Allergen immunotherapy safety: Characterizing systemic reactions and identifying risk factors

Matthew A Rank, Corrine L. Oslie, Jennifer L. Krogman, Miguel Park, James T. Li

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Systemic reactions (SRs) pose a risk to those treated with subcutaneous allergen immunotherapy (AIT). The goals of the study were to calculate a rate of SRs to AIT, characterize the timing and treatment of these SRs, and analyze a case-control sample of patients for putative SR risk factors. A case-control study based on a retrospective chart review from 2004 to 2006 at a single institution was performed for patients receiving AIT. A control group received AIT over the same time period but did not have an SR. Three hundred thirty-eight patients had 10,497 AIT injection visits and 25 patients experienced 29 SRs for a rate of 0.28% per injection visit and 7.4% per patient. Gender, phase (build-up versus maintenance), asthma, angiotensin-converting enzyme inhibitors, beta-blockers, initial skin-prick test size, or allergen type did not increase the odds of an SR to AIT. Nearly one-half (48%) of the SRs occurred >30 minutes after the injection. All five patients with an abnormal physical exam or a >20% decrease in peak expiratory flow during their SRs occurred in patients presenting with their SRs >30 minutes after the injection (p = 0.02). This study found a low rate of SRs to AIT. However, a high percentage of SRs occurred >30 minutes after the injection, and many of these SRs required epinephrine. This study was unable to identify specific risk factors that predict SRs to AIT.

Original languageEnglish (US)
Pages (from-to)400-405
Number of pages6
JournalAllergy and Asthma Proceedings
Volume29
Issue number4
DOIs
StatePublished - Jul 2008

Fingerprint

Immunologic Desensitization
Safety
Injections
Skin Tests
Angiotensin-Converting Enzyme Inhibitors
Allergens
Epinephrine
Case-Control Studies
Asthma
Maintenance
Control Groups

Keywords

  • ACE-inhibitor
  • Allergens
  • Anaphylaxis
  • Asthma
  • Beta-blocker
  • Desensitization (immunologic)
  • Epinephrine
  • Risk factors
  • Safety
  • Subcutaneous immunotherapy

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Allergen immunotherapy safety : Characterizing systemic reactions and identifying risk factors. / Rank, Matthew A; Oslie, Corrine L.; Krogman, Jennifer L.; Park, Miguel; Li, James T.

In: Allergy and Asthma Proceedings, Vol. 29, No. 4, 07.2008, p. 400-405.

Research output: Contribution to journalArticle

Rank, Matthew A ; Oslie, Corrine L. ; Krogman, Jennifer L. ; Park, Miguel ; Li, James T. / Allergen immunotherapy safety : Characterizing systemic reactions and identifying risk factors. In: Allergy and Asthma Proceedings. 2008 ; Vol. 29, No. 4. pp. 400-405.
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