Safety of home‐based and office allergy immunotherapy: A multicenter prospective study

Hurst, David S.; Gordon, Bruce R.; Fornadley, John A.; Hunsaker, Darrell H.

doi:10.1016/s0194-5998(99)70055-0

Cited by 35 publications

(32 citation statements)

References 32 publications

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“…Además la inmunoterapia domiciliaria es más segura y produce menos reacciones adversas graves (9). Se observó una reducción drástica de la toxicidad, además de confirmar la eficacia de la combinación terapéutica subcutánea a bajas dosis (8) e incluso la remisión del tumor a largo plazo (7).…”

Section: Resultsunclassified

Efectos de la inmunoterapia en el paciente adulto en el domicilio: revisión sistemática

Pena

Valero

2018

Hosp Domic

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Hosp Domic. 2018;2(2):55-65 Artículo de revisión: Domingo Pena V. Sanz-Valero J. RESUMENObjetivo: Revisar la literatura científica relacionada con los efectos de la inmunoterapia en el paciente adulto con atención de salud en el domicilio.Método: Análisis crítico de los trabajos recuperados mediante revisión sistemática. Los datos se obtuvieron de la consulta directa y acceso, vía Internet, a las siguientes bases de datos bibliográficas del ámbito de las ciencias de la salud: MEDLINE (vía PubMed), The Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINHAL) y Web of Science. También se hizo uso de la base de datos de la Biblioteca de la Universidad Miguel Hernández. Se consideró adecuado el uso de los Descriptores "Immunotherapy" y "Home Care Services", añadiendo los filtros: "Humans", "Adult 19+ years" y "Comparative Study" o "Clinical Trial". Fecha de la búsqueda: febrero de 2017.Resultados: Al atribuir los criterios de inclusión y exclusión a la búsqueda se aceptaron 7 estudios para su revisión y análisis crítico. Se evaluó la calidad de los artículos seleccionados mediante el cuestionario CONSORT, obteniendo puntuaciones que oscilaron entre 9 y 18 sobre una puntuación máxima de 25.Conclusiones: Debido a la falta de artículos coetáneos que abarquen tanto la inmunoterapia como la administración de la misma fuera del servicio hospitalario, así como la presencia de numerosos trabajos que no se pueden enmarcar dentro del grupo de estudios de alta evidencia, mediante este análisis se puede concluir que la terapia actual precisa de nuevos ensayos e investigaciones que permitan encontrar formas más innovadoras de inmunología para poder ser aplicadas a un rango más amplio de patologías inmunitarias, y de esta forma poder generalizarlas a grupos de distintas edades.Palabras clave: Servicios de atención de salud a domicilio; Servicios de atención a domicilio provisto por hospital; Inmunoterapia; Adulto. ABSTRACTObjective: To review the scientific literature related to the effects of immunotherapy in the adult patient with home health care.Method: Critical analysis of the works recovered by systematic review. The data were obtained from direct consultation and access, on the Internet, in the following bibliographic databases in the area of health sciences: MEDLINE (via PubMed), The Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINHAL) and Web of Science. The database of the Miguel Hernández University Library was also used. The use of the Descriptors "Immunotherapy" and "Home Care Services" was considered appropriate, adding the filters: "Humans", "Adult 19+ years" and "Comparative Study" or "Clinical Trial". Date of search: February 2017.Results: Attributing the inclusion and exclusion criteria to the search, 7 studies were accepted for review and critical analysis. The quality of the selected articles was evaluated through the CONSORT questionnaire, obtaining scores that ranged from 9 to 18 over a maximum score of 25.Conclusions: Due to the lack ...

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Section: Resultsunclassified

Efectos de la inmunoterapia en el paciente adulto en el domicilio: revisión sistemática

Pena

Valero

2018

Hosp Domic

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“…12 Consistent with these results, several other reports have previously documented the safety of self-administered or home-based SCIT. 13–17 The authors concluded that the low systemic reaction rates reported showed that home-based immunotherapy was safe. 13–17 …”

Section: Discussionmentioning

confidence: 99%

“…13–17 The authors concluded that the low systemic reaction rates reported showed that home-based immunotherapy was safe. 13–17 …”

Section: Discussionmentioning

confidence: 99%

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The efficacy assessment of a self‐administered immunotherapy protocol

Schaffer

Garner

Ebeling

et al. 2015

Int Forum Allergy Rhinol

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Background We previously reported the safety of a self-administered subcutaneous immunotherapy (SCIT) protocol. Here we report the results of the retrospective efficacy trial of the United Allergy Service (UAS) self-administered SCIT protocol. We hypothesized that by utilizing a slow SCIT buildup phase, designed to attain recommended allergen concentrations on a cumulative basis, efficacious outcomes and clinical relevance would be achieved. Methods We enrolled 60 SCIT patients and 56 control patients. The study contrasted baseline and treatment period combined symptom plus medication scores (CSMS) as the primary outcome measure and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores as the secondary study outcome measure. Changes in pollen counts were also examined with regard to effects on these efficacy parameters. Results The treatment group showed significantly improved CSMS (standardized mean difference [SMD]: −1.57; 95% confidence interval [CI], −1.97 to −1.18; p < 0.001) and RQLQ (SMD: −0.91; 95% CI, −1.23 to −0.59; p < 0.001). These treatment group outcome measures were respectively improved by 33% and 29% compared to baseline and greater than 40% in comparison to the control group (p < 0.0001). Significant results were also shown when examining these outcome measures with regards to either monotherapy or poly-allergen SCIT. Furthermore, a comparison to recent meta-analyses of SCIT studies showed equivalent efficacy and clinical relevance. Assessment of pollen counts during the baseline and treatment periods further corroborated the efficacy of the UAS SCIT protocol. Conclusion These efficacy results, and our previous safety results, show that a carefully designed and implemented self-administered SCIT protocol is efficacious and safe.

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“…Single intradermal tests not paired with SPT are very sensitive but have a greater potential to cause significant adverse reactions 31 . IDT was evaluated through a prospective, multicenter study that showed that serious reactions are uncommon 32 . This technique and its related immunotherapy have not been shown to have a higher risk of serious local or systemic reaction when comparing IDT with SPT 15 .…”

Section: Introductionmentioning

confidence: 99%

Use of Intradermal Dilutional Testing and Skin Prick Testing: Clinical Relevance and Cost Efficiency

2006

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Antigens which show reactivity to a multiple SPT device usually have a treatable endpoint that is independent of the degree of positivity of the SPT result. IDT is an important step in the determination of the strongest starting dose of immunotherapy that may be safely administered. Initiating immunotherapy in this manner may potentially create significant health care savings by shortening the time required for a patient to reach their individual maximally tolerated dose. The use of a relatively large screening panel is cost effective and does not increase the average number of antigens treated by immunotherapy. Blended allergy testing techniques that include IDT in their protocol are comparable in cost with commonly used allergy testing protocols.

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Safety of home‐based and office allergy immunotherapy: A multicenter prospective study

Cited by 35 publications

References 32 publications

Efectos de la inmunoterapia en el paciente adulto en el domicilio: revisión sistemática

Efectos de la inmunoterapia en el paciente adulto en el domicilio: revisión sistemática

The efficacy assessment of a self‐administered immunotherapy protocol

Use of Intradermal Dilutional Testing and Skin Prick Testing: Clinical Relevance and Cost Efficiency

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