Safety of allergen-specific immunotherapy. Relation between dosage regimen, allergen extract, disease and systemic side-effects during induction treatment

2000 ◽  
Vol 30 (10) ◽  
pp. 1423-1429 ◽  
Author(s):  
M. T. Mellerup ◽  
G. W. Hahn ◽  
L. K. Poulsen ◽  
H.-J. Malling
2021 ◽  
Vol 19 (3) ◽  
pp. 156-165
Author(s):  
Nazan TÖKMECI ◽  
Ali DEMIRHAN ◽  
Merve TURKEGUN SENGUL ◽  
Burcu CAGLAR YUKSEK ◽  
Aylin KONT ÖZHAN ◽  
...  

Objective: Allergen-specific immunotherapy (allergen-SIT) is a treatment method with variable efficacy in allergic diseases. This study aimed to investigate the effectiveness of allergen immunotherapy, frequency of LRs and SRs and variables affecting these parameters in patients who underwent allergen-SIT. Materials and Methods: In this study, the recorded data of 81 patients, who received subcutaneous (SCIT) or sublingual (SLIT) allergen immunotherapy for respiratory allergic diseases between 2014 and 2019, were analyzed. In asthma and/or allergic rhinoconjunctivitis (ARC) patients, the effectiveness of treatment was evaluated by analysing the change rates in disease symptom, medication and combined scores (symptom + medication) and visual analog score (VAS). Treatment success was defined by the degree of decrease in scores as; high response above 50%; low response between 20-50%; and failure <20%.Results: The mean age of allergen-SIT initiation was 11.4± 3.1 years. Diagnostic distributions of the patients were asthma (± ARC) in 64.2%, and ARC (without asthma) in 35.8%. The mode of allergen-SIT was SCIT in 77.8% (65% asthma and 35% ARC) and SLIT in 22.2% (61.1% asthma and 38.9% ARC). The main allergens used in allergen-SIT were mite (79%), grass-grain pollen (33.3%), alternaria (9.9%) and olea (8.6%). There was a significant decrease in symptoms, medication, combined and VAS scores in the asthma and ARC groups (p <0.0001), when end-SCIT values were compared to baseline. SLIT also resulted in significant decreases in these scores except asthma medication score. Among the asthma patients the rate of high-responders was 88.8% by SCIT and 50% by SLIT, according to combined asthma score. Among the ARC (without asthma) patients the rate of high-responders was 100% for both SCIT and SLIT. SCIT resulted in local (LR) and systemic side effects (SR) in 18% and 0.6% (all Grade I and Grade II) of the total injections performed. A high number of total injections was significantly associated with higher LR and SR rates. While LR was observed in 16.6% of the patients who underwent SLIT, no systemic reaction was found in any of the patients. Conclusion: SCIT was highly successful in the treatment of asthma and ARC in terms of the degree of therapeutic response. SLIT resulted in a high rate of good response in ARC patients, but a lower response degree in asthmatic patients. Systemic side effects were very low as a result of close risk monitoring and the dose adjustments performed. Keywords: Allergen-specific immunotherapy, SCIT, SLIT, efficacy, symptom score, medication score, visual analog score, side effects


2009 ◽  
Vol 6 (1) ◽  
pp. 45-50
Author(s):  
I M Gayduk ◽  
I V Makarova ◽  
O V Trusova ◽  
D V Breykin ◽  
V G Sukhorukova ◽  
...  

Background. The research of effective methods of allergen-specific immunotherapy (ASIT) with good tolerability is important in children with allergic disorders. The aim of the study was to investigate effectiveness and safety of ASIT with pollen allergoids for hay fever treatment in children. Methods. 71 patients 5 to 17 years old with diseases caused by tree pollen sensitization: allergic rhinoconjunctivitis in 36 patients, rhinitis combined with pollen asthma in 17, combined with atopic dermatitis in 1, and pollen asthma in 17, were included in the study. 2 courses of subcutaneous ASIT out of flowering season were conducted in every child using commercially available pollen allergoids. ASIT effectiveness was assessed using 4-point scale where 4 points represents complete disease remission, and 1 point represents lack of effectiveness. Local and systemic side effects were registered as parameters of ASIT safety. Results. Total dose of allergen was 13 768 PNU after the 1st course of ASIT, and 12 700 PNU after the 2nd course. Effectiveness of the 1st course of ASIT was 4,0 points out of 4,0 and of the 2nd course - 4,0 points. Local side effects (infiltration larger than 25 mm, itching and oedema in injection site) in 19,7% patients and systemic side effects (allergic rhinitis exacerbation, urticaria) in 11,3% patients were stopped after allergoid dose adjustment. Conclusion. ASIT with pollen allergoids is effective for hay fever treatment in children. Children with bronchi al asthma are at higher risk for adverse events and need individual dose adjustment.


