Safety of multiple aeroallergen rush immunotherapy using a modified schedule

Area of Science:

• Allergy and Immunology
• Clinical Research

Background:

• Rush immunotherapy (RIT) expedites traditional immunotherapy (IT) build-up, offering quicker symptomatic relief.
• Aeroallergen RIT presents a higher risk of systemic reactions (SRs) than traditional IT.

Purpose of the Study:

• To evaluate the safety of a modified 1-day multiple aeroallergen RIT protocol.
• To determine the rate of systemic reactions (SRs) in patients undergoing this modified RIT.

Main Methods:

• Retrospective chart review of 138 patients undergoing RIT between November 2007 and February 2011.
• A 1-day protocol with eight injections over 5 hours, premedication with prednisone and antihistamines.
• Primary endpoint: rate of systemic reactions (SRs).

Main Results:

• 138 patients received 2911 RIT injections, with 38 patients (28%) experiencing SRs.
• The overall SR rate was 1.3% per injection, with most reactions occurring after the final dose.
• No SRs required emergency department or hospitalization; SR rates were comparable to traditional IT.

Conclusions:

• The modified 1-day aeroallergen RIT protocol demonstrated a systemic reaction rate comparable to traditional IT, with no severe anaphylaxis.
• Modifying the protocol to end at a lower dilution did not significantly reduce the SR rate.
• Aeroallergen RIT, unlike hymenoptera RIT, remains associated with a substantial risk of systemic reactions.