to horse epithelium , when occupational exposure and/or severe impact on quality of life is present, AIT could be considered 8.16 8 6.45 1 A
  1. A = Agreement; D = Disagreement; NC = No Consensus; IQ = Interquartile range.
  2. % panellists = percentage of panellists out of the median region.