Rush immunotherapy with multiple aeroallergens is safe in an adult population

Abstract

Background: The safety of rush subcutaneous immunotherapy (SCIT) to multiple aeroallergens has not been widely studied. The objectives of this retrospective study were to evaluate the incidence of adverse reactions of a rush immunotherapy scheme with five injections at the first day with different allergens in adult patients with allergic rhinitis with or without asthma. All patients took an antihistamine before the start of the first injection of the rush scheme. Methods: adverse reactions were analysed in a prospectively recorded database of 232 rush SCIT treatments with tree pollen, given to 138 patients with allergic rhinoconjunctivitis (61 (44%) male), mean age 31 years old ( 9-57), 45 (33%) with concomitant asthma, and 28 (20%) with eczema. Results: Systemic adverse reactions (gr 1-2) were reported 7 times (3%), one patient on house dust mite (HDM) complained of shortness of breath and had a reduction in peak expiratory flow (PEF) of 10% (gr 2). The other 6 patients (4 on HDM and 2 on GP) complained of mild upper respiratory symptoms mostly itchy throat. Four of the 7 participants who had systemic adverse reactions, had also received at least one rush SCIT with another allergen in the week before. A local reaction (with redness and swelling) was reported in 13 patients. Two HDM SCIT rushes were aborted, and patients proceeded on a conventional schedule. Conclusion: Rush SCIT with 5 injections on the first day of the treatment does not give more adverse reactions than what is usually reported with conventional immunotherapy.

Keywords

• immunotherapy
• rush immunotherapy
• allergic rhinitis
• allergic rhinoxonjunctivitis
• treatment
• adverse reactions
• systemic
• local reaction