| ive Myself Immunotherapy by Intentionally | | | | discontinuing immunotherapy. Therefore, the decision |
| Being Exposed to the Allergen? | | | | to stop immunotherapy is an individual one, after |
| No, if you are allergic to a substance such as Chinese | | | | consulting with your allergist/immunologist. |
| elm, you will not overcome your allergy by | | | | Are There Risks or Side Effects? |
| repeatedly inhaling Chinese elm pollen into your nose | | | | A report from the Mayo Clinic on 79,593 |
| or lungs. So then, how can a series of injections | | | | immunotherapy injections over a 10-year period |
| allergen relieve your allergy symptoms? | | | | showed the incidence of adverse reactions to be less |
| Allergen immunotherapy is almost like a vaccine. Your | | | | than two-tenths of 1 percent (0.137 percent). Most |
| body responds to the injected amounts of a | | | | of these reactions were mild and responded to |
| particular allergen, given in gradually increasing doses, | | | | immediate medical treatment. There were no |
| by developing an immunity or tolerance to the | | | | fatalities. |
| allergen(s). | | | | However, it is possible to have an adverse reaction. |
| As a result of these immune changes, | | | | There are two types of reactions that can occur |
| immunotherapy can lead to decreased, minimal or no | | | | with immunotherapy: local and/or systemic reactions. |
| allergy symptoms when you are exposed to the | | | | Local reactions are relatively common and can show |
| allergen(s) included in the allergy vaccine. | | | | up as redness and swelling at the injection site. This |
| What is the Immunotherapy Process? | | | | may happen immediately, or a few hours after the |
| There generally are two phases to immunotherapy: a | | | | treatment. |
| build-up phase and a maintenance phase. | | | | Systemic reactions are much less common. Systemic |
| Build-up phase is the initial period of receiving | | | | reactions are usually mild and respond rapidly to |
| injections with increasing amounts of the allergens. | | | | medications. Symptoms can include increased allergy |
| The frequency of injections during this phase | | | | symptoms such as sneezing, nasal congestion or |
| generally ranges from 1 to 2 times a week. The | | | | hives. Rarely, a serious systemic reaction, called |
| duration of this phase depends on the frequency of | | | | anaphylaxis, can develop after an immunotherapy |
| the injections but generally ranges from 3 to 6 | | | | injection. In addition to the symptoms associated |
| months. | | | | with a mild systemic reaction, symptoms of an |
| Maintenance phase begins when the effective | | | | anaphylactic reaction can include swelling in the throat, |
| therapeutic dose has been reached. The effective | | | | wheezing or a sensation of tightness in the chest, |
| maintenance dose is different for each person, | | | | nausea, dizziness or other symptoms. Systemic |
| depending on individual sensitivity (how allergic | | | | reactions require immediate treatment. Most serious |
| they are' to the vaccine) and their response to the | | | | systemic reactions develop within 30 minutes of the |
| immunotherapy build-up phase. Once the maintenance | | | | allergy injections and this is why it is usually |
| dose is reached, there will be longer periods of time | | | | recommended that you wait in the office for 30 |
| between immunotherapy treatments. The intervals | | | | minutes after your allergy injections. It is for your |
| between maintenance injections, generally ranges | | | | own safety. Allergist/immunologists are trained to |
| from every 2 to 4 weeks. Your allergist/immunologist | | | | monitor for reactions, as is members of his or her |
| will determine what range is most appropriate for | | | | staff able to identify and treat systemic reactions. |
| you. | | | | Guidelines for safe and effective immunotherapy |
| Reduced allergy symptoms are not normally | | | | Although side effects are rare, the American College |
| immediate or dramatic. Improvement with | | | | of Allergy, Asthma & Immunology offers the |
| immunotherapy is usually a progressive, cumulative | | | | following guidelines to ensure the safety of any |
| effect that happens slowly throughout the | | | | patient receiving immunotherapy: |
| immunotherapy treatment period. Effectiveness of | | | | Only an allergist/immunologist or other physician who |
| immunotherapy appears to be related to length of | | | | is expertly trained in the therapy should prescribe |
| treatment and the dose of the allergen. | | | | immunotherapy. |
| Does Immunotherapy Ever Fail? | | | | Immunotherapy should be administered under the |
| Most individuals receive at least some benefit from | | | | supervision of an allergist-immunologist or other |
| the treatment. However, it is 100% guaranteed to be | | | | physician specifically trained in immunotherapy, the |
| effective for everyone. Failure to respond to | | | | early signs and symptoms of anaphylaxis, and |
| immunotherapy may be due to several factors | | | | appropriate emergency procedures and medications. |
| including: | | | | Patients must be suitably selected for |
| Inadequate dose of allergen in the allergy vaccine. | | | | immunotherapy. Immunotherapy should be given only |
| Missing allergens not identified during the allergy | | | | in facilities equipped to treat anaphylaxis. The health |
| evaluation. | | | | status of the patient should be evaluated prior to |
| High levels of allergen in environment (i.e. inadequate | | | | every injection. Patients who are acutely ill, especially |
| environmental control). | | | | with asthma or respiratory difficulties, should not |
| Significant exposure to non-allergic triggers (i.e. | | | | receive immunotherapy until their disease is stabilized. |
| tobacco smoke). | | | | Patients should always be asked about current |
| If there is no improvement after a year of | | | | medications prior to immunotherapy, to avoid |
| maintenance immunotherapy, possible reasons for | | | | interactions with beta-blockers and other conflicting |
| failure to respond should be explored. If no apparent | | | | medications. Patients must wait at the health care |
| reason is found then discontinuation of | | | | facility a minimum of 20 minutes after an allergen |
| immunotherapy should be considered and other | | | | injection. The time period may be extended for |
| treatment options should be pursued. | | | | high-risk patients. |
| How Long Does Immunotherapy Last? | | | | Who Decides If a Patient Should Receive |
| When immunotherapy happens successfully, | | | | Immunotherapy Treatment? |
| maintenance treatment is generally lasts around 3 to | | | | Ultimately the decision about whether or not to |
| 5 years. The decision to stop immunotherapy should | | | | receive immunology treatment is up to the individual |
| be thoroughly discussed with your allergist | | | | and their family, although the allergist has the |
| immunologist after 3 to 5 years of treatment. Some | | | | expertise to help his or her patient understand what |
| individuals may experience long-lasting remission of | | | | options are most appropriate