皮下免疫疗法缺口后剂量调整的影响:来自北美免疫疗法监测研究 (2008-2023) 的更新
Tolly G Epstein1, Karen Berendts2, David I Bernstein3
1Division of Immunology, Allergy, and Rheumatology, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio; Allergy Partners of Central Indiana, Indianapolis, Ind.
The journal of allergy and clinical immunology. In practice
|October 31, 2025
概括
过敏注射方案缺乏证据. 治疗间隔后调整剂量和优化皮下过敏原免疫疗法 (SCIT) 的维护间隔需要进一步研究以确保患者的安全性和有效性.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 免疫疗法研究 免疫疗法研究
- 临床实践指南 临床实践指南
背景情况:
- 目前,在治疗间隔后调整过敏注射剂量和确定最佳维持间隔的协议仅基于专家意见.
- 需要基于证据的指导方针,以确保皮下过敏原免疫疗法 (SCIT) 的安全和有效使用.
研究的目的:
- 为了确定与SCIT相关的全身过敏反应 (SRs) 的发生率.
- 确定减轻SRs风险的临床实践.
- 评估SCIT相关的感染和治疗中断所带来的风险.
主要方法:
- 分析了从2008年到2023年通过年度调查收集的8410万次注射访问和490万名患者的数据.
- 自2020年以来,包括针对免疫治疗间隙和维持间隔后剂量调整的具体问题.
- 自2014年以来对SCIT相关感染的评估.
主要成果:
- 在2018年至2023年期间,四起与SCIT相关的死亡事件被证实;SCIT感染的风险非常低.
- 实践调整剂量通过减少到一个较低的瓶子为患者的间隔超过7周 (维护) 或28天 (建立) 显示较少严重的SRs.
- 较长的维持间隔 (超过4周) 与SRs的增加率有关.
结论:
- 对SCIT的致命反应仍然很少见,感染风险最小.
- 需要基于证据的策略来调整治疗间隔后的剂量,以及空气过敏原SCIT的最佳维护间隔.
- 进一步的受控研究对于制定SCIT管理的最终指导方针至关重要.
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