Systemic reactions in multiple aeroallergen rush immunotherapy: A two-year follow-up

Abstract

Rationale Rush immunotherapy is a form of allergy immunotherapy that allows patients to achieve a maintenance dose of their allergy vaccine in an expedited manner, often in as little as two months. While it is well known that adverse reactions frequently occur with rush immunotherapy, there is little published data available examining adverse reactions rates for multiple aeroallergen rush immunotherapy. Methods The medical records of all patients who underwent rush immunotherapy for allergic rhinitis between October 2001 and September 2003 were examined to determine adverse reaction rates during rush immunotherapy, as well as during all subsequent allergy injections. Results 111 patients underwent rush immunotherapy for allergic rhinitis between October 5, 2001, and September 3, 2003. Seventeen patients experienced systemic reactions during their rush immunotherapy on day 1, for a systemic reaction rate of 15.3%. Only 2 of these reactions, 11.8%, necessitated treatment with epinephrine. Subsequently, these 111 patients received a total of 2220 allergy vaccinations. In receiving these shots, 28 patients experienced 45 systemic reactions, for a subsequent systemic reaction rate of 2.03%. 10 of these 45 reactions (22.2%) required epinephrine, but in only one case did a patient experience hypotension during their systemic reaction. Approximately half of these subsequent systemic reactions (48.9%) did not require any immediate intervention. Conclusions Rush immunotherapy utilizing multiple aeroallergens is associated with a higher systemic reaction rate than experienced during conventional immunotherapy. In most cases, patients experienced very mild reactions that were easily treated, or required no treatment at all.