Physician reported patient response to immunotherapy: a retrospective study of factors affecting the response

This study assessed physician evaluation of immunotherapy derived from questionnaires completed at specified intervals during the course of each program in 901 randomly selected patients in the Allergy Clinic, Kingston General Hospital, (1975 to 1985). The objective was to determine safety and efficacy and factors contributing to these from this information. Approximately ninety-six percent of completed questionnaires and 97.5% of patients reported symptomatic improvement. The requirement for supplemental medication was reported in 21.6% of questionnaires and by 35.6% of patients. This requirement was greater in females, in patients with asthma, and in patients with greater numbers of antigens administered. Single antigen programs provided the best response. Systemic reactions were reported in 6.7% of patients treated. In 1% of patients these reactions were severe and required adrenalin for management. Severe reactions occurred when higher concentrations of antigens were injected and frequently developed without warning of prior milder episodes. It was concluded that immunotherapy programs are safe and effective given in appropriate circumstances and with proper safeguards. A monitoring system, however, would provide valuable information on patient progress and collectively may indicate trends in response.