Weight is less than 150 kg (330 lbs) Chronic urticaria: 3 months Allergic sensitization demonstrated by positive skin testing or in testing for IgE to an allergen that is present year round (a perennial allergen), such as dust mite, animal dander, cockroach, or molds Renewal: Evidence of reversible disease (12% or greater improvement in FEV1 with at least a 200-ml Asthma: 1 year increase or 20% or greater improvement in PEF as a result of a short-acting bronchodilator Requires demonstration of challenge clinical improvement (e.g., Patient should be non-smoking or actively receiving smoking cessation treatment use of rescue Patient has tried and failed conventional immunotherapy or immunotherapy is not ↓ medications or systemic indicated. (Immunotherapy has demonstrated efficacy against dust mites, animal dander, corticosteroids, in FEV1 and pollens but not against molds and cockroach allergies). ↑ from pre-treatment Asthma symptoms are not adequately controlled by high dose inhaled corticosteroids AND baseline, in number of a long-acting beta agonist (LABA) for 6 months ↓ ED visits or Inadequate control is defined as: hospitalizations) and Requirement for systemic corticosteroids (oral, parenteral) to treat asthma compliance with asthma exacerbations controller medications, and OR non-smoking status. Daily use of rescue medications (short-acting inhaled beta-2 agonists) OR Chronic urticaria: 6 months 2 ED visits or 1 hospitalization for asthma in the last 12 months OR Requires 2-3 unscheduled office visits with documentation of intensive care for acute demonstration of asthma exacerbation adequate symptom OR control (e.g., itching) ↓ Nighttime symptoms occurring more than once a week For the treatment of chronic urticaria: Symptoms continuously or intermittently present for at least 6 weeks. Prescribed by an allergist/immunologist or dermatologist 12 years of age or older Currently receiving H1 antihistamine therapy Failure of a 4 week, compliant of at least two high dose H1 antihistamines
Weight is less than 150 kg (330 lbs) Allergic sensitization demonstrated by positive skin testing or in testing for IgE to an allergen that is present year round (a perennial allergen), such as dust mite, animal dander, cockroach, or molds Evidence of reversible disease (12% or greater improvement in FEV1 with at least a 200-ml increase or 20% or greater improvement in PEF as a result of a short-acting bronchodilator challenge Patient should be non-smoking or actively receiving smoking cessation treatment Patient has tried and failed conventional immunotherapy or immunotherapy is not indicated. (Immunotherapy has demonstrated efficacy against dust mites, animal dander, and pollens but not against molds and cockroach allergies). Asthma symptoms are not adequately controlled by high dose inhaled corticosteroids AND a long-acting beta agonist (LABA) for 6 months Inadequate control is defined as: Requirement for systemic corticosteroids (oral, parenteral) to treat asthma exacerbations OR Daily use of rescue medications (short-acting inhaled beta-2 agonists) OR 2 ED visits or 1 hospitalization for asthma in the last 12 months OR 2-3 unscheduled office visits with documentation of intensive care for acute asthma exacerbation OR Nighttime symptoms occurring more than once a week For the treatment of chronic urticaria: Symptoms continuously or intermittently present for at least 6 weeks. Prescribed by an allergist/immunologist or dermatologist 12 years of age or older Currently receiving H1 antihistamine therapy Failure of a 4 week, compliant of at least two high dose H1 antihistamines Chronic urticaria: 3 months Renewal: Asthma: 1 year Requires demonstration of clinical improvement (e.g., ↓ use of rescue medications or systemic corticosteroids, ↑ in FEV1 from pre-treatment baseline, ↓ in number of ED visits or hospitalizations) and compliance with asthma controller medications, and non-smoking status. Chronic urticaria: 6 months Requires demonstration of adequate symptom control (e.g., ↓ itching)
MMIC-PA-SMI-Guidelines.docx