[Specific (allergenic) immunotherapy: bibliographic analysis, efficacy and current practice]

After a history of specific immunotherapy in this exhaustive review, the author discusses the results of all the documented double blind studies and defines rules of good practice for its use in allergic subjects. This takes into account only studies in which the method of evaluation includes an objective index of clinical benefit, such as the drug/symptom or measurement of the threshold of response to provocation. In some cases, the level of improvement seems to be marginal and the variability of responses can be explained by the selection of the subjects and the dose of allergens administered. Only studies done with conventional specific immunotherapy, at high doses, by the injected routes, with extracts that are either aqueous or modified by adsorption or polymerisation have shown results that are clinically significant and these are dose-dependent. Indications for hyposensitisation are discussed fully as well as rules of administration.