Efficacy of epinephrine rinse in allergen immunotherapy with aeroallergen and venom

Abstract

Introduction In a suburban allergy outpatient office, the practice of epinephrine rinse of subcutaneous allergen immunotherapy (SCIT) syringes prior to injection has been employed for over 30 years with documented favorable clinical outcomes. A retrospective study was conducted to explore the effectiveness of epinephrine rinsing of SCIT syringes in managing local site reactions (LSR) in patients with allergen hypersensitivity. Methods Chart review of patients currently receiving SCITs was conducted using the clinical database at the outpatient office. 549 SCITs were reviewed, and 140 cases were traced to employ the use of epinephrine rinse to improve LSRs. The data was separated into allergic rhinitis and venom immunotherapy groups and was recorded for both build-up and maintenance phases. Results Out of 140 total patients requiring epinephrine rinse, 88.6% were in the allergic rhinitis group and 11.4% were in the venom group. In the allergic rhinitis group, 69.3% of patients and 87.5% in the venom group required epinephrine rinse during the build-up phase. In the allergic rhinitis group, 65.7% patients receiving SCIT at maintenance dose and 69.8% patients at build-up dose had resolution of LSR post-epinephrine rinse. In the venom group, 64.2% patients receiving SCITs at build-up dose improved LSR after epinephrine rinse. Conclusion Epinephrine rinse technique prior to injection showed favorable outcomes in over 60% of patients currently receiving treatment for allergen hypersensitivity. Epinephrine rinse is beneficial during the build-up phase of SCIT to manage LSR to effectively increase allergen dose.