Author(s):  
Ekaterina Pashkina ◽  
Veronika Evseenko ◽  
Natalya Dumchenko ◽  
Maxim Zelikman ◽  
Alina Aktanova ◽  
...  

The most effective method of treating allergic diseases, aimed not at relieving symptoms, but at eliminating the cause of the disease, is allergen-specific immunotherapy (AIT). To reduce the risk of side effects and improve the delivery of allergens to the mucosa, various delivery systems, such as liposomes, dendrimers, nanoparticles, etc., can be used. To date, there are data on the creation of delivery systems based on glycyrrhizic acid (GA) and its derivatives, but such a delivery system has not been used for allergen-specific therapy until now. At the same time, it is known that GA has an anti-inflammatory effect, shifts the balance towards Th1, and increases the number of Treg cells, which means that in the future it can enhance the anti-allergic effect of AIT and reduce the risk of unwanted side effects. Thus, the study of the immunomodulatory effect of supramolecular complexes (micelles) of GA with extracts of allergens seems to be very promising for the development of new drugs for AIT.


2006 ◽  
Vol 36 (3) ◽  
pp. 254-260 ◽  
Author(s):  
L. Winther ◽  
J. Arnved ◽  
H.-J. Malling ◽  
H. Nolte ◽  
H. Mosbech

2017 ◽  
pp. 116-119
Author(s):  
S. V. TSAREV

This article discusses the place and role of an allergen-specific immunotherapy in the treatment of allergic diseases. It provides an action mechanism, indications for use, contraindications, and side effects of an allergen-specific immunotherapy. A comparison of different methodologies for an allergen-specific immunotherapy was made. The advantages of sublingual allergen-specificimmunotherapy in paediatric practice were demonstrated. Provides data on the efficiency and safety of pollinosis sublingual immunotherapy with sensitization to grass


2020 ◽  
Vol 17 (3) ◽  
pp. 64-73
Author(s):  
Olga V. Trusova ◽  
Andrey V. Kamaev ◽  
Irina V. Makarova

BACKGROUND:Sublingual allergen-specific immunotherapy (SLIT) inefficiencie is mainly caused by non-compliance with the treatment regimen and premature treatment termination. AIM:Frequency and causes of dropouts determination in children receiving SLIT with birch pollen according to the pre-coseasonal protocol, and approbation of the developed visit-to-visit patient management plan (Plan). MATERIALS AND METHODS:332 cases of treatment with birch pollen in children are analyzed. 290 patients (72.1% boys, aged 518 years (9.82 years [5.93; 14.67]), received SLIT with birch pollen in 20122019. 42 patients received SLIT according to the Plan (69% boys, 8.95 years old [5.38; 11.79]) in 20172019. RESULTS:A low dropout frequency was noted in the 1st and 2nd year of therapy (2 years after the start of treatment, 85% patients continue it). However, only 63.1% complete 3 years of therapy, and 11% 4 years of therapy. It has been shown that experienced allergists have more efficient patient retention. The implementation of the Plan increased patient retention in treatment at the 3rdyear of treatment up to 82.9% (p=0.02). CONCLUSION:The study confirmed the main reasons for the withdrawal of patients from SLIT: doubts about the effectiveness, cost and side effects. A low dropout frequency was shown according to the results of the 1stand 2ndyears of therapy, but only a small proportion of patients (11%) receive 4 or more courses of therapy. Visit-to-visit Plan optimizes the patients management, reduces patients withdrawal from treatment and can be recommended for practical healthcare.


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