AAAAI/ACAAI Subcutaneous Immunotherapy Surveillance Study (2013-2017): Fatalities, Infections, Delayed Reactions, and Use of Epinephrine Autoinjectors

Epstein, Tolly; Liss, Gary M.; Berendts, Karen; Bernstein, David I.

doi:10.1016/j.jaip.2019.01.058

Cited by 78 publications

(55 citation statements)

References 20 publications

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“…Therapeutic failure can be considered as resulting from either inadequate clinical response or intolerable side effects. 14,15 The possible reasons for inadequate clinical response are summarized in Table 1. The current published guidelines and the medical literature (Pubmed, Cochrane Library, National Institute of Health, and Care Excellence) have been reviewed to look for guidance as to appropriate management when therapeutic failure arises.…”

Section: Discussionmentioning

confidence: 99%

“…We have considered therapeutic failure as either inadequate symptomatic response or intolerable side effects, which are both well recognized. 14,15 This is a series of 4 cases (3 therapeutic failure and 1 early relapse) encountered in our AIT clinic, where patients are treated using either SCIT or SLIT protocols, depending on clinical evaluation and patient preference. All patients provided informed consent to be included.…”

Section: Introductionmentioning

confidence: 99%

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Illustrative Case Series and Narrative Review of Therapeutic Failure of Immunotherapy for Allergic Rhinitis

Campisi

Yong

Kasternow

et al. 2020

Allergy�Rhinol (Providence)

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This is a series of 4 cases (3 therapeutic failure and 1 early relapse) in adult patients treated with allergen immunotherapy (AIT) for allergic rhinitis (AR) in our immunotherapy clinic, which treats 110 new patients per year. AIT includes both subcutaneous and sublingual routes. The current national/international AIT recommendations and the literature have been searched to identify guidance for the optimal management of therapeutic failure of AIT in AR. There is scant information available to support clinicians when treatment failure and/or intolerable side effects occur. The importance is highlighted for developing the guidance and evidence base for the benefit of this patient subgroup. The potential strategies that clinicians have proposed are discussed in this article, though it is acknowledged that these are mostly not evidence-based.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Illustrative Case Series and Narrative Review of Therapeutic Failure of Immunotherapy for Allergic Rhinitis

Campisi

Yong

Kasternow

et al. 2020

Allergy�Rhinol (Providence)

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“…In a survey of practicing allergists through the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology, Epstein et al 23 reported that 85% of SRITs occurred within 30 minutes postinjection. The model assumed that all SRITs would be promptly treated with EAI either at home or in clinic; however, sensitivity analyses explored reduced rates of home EAI administration.…”

Section: Probabilities and Eventsmentioning

confidence: 99%

“…The model assumed that all SRITs would be promptly treated with EAI either at home or in clinic; however, sensitivity analyses explored reduced rates of home EAI administration. Epstein et al 23 reported 6 to 7 fatalities from 2008 to 2016 among 54.4 million injections (modeled AIT fatality rate per injection, 1.3 Â 10 À7 ). Automobile fatality rates were incorporated on the basis of a rate of 1.18 fatalities per 100 million vehicle miles traveled.…”

Section: Probabilities and Eventsmentioning

confidence: 99%

Health and Economic Outcomes of Home Maintenance Allergen Immunotherapy in Select Patients with High Health Literacy during the COVID-19 Pandemic: A Cost-Effectiveness Analysis During Exceptional Times

Shaker

Mosnaim

Oppenheimer

et al. 2020

The Journal of Allergy and Clinical Immunology: In Practice

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What is already known on this topic: Allergy/immunology clinical practices are not immune to natural disasters or global pandemics, which may force service reduction or abrupt changes in practice. What does this article add to our knowledge: Home allergen immunotherapy can be cost-effective in highly selected patients under pandemic shelter-in-place conditions provided home systemic reactions to immunotherapy rates remain stable; however, careful patient selection is critical. How does this study impact current management guidelines: This cost-effectiveness analysis demonstrates potential feasibility of allergen immunotherapy for appropriately screened patients. This may help inform decision making regarding how to provide this valuable allergy service in a current or future natural disaster or pandemic. BACKGROUND: Allergen immunotherapy (AIT) is safe and effective but is typically administered under strict clinic observation to mitigate the risk of a systemic reaction to immunotherapy (SRIT). However, in the setting of the global coronavirus disease 2019 pandemic, alternative care models should be explored. OBJECTIVE: To evaluate the cost-effectiveness of home immunotherapy self-administration (HITSA) in a highly

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“…Although not specifically queried for nonfatal reactions, there were no reports of fatal reactions occurring owing to a gap in therapy. 5 As discussed below, the issue of gaps in therapy will be more extensively queried in this year's upcoming surveillance survey.…”

Section: Published Data Related To Gaps In Subcutaneous Allergen Immumentioning

confidence: 99%

Gaps in allergen immunotherapy administration and subcutaneous allergen immunotherapy dose adjustment schedules

Larenas‐Linnemann

Epstein

Ponda

et al. 2020

Annals of Allergy, Asthma & Immunology

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AAAAI/ACAAI Subcutaneous Immunotherapy Surveillance Study (2013-2017): Fatalities, Infections, Delayed Reactions, and Use of Epinephrine Autoinjectors

Cited by 78 publications

References 20 publications

Illustrative Case Series and Narrative Review of Therapeutic Failure of Immunotherapy for Allergic Rhinitis

Illustrative Case Series and Narrative Review of Therapeutic Failure of Immunotherapy for Allergic Rhinitis

Health and Economic Outcomes of Home Maintenance Allergen Immunotherapy in Select Patients with High Health Literacy during the COVID-19 Pandemic: A Cost-Effectiveness Analysis During Exceptional Times

Gaps in allergen immunotherapy administration and subcutaneous allergen immunotherapy dose adjustment schedules

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