Faster Allergy Immunotherapy Proves Effective

New method deemed safe and increases compliance among patients

MONDAY, Nov. 15, 2004 (HealthDayNews) -- A new, more intensive way of delivering allergy shots can dramatically and safely shorten the time it takes for young patients to find relief from their condition, a new study contends.

In the study of 148 children with asthma, allergic rhinitis and chronic sinusitis, doctors found no serious health reactions following an initial two-and-a-half hour session during which the children received allergy shots of increasing doses, called Rapid Allergen Vaccination (RAV).

In addition, the treatment time for the initial phase of the regimen was reduced from eight months to two months, and the compliance rates for remainder of the treatment were extremely high, the researchers said.

"This is an alternative to the traditional treatment and can be done safely, which is the major concern about RAV," said Dr. William Smits, an associate professor at Indiana University Medical School and an allergist at the Asthma and Allergy Center in Fort Wayne.

Smits presented his study Nov. 15 at the American College of Allergy, Asthma & Immunology's annual meeting in Boston.

Conventional Allergen Vaccination (CAV), or allergy shots, is the standard way to help allergy patients reduce their reaction to allergens. By getting shots, in slowly increasing doses, of the allergen that triggers a reaction, the patients can become immune to the allergic effects they've suffered.

The procedure takes years, Smits said, including an initial eight-month period of weekly shots to slowly allow patients to build up tolerance to the allergen. Following that, they receive shots once a month for four to five years to help relieve their symptoms.

But Smits and his colleagues found that when they "pre-medicated" the young patients with cortisone and antihistamines, and carefully regulated the allergen dose, they could give each child six shots in each arm within a two-and-a-half hour period, increasing their tolerance for the allergen, and none of the patients suffered a severe life-threatening allergic reaction.

And the researchers were able to compress the initial phase of inoculations from eight months to two months, they said.

Further, the children experienced relief much faster than with CAV and were much more likely to adhere to the vaccine regimen until it was completed several years later, Smits said.

"Contrary to what everyone thinks, there is a way to do this safely, with pre-medication and lowering the target, end-point dosage," he said.

The latter is the key, he said. Previous studies of Rapid Allergen Vaccination had found the majority of the harmful reactions occurred at the end of the initial phase of treatment, when the patient received his or her final, high dose that was maintained for the rest of the therapy. By stopping just before that time, and having patients have those last shots over a two-month period, there were no life-threatening reactions, Smits said.

For the study, Smits and his colleagues treated 148 children between the ages of 1 and 18, with a median age of between 10 and 12. Eighty-eight of the participants were male and 60 were female. They received cortisone and antihistamines for three days prior to Rapid Allergen Vaccination. During the procedure, eight patients suffered reactions like a runny nose or allergy symptoms and were treated safely. Every patient who received RAV was discharged after two hours, and none experienced a life-threatening allergic reaction.

Smits has been using RAV with his patients for about five years and treats about 75 percent of them -- adults and children -- that way, rather than with conventional immunotherapy.

"It costs less, incidents of illness are reduced, and people see results more quickly," Smits said. And, he added, compliance rates after a year are nearly 80 percent, compared to about 50 percent with Conventional Allergen Vaccination.

Several allergists contacted by HealthDay declined to comment on Smits' research, saying they were unfamiliar with it.

More information

For more on allergies, visit the National Institute of Allergy and Infectious Diseases.

SOURCES: William Smits, M.D., associate professor, Indiana University School of Medicine, Fort Wayne, Ind; Nov. 15, 2004, presentation, American College of Allergy, Asthma & Immunology annual meeting, Boston
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