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Survey on immunotherapy practice patterns: dose, dose adjustments, and duration.
Désirée E S Larenas-Linnemann1, Payel Gupta, Sima Mithani
1Hospital Médica Sur, Mexico City, Mexico. marlar1@prodigy.net.mx
Summary
Many allergists deviate from recommended allergen immunotherapy (AIT) dosing, with some administering lower doses. Further research is needed on optimal missed-dose adjustments and AIT duration.
Area of Science:
- Allergy and Immunology
- Clinical Practice Research
Background:
- Practical aspects of allergen immunotherapy (AIT) administration by European and US allergists are not well understood.
- Existing guidelines partially address concerns regarding AIT practices.
Purpose of the Study:
- To survey AIT practice patterns among global members of the American Academy of Allergy, Asthma and Immunology (AAAAI).
Main Methods:
- A web-based survey was distributed to AAAAI members.
- The survey focused on AIT dosing, dose adjustments after missed doses, and treatment duration.
Main Results:
- 1,201 responses were collected, with 10% from outside the US and Canada.
- 57%-65% of US-Canadian AIT dosing fell within recommended ranges, with 9.4%-19% being too low.
- Dose adjustments for missed AIT were primarily based on time elapsed since the last dose; practices varied between US-Canadian and non-US-Canadian allergists.
- Median AIT duration was 3 years for non-US-Canadian allergists and 5 years for US-Canadian allergists.
Conclusions:
- A significant number of patients may receive sub-recommended AIT doses.
- Further research should focus on establishing optimal dose-adjustment protocols for missed AIT administrations.
- Exploration of the maximum appropriate duration for AIT is warranted.
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