Skip Navigation LinksHome > December 2013 - Volume 13 - Issue 6 > Reducing and managing systemic reactions to immunotherapy
Current Opinion in Allergy & Clinical Immunology:
doi: 10.1097/ACI.0b013e328364c876
IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush

Reducing and managing systemic reactions to immunotherapy

Ravi, Anupamaa; Rank, Matthew A.b

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Purpose of review: To identify and discuss recent articles pertaining to the reduction and management of systemic reactions to allergen immunotherapy (AIT).

Recent findings: Fatal reactions to AIT may be declining. Screening asthma patients before AIT and dose adjustment during pollen season may contribute to lower systemic reaction rates. Cluster build-up protocols with multiallergen subcutaneous immunotherapy (SCIT) may lead to an increased risk of systemic reactions compared with cluster build-up protocols with single-allergen SCIT. Sublingual immunotherapy (SLIT) studies confirm the low rates of systemic reactions using this method, including for rapid build-up schedules. Studies of newer forms of AIT (intralymphatic, epicutaneous, recombinant allergens) have too few patients to form confident systemic reaction risk estimates. High-grade delayed systemic reactions to AIT may be less frequent than previously reported.

Summary: Recent studies increase confidence in risk estimates for systemic reactions to AIT, suggest useful strategies to predict systemic reactions to AIT, and offer strategies to prevent systemic reactions.

© 2013 by Lippincott Williams & Wilkins, Inc.


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