A prospective Italian survey on the safety of subcutaneous immunotherapy for respiratory allergy

Abstract

In this large prospective study, the rate of SRs was low, thus confirming that injection immunotherapy has an acceptable risk/benefit ratio when prescribed and carried out according to recommendations.

En niños alérgicos con asma o rinitis, ¿es útil la inmunoterapia?

“…Un estudio reciente describe que el riesgo es mayor en pacientes asmáticos que en los que solo tienen RCA 10 . En cuanto a que la IT produzca una disminución de las enfermedades alérgi-cas a largo plazo, los estudios publicados que describen estos resultados proceden del proyecto Preventive Allergy Treatment Study (PAT) 11 .…”

Allergen Specific Immunotherapy in Asthma

“…An Italian survey [52], stated an overall rate of systemic reactions in about 5% of patients, and a Spanish survey, which included 423 patients [53] showed a prevalence of 3.7% reactions per patient. A recent multi-centre observational study [54] suggested that systemic reactions are slightly more frequent in rhinitis with asthma than in patients with rhinitis alone, although another retrospective study [55] found no significant association between SRs and asthma. According to the more recent meta-analysis of clinical trials [12], the occurrence of systemic reactions with SCIT (of any type and severity) is about 1 per 9 patients.…”

Baseline Serum Tryptase Levels and Adverse Reactions to Injection Specific Immunotherapy with Airborne Allergens: Is There a Relationship?

“…A systemic reaction was defined as the occurrence of urticaria with or without angioedema, asthma, gastrointestinal symptoms and/or hypotension after the subcutaneous administration of a depot aluminium hydroxide- or calcium phosphate-absorbed airborne allergen extract in subjects who were well and showed a normal clinical examination before the injection. Most systemic reactions were immediate (within 30 min); however, in view of a recent study showing a high prevalence of delayed systemic reactions following injection SIT, reactions occurring within 6 h after the shot were also considered [8]. The severity of adverse reactions was graded based on the symptoms and response to rescue medication, according to the European Academy of Allergy and Clinical Immunology classification [9] revised by the World Health Organization [10] with some modifications, as follows: grade 0 = no symptoms; grade 1 = nonspecific symptoms, probably non-IgE-mediated; grade 2 (mild) = mild rhinitis or asthma, or mild urticaria responding to antihistamines or β 2 bronchodilators; grade 3 (non-life-threatening) = severe urticaria, angioedema and/or severe asthma that responds to treatment; grade 4 (anaphylactic shock) = rapidly evoked reaction including at least 2 out of skin (itching, flushing, erythema, urticaria, angioedema), respiratory (bronchial obstruction, rhinoconjunctivitis), cardiovascular (hypotension or collapse) and/or gastrointestinal symptoms requiring intensive treatment.…”

“…Its effectiveness has been demonstrated by a number of properly performed studies and is now generally accepted. Injection SIT is generally considered a fairly safe procedure although systemic adverse reactions may occasionally occur [8]. In clinical practice, most patients undergoing injection SIT show excellent tolerance of the treatment and reach the scheduled high maintenance dose within a relatively short time and limited number of shots.…”