Allergen Immunotherapy Evolves as Faster, Safer and Longer-Lasting Treatment

Time-tested for a century, allergen immunotherapy has evolved into revolutionary methods of administration, as well as faster, safer and longer-lasting treatments according to the latest research presented at the Annual Meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Dallas.

Recent studies have shown subcutaneous immunotherapy, or allergy shots, may prevent the progression of allergic disease and reduce the risk of developing asthma; reduce the need for medication; reduce utilization and costs of health care services; and provide long term remission after discontinuation of treatment.

“In a recent study of allergy immunotherapy among Florida Medicaid-enrolled children with allergic rhinitis, there was a significant reduction in utilization and costs of health care services, especially inpatient care,” said Linda S. Cox, M.D., assistant clinical professor of medicine at the Southeastern University Osteopathic College of Medicine, Miami, Fla., and chair of the ACAAI Immunotherapy and Diagnostics Committee.

In another study investigators demonstrated allergen immunotherapy has an economic advantage on standard anti-allergic drugs in patients with pollen-induced rhinitis and asthma, she said. Findings showed a cost reduction of approximately 15 percent the second year and 48 percent the third year, with a highly statistical significance that was maintained up to the sixth year – 3 years after stopping immunotherapy – when an 80 percent reduction was found. The net saving for each patient at the final evaluation corresponded to $830 per year.

“These findings confirm some previous observations in studies from Germany and the United States that subcutaneous immunotherapy has significant economic advantages over anti-allergic drug treatment in the long term,” Dr. Cox said.

Immunotherapy decreases a patient’s sensitivity by introducing increasingly larger doses of the substances to which the patient is allergic. The treatment is a method for increasing the allergic patient’s natural resistance to the things that are triggering the allergic reactions. The immunization procedure begins with injections of small amounts of purified “extracts” of the substances that are causing allergic reactions. They are approved for this use by the Food and Drug Administration (FDA), and over the years they have been improved considerably.

Compared to conventional immunotherapy, rush immunotherapy (also known as rapid desentization) provides the advantages of improved patient compliance, cost-effectiveness and therapeutic efficacy. Rush schedules, which have been used successfully for more than 70 years, can achieve a maintenance dose more quickly than weekly schedules. Rush immunotherapy is associated with an increased risk of systemic reaction, which is reduced with pre-medication.

Sublingual Immunotherapy

Oral/sublingual immunotherapy has gained wide acceptance in the treatment of allergic disease throughout Europe and South America. The main advantage of sublingual immunotherapy over traditional immunotherapy is patient convenience, since it can be administered at home, and it appears to be safer than conventional immunotherapy, Dr. Cox said.