Systemic tolerability of specific subcutaneous immunotherapy with index-of-reactivity–standardized allergen extracts administered using clustered regimens: a retrospective, observational, multicenter study

Serrano, Pilar; Justicia, Jose-Luis; Sanchez, C Puente; Cimarra, M; Fernández-Távora, L; Orovitg, A.; Moreno, C; Guerra, Francisco; Alvà, Víctor

doi:10.1016/s1081-1206(10)60088-9

Cited by 31 publications

(13 citation statements)

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“…The reported rate of systemic reactions per injection has been variable from 0.06% to 2.033% [9,11,13,19,31,32,35,39,[42][43][44][45][46][47]. Our frequency of SRs was 0.21% and within the range reported by several studies.…”

Section: Discussionsupporting

confidence: 60%

“…This form of therapy has a potential risk of serious systemic reactions, as it involves subcutaneous injection of allergen extracts to which the patients is sensitive [10]. Despite clear advances in the prevention of such reactions, varying rates of severs reactions have been reported since the introduction of standardized and more potent extracts [11][12][13][14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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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: 60%

Section: Introductionmentioning

confidence: 99%

Systemic Adverse Reaction to Specific Immunotherapy

Alsamarai¹,

Alobaidi²,

Alwan³

et al. 2011

J Aller Ther

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“…Rush schedules were less strongly associated with SRs. Although contradictory data have been published , these differences could be due to the type of extract associated preferentially with each protocol. Sensitization to animal dander or pollen, regardless of whether or not these allergens were present in the AIT formulation used. These findings emphasized the importance of correct patient selection.…”

Section: Discussionmentioning

confidence: 99%

European Survey on Adverse Systemic Reactions in Allergen Immunotherapy (EASSI): a real-life clinical assessment

Calderón

Vidal

Río

et al. 2016

Allergy

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“…22 A review that used the 2006 EAACI grading system comparing the safety of different cluster schedules reported that 16% of systemic adverse reactions were grade 0, which is defined as ''no symptoms or nonspecific symptoms.'' 23 Moreover, investigators of SCIT studies develop their own unique classification systems for grading SRs. 24 This variability and lack of uniformity in classifying SCIT SR make it impossible to compare the safety results in one trial versus another.…”

Section: Current Classification Systems For Grading Scit Sr: History mentioning

confidence: 99%

Speaking the same language: The World Allergy Organization Subcutaneous Immunotherapy Systemic Reaction Grading System

Cox

Larenas‐Linnemann

Lockey

et al. 2010

Journal of Allergy and Clinical Immunology

450

324

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Systemic tolerability of specific subcutaneous immunotherapy with index-of-reactivity–standardized allergen extracts administered using clustered regimens: a retrospective, observational, multicenter study

Cited by 31 publications

References 20 publications

Systemic Adverse Reaction to Specific Immunotherapy

Systemic Adverse Reaction to Specific Immunotherapy

European Survey on Adverse Systemic Reactions in Allergen Immunotherapy (EASSI): a real-life clinical assessment

Speaking the same language: The World Allergy Organization Subcutaneous Immunotherapy Systemic Reaction Grading System

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