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Systemic reactions to immunotherapy

S M Matloff, I W Bailit, P Parks

    Allergy Proceedings : the Official Journal of Regional and State Allergy Societies
    |September 1, 1993
    PubMed
    Summary
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    Systemic reactions (SR) during allergen immunotherapy are uncommon (0.51%). Most SR are mild, but a history of asthma or prior reactions increases risk. Vigilance is needed as reactions can occur hours later.

    Area of Science:

    • Allergy and Immunology
    • Clinical Research
    • Public Health

    Background:

    • Systemic anaphylactic reactions are a known risk of allergen immunotherapy.
    • Understanding the incidence and characteristics of these reactions is crucial for patient safety.

    Purpose of the Study:

    • To determine the incidence of systemic reactions (SR) to allergen immunotherapy over a 1-year period.
    • To analyze factors associated with SR, including patient history and reaction timing.

    Main Methods:

    • A retrospective study analyzing 27,806 injection visits over 12 months.
    • Data collection included reaction onset, symptoms, treatment, patient history (asthma, prior SR), and extract concentration.

    Main Results:

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  • The incidence of SR was 0.51% (143 reactions).
  • Patients with a history of asthma (50%) or prior SR (45%) were more likely to experience reactions.
  • Most reactions (72%) occurred within 30 minutes, but 8% occurred after 2 hours; 83% were mild.

    • Conclusions:

    • Systemic reactions are a small but definite risk associated with allergen immunotherapy.
    • While most reactions are mild, some can be severe, necessitating prompt recognition and treatment.
    • Patient history of asthma or previous reactions, and delayed onset, are important considerations for managing immunotherapy safety.