Risk management in allergen immunotherapy

Area of Science:

• Allergy and Immunology
• Clinical Medicine

Background:

• Systemic anaphylactic reactions are the primary risk associated with allergen immunotherapy.
• The frequency of these reactions varies significantly, from less than 1% in conventional therapy to over 36% in rush immunotherapy.

Purpose of the Study:

• To review the characteristics and risk factors of systemic and fatal reactions to allergen immunotherapy.
• To discuss recommended precautions and potential interventions to improve patient safety during allergen immunotherapy.

Main Methods:

• Literature review of studies on allergen immunotherapy reactions.
• Analysis of risk factors, reaction onset times, and patient characteristics.

Main Results:

• Systemic and fatal reactions share similar characteristics, with onset typically within 30 minutes post-injection for about 70% of patients.
• Key risk factors include a history of asthma, increasing allergen dose, high allergen sensitivity, prior systemic reactions, and injections during active allergen seasons.

Conclusions:

• Precautions and interventions like premedication, peak flow monitoring, and immediate access to emergency medications are suggested to enhance safety.
• Further research is needed to validate these interventions before routine implementation in allergen immunotherapy protocols.