Is the subcutaneous allergen immunotherapy safe enough as a treatment modality?

Abstract

Objective: Allergen immunotherapy has been proven to be effective and potentially curative therapy in allergic respiratory diseases and in venom allergy. But occurance of adverse systemic reactions due to specific allergen immunotherapy (SIT) remains still major problem. In this study we aimed to assess the adverse reactions of SIT which has been given to patients diagnosed as allergic asthma and/or rhinitis.Materials and Methods: The 58 patients (37 female/21 male) followed up at Allergy Outpatient and received SIT were included to the study. Local or systemic reactions that occured during total 2939 injections were analyzed.Results: Total 2939 injections with standardized allergen extracts were administered to patients diagnosed as allergic asthma (n= 9), allergic rhinitis (n= 6), allergic asthma and allergic rhinitis (n= 43). Total 39 (1.3%) reactions were observed in 15 (25.8%) patients. Among these reactions 20 ones were local and 19 ones were systemic reactions. Among reactions 15 (75%) of local and 14 (73.7%) of systemic were occurred during build-up phase; 5 (25%) of local and 5 (26.3%) of systemic were occurred during maintenance phase (p< 0.05). According to allergen type while among systemic reactions 13 (68.4%) occured by polen extracts and 6 (31.6%) by mite extracts, among local reactions 15 (75%) occurred by polen extracts and 5 (25%) by mite extracts. (p< 0.05). These systemic reactions were urticaria, itching of body, flushing and feeling of fever, dyspnea and vertigo/headache. Reactions due to grass polen allergen occurred during season were two systemic and one local reaction.Conclusion: We believe that spesific immunotherapy is safe when used with strict safety protocols and administered by staff specialized in allergy. It is needed to have more researches to determine the factors predisposing the adverse reactions to SIT.