The risk of inducing constitutional reactions in allergic patients

VanArsdel, Paul P.; Sherman, William B.

doi:10.1016/0021-8707(57)90130-2

Cited by 34 publications

(2 citation statements)

References 20 publications

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“…19 Although frequently used, immunotherapy is potentially dangerous because a known reactive substance is intentionally administered to a patient who is known to be sensitive to it. In the first 45 years of immunotherapy, many fatalities were due to either use of excessive allergen doses or use of allergens with high sensitizing potential, 12 such as horse serum antitoxins. 13 Also, a history of reaction was found to be a good predictor of future reactions.…”

Section: Historic Anaphylaxis Experiencementioning

confidence: 99%

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

Hurst

Gordon

Fornadley

et al. 1999

Otolaryngol.--head neck surg.

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During a 1-year period, 27 otolaryngic allergy practices recorded all systemic reactions to immunotherapy resulting from 635,600 patient visits and 1,144,000 injections. Sixty percent of injections were given at home. Major systemic reactions were observed after 0. 005% of injections. There were no hospitalizations or deaths. Eighty-seven percent of major reactions began within 20 minutes of injection. Frequently observed risk factors for major reactions were buildup phase of immunotherapy, active asthma, and first injection from a treatment vial. Home and office injections had similar rates of total systemic reactions, but home-based immunotherapy had far fewer major reactions. Home-based immunotherapy was found to be safe. The methods and precautions used to treat patients with this degree of safety are specified and discussed.

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Section: Historic Anaphylaxis Experiencementioning

confidence: 99%

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

Hurst

Gordon

Fornadley

et al. 1999

Otolaryngol.--head neck surg.

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“…The rate of systemic reactions varied widely from almost none to up to 55.6% per patient, and from 0.05 to 6.4% of injections (Greenberg et al 1986;Nelson et al 1986;Van Arsdel et al 1957;Van Metre et al 1980Vervloet et al 1980). U sing aqueous nonstandardised extracts, the occurrence of systemic reactions is not easy to predict.…”

Section: Aqueous Non-standardised Extractsmentioning

confidence: 96%

Safety Considerations in Assessing the Role of Immunotherapy in Allergic Disorders

Bousquet

Michel

1994

Drug Safety

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Specific immunotherapy (SIT) is accepted as an effective treatment of allergic diseases when high quality extracts are used. However, this form of treatment can cause untoward reactions among which systemic reactions are the most severe. Although life-threatening reactions are rare and deaths exceptionally reported, SIT should be prescribed by allergists to patients with well defined characteristics, and administered with care by (or under the close supervision of) physicians trained to deal rapidly with the reactions. Reactions with standardised extracts occur mostly during the dose increase phase but they can be prevented using adapted schedules and premedication. During maintenance injections or when vial batches are changed, standardised extracts of known shelf-life usually result in a low rate of systemic reactions. Patients with asthma are more prone to develop systemic reactions, and allergens should not be administered to patients with a forced expiratory volume in 1 second (FEV1) under 70% of predicted or in those who have unstable or symptomatic asthma. Systemic reactions may be observed with all allergens and allergenic preparations although it appears that high molecular weight extracts may be safer.

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The Metabolism and Functions of Histamine

Arsdel¹

1960

Arch Intern Med

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The risk of inducing constitutional reactions in allergic patients

Cited by 34 publications

References 20 publications

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

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

Safety Considerations in Assessing the Role of Immunotherapy in Allergic Disorders

The Metabolism and Functions of Histamine

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