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Risk factors for systemic reactions to allergen immunotherapy

Iglesias-Cadarso, Alfredo; Hernández-Weigand, Pilar

Current Opinion in Allergy and Clinical Immunology: December 2011 - Volume 11 - Issue 6 - p 579–585
doi: 10.1097/ACI.0b013e32834c229e
Immunotherapy and new treatments: Edited by Giovanni Passalacqua and Robert Bush

Purpose of review To update safety information regarding allergen-specific immunotherapy (ASIT) in clinical practice and highlight the risk factors associated with the adverse reactions, product and each dose.

Recent findings Efforts in recent years have focused on increasing our understanding of the efficacy and safety of ASIT, especially the sublingual variety (SLIT), in multicenter studies. Moreover, new Clinical Practice Guidelines (CPGs) and an international consensus concerning ASIT have been published recently. Although no deaths as a result of subcutaneous immunotherapy or SLIT have been reported in the last 2 years, systemic reactions mainly arising from administration errors still appear. Recent studies support the safety of new forms of specific immunotherapy.

Summary An understanding of the risk factors for each patient, product and dose, and the implementation of CPGs are the main factors that could improve the safety of ASIT. The standardization of all procedures for prescribing and administering ASIT, and the systematic collection of standardized safety data in a multicenter database (postmarketing surveillance), may be required to generate new information on the safety of ASIT.

aAllergy Department, Hospital Puerta de Hierro – Majadahonda

bENT Department, Hospital Clínico San Carlos, Madrid, Spain

Correspondence to Alfredo Iglesias-Cadarso, Allergy Department, Hospital Puerta de Hierro – Majadahonda, C/Manuel de Falla 1, Majadahonda, 28222 Madrid, Spain Tel: +34 911917180; e-mail:,

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