Abstract
Allergen-specific immunotherapy is a potentially disease-modifying therapy that is effective for the treatment of allergic rhinitis/conjunctivitis, allergic asthma and stinging insect hypersensitivity. However, despite its proven efficacy in these conditions, it is frequently underutilized in Canada. The decision to proceed with allergen-specific immunotherapy should be made on a case-by-case basis, taking into account individual patient factors such as the degree to which symptoms can be reduced by avoidance measures and pharmacological therapy, the amount and type of medication required to control symptoms, the adverse effects of pharmacological treatment, and patient preferences. Since this form of therapy carries the risk of anaphylactic reactions, it should only be prescribed by physicians who are adequately trained in the treatment of allergy. Furthermore, injections must be given under medical supervision in clinics that are equipped to manage anaphylaxis. In this article, the authors review the indications and contraindications, patient selection criteria, and the administration, safety and efficacy of allergen-specific immunotherapy.
Highlights
Allergen-specific immunotherapy is an effective treatment used by allergists and immunologists for common allergic conditions, allergic rhinitis/conjunctivitis, allergic asthma and stinging insect hypersensitivity [1,2,3,4]
Immunotherapy administration and schedules Allergen-specific immunotherapy carries the risk of anaphylactic reactions and, should only be prescribed by physicians who are adequately trained in the treatment of allergy and the use of immunotherapy
Allergen-specific immunotherapy is a potentially disease-modifying therapy that is effective for the treatment of allergic rhinitis/conjunctivitis, allergic asthma and stinging insect hypersensitivity
Summary
Allergen-specific immunotherapy ( known as allergy shots) is an effective treatment used by allergists and immunologists for common allergic conditions, allergic rhinitis/conjunctivitis, allergic asthma and stinging insect hypersensitivity [1,2,3,4]. Patients with stinging insect (venom) hypersensitivity Patients with allergic rhinitis/conjunctivitis and/or allergic asthma who have evidence of specific IgE antibodies to clinically relevant allergens; includes patients who: – Do not achieve control of symptoms with avoidance measures and pharmacotherapy – Do not want ongoing or long-term pharmacotherapy – Experience undesirable side effects with pharmacotherapy. Contraindications Allergen-specific immunotherapy is contraindicated in patients with medical conditions that increase the patient’s risk of dying from treatment-related systemic reactions, such as those with severe or poorly controlled asthma or significant cardiovascular diseases (e.g., unstable angina, recent myocardial infarction, significant arrhythmia, and uncontrolled hypertension) (see Table 1). Following a systemic reaction to immunotherapy, consideration should be given to reducing the therapeutic dose or to possibly discontinuing therapy, if the patient has repeated systemic reactions following injections [5-7]
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Schedule a callMore From: Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology
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