Follow‐up after systemic adverse reactions of immunotherapy

Toubi, Elias; Kessel, Aharon; Blant, A; Golan, TD

doi:10.1034/j.1398-9995.1999.t01-1-00094.x

Cited by 17 publications

(10 citation statements)

References 3 publications

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“…A finding consistent with that reported by others [9,35,41] and not agreed with results of others [11,19,[42][43][44]. Although more than half of systemic reactions cases developed as immediate reactions, our results indicated an important aspect of development of 43% of systemic reactions were of late onsets.…”

Section: Discussionsupporting

confidence: 79%

“…Both Mould and HDM allergens systemic reactions development rates were significantly different (p<0.0001) from other inhalant allergens evaluated in this study. This finding was in consistent with some studies [19,32,40,41] and not with others [42]. Indoor allergens were a significant risk factor for development of systemic reactions to subcutaneous immunotherapy [OR=18.2, P<0.0001].…”

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confidence: 80%

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Systemic Adverse Reaction to Specific Immunotherapy

Alsamarai¹,

Alobaidi²,

Alwan³

et al. 2011

J Aller Ther

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Background: Allergen immunotherapy has been reported to be effective in reducing allergic symptoms and drug consumption in cases of respiratory allergy. However, some concerns still exist about the relative safety of allergen immunotherapy. This form of therapy has a potential risk of serious systemic reactions.Objective: To evaluate the frequency of systemic reactions due to subcutaneous allergen immunotherapy in Iraq and to identify factors associated with increased risk of adverse systemic reaction. Methods:From January 2000 to December 2008, we selected 693 patients with allergic rhinitis and asthma to receive subcutaneous specific immunotherapy. Prospective immunotherapy safety was evaluated by recording postinjection adverse effects. The adverse reaction observed during the administration of subcutaneous immunotherapy within a period of 9 years (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008), was analyzed in this study.Result: Data were obtained from 693 patients who received subcutaneous immunotherapy (SCIT). The mean number of skin tests positivity and number of injections were significantly higher in systemic reaction group compared to negative systemic reaction group. During the study period, a total of 39281 injections were administered to 693 patients. Of the 693 patients, 82 (11.8%) had systemic reaction, with an incidence of 2.1/1000 injection. Sixty nine of the 82 systemic reaction (84%) developed in the build up phase, versus 13 (16%) in the maintenance phase (p<0.0001), with respect to reaction time, 47 (57%) of the systemic reaction were immediate (within 30 minutes respect to reaction time), and 35 (43%) were delayed. There were higher significant influences of polysensitisation, age, asthma, combination of asthma and allergic rhinitis, type of allergen, and indoor allergens on the development of systemic adverse reactions to subcutaneous immunotherapy. Conclusion:The present study suggests that SCIT was a safe treatment with a low risk to elicit severe systemic reaction, in which no fatality was observed. Furthermore, this study indicated that mold, HDM, asthma, presence of asthma and allergic rhinitis (AR), polysensitisation, and indoor allergens sensitization were a risk factors contributing to systemic reactions. consents were obtained from all patients (or their parents for children) before the initiation of immunotherapy and the guidelines were followed to monitor patients during allergen extract injection. Systemic Adverse Reaction to Specific ImmunotherapyThe adverse reaction observed during the administration of subcutaneous immunotherapy within a period of 9 years (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008), was analyzed in this study. Demographic and clinical data and peak expiratory flow before and after injection were recorded by the investigators on a standardized form. Immunotherapy scheduleImmunotherapy was given in term of conventional schedule. Conventional Immunotherapy build-up was typically given as injection per week until the maintenance dose wa...

