Thursday, April 27, 2006

Allergy shots

I don't keep up with the non-pulmonary allergy literature as I should. I often see atopic patients with or without true asthma who have allergy testing and then are started on allergy shots for desensitization. I have just seen someone who has been getting those three times a week for the past 6 years.
How often do you use allergy testing or shots in your practice? Any good literature on that in pulmonary practice?

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Anonymous said...

I know this is an old post but I just found this blog recently. I am trained and boarded in pulmonary and allergy. In patients with mild to moderate asthma who also have a significant component of allergic rhinitis, allergen specific immunotherapy (SIT) can be beneficial. The Cochrane database has reviewed this topic here;

Regarding the patient you mention. According to the AAAAI guidlines, maintenance SIT can be given every 2-4 weeks and maximal benefit is provided after 3-5 years of maintenance therapy. Unfortunately I am very skeptical of many of my colleagues out in practice. I have often seen patients who are being under dosed with IT. While this significantly reduces the risk of a systemic reactions it also reduces the effectiveness of SIT. Someone who is getting SIT 3x/week for 6 years is very suspicious. While even lower than optimal dosing may have some benefit with regards to allergic rhinitis symptoms it is unlikely they will be long-lasting and I can't explain why in your patient, the shots are given 3x/week.