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Section: Discussionsupporting

confidence: 79%

supporting

confidence: 80%

Systemic Adverse Reaction to Specific Immunotherapy

Alsamarai¹,

Alobaidi²,

Alwan³

et al. 2011

J Aller Ther

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“…Parietaria pollen, a weed of the Urticaceae family, is one of the main causes of respiratory allergy in the Mediterranean area with a prevalence of 5.2–80% in Italy and Greece and 25–40% in Spain and southern France [1,2,3,4,5,6]. The plant is also present on the Pacific coast of the USA and in Australia, where it is the cause of allergy [7,8,9].…”

Section: Introductionmentioning

confidence: 99%

Possible Relationship between Systemic Side Effects and Sensitization to rPar j 2 in Allergic Patients Submitted to an Ultra-Rush (20 min) Sublingual Immunotherapy and Selected by Component Resolved Diagnosis

Rossi

Monasterolo²,

Coco³

et al. 2005

Int Arch Allergy Immunol

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Background: The pollen of Parietaria spp., a weed of the Urticaceae family, is a major cause of respiratory allergy in the Mediterranean area, where the most common species are Parietaria judaica and Parietaria officinalis. In this study, we evaluated the specific serum IgE-binding profiles to individual P. judaica pollen recombinant major allergen, and Phleum pratense cytoskeletal profilin and a 2-EF-hand calcium-binding allergen homologous to cross-reactive Parietaria pollen allergens, in patients allergic to pollen with positive skin test towards Parietaria spp. extract. Methods: The present observation included 220 patients from the province of Cuneo, north-west Italy, all suffering from rhino-conjunctivitis and/or asthma selected on the basis of skin test positive to P. judaica extract. The sera were evaluated for specific IgE reactivity to P. judaica pollen major recombinant(r) allergen Par j 2, Phleum pratense pollen allergens rPhl p 7 (2-EF-hand calcium binding protein) and rPhl p 12 (profilin), both identified as cross-reactive Parietaria spp. allergens, using Pharmacia CAP System. Out of 220 patients, 37 patients with IgE reactivity to rPar j 2 and 105 patients sensitized to at least one timothy pollen major allergen (i. e. rPhl p 1, rPhl p 2, natural Phl p 4 and rPhl p 6) were submitted to an ultra-rush protocol of sublingual immunotherapy (SLIT). The occurrence of adverse reactions were evaluated in both groups. Results: All 220 patients with pollinosis and positive in vivo skin prick tests had in vitro positive CAP results to P. judaica natural extract. On the contrary, in these patients the prevalence of Par j 2-specific IgE was only 33.2% (73/220). In fact, 116/220 (52.7%) patients with serum specific IgE to crude Parietaria pollen extract had specific IgE to Phl p 12, 18/220 (8.1%) subjects with specific IgE to rPhl p 12 also exhibited specific IgE to Phl p 7 and 26/220 (11.8%) subjects had specific IgE against rPhl p 7. Particularly, geometric mean (25th–75th percentile) of specific IgE to rPar j 2 were as follows: 2.87 kUA/l (1.005–7.465). Out of 73 patients with specific IgE to rPar j 2, 7 subjects (9.6%) had also specific IgE to rPhl p 7, 12 (16.4%) had specific IgE to rPhl p 12 and 4 (4.1%) patients had specific IgE to both recombinant allergens. Of 37 patients under an ultra-rush protocol of SLIT, 3 subjects (8.1%) experienced generalized urticaria, and 1 of them also had diarrhea 3 h after the last dose of Parietaria judaica extract oral-vaccine administration. On the contrary, no systemic reactions were observed in 105 patients after Phleum pratense extract oral intake after a similar ultra-rush SLIT protocol (p = 0.0046). Conclusions: In the light of present findings, allergen extract-based diagnosis, in vivo and in vitro, cannot discriminate allergic patients that are genuinely sensitized to Parietaria spp. major allergens or to other major allergens to which current immunotherapeutic allergy extracts are standardized. Therefore, in vitro component resolved diagnosis is the unique tool t...

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“…Although the documented effectiveness of SIT in the treatment of allergic rhinitis and allergic asthma, the real life efficacy and use of this treatment option is severely limited by perceived low patient compliance [17,18], adverse local and systemic side effects [19,20] and significant delay in effect after the initiation of therapy, all of which may lead to relatively low adherence rate [8].…”

Section: Introductionmentioning

confidence: 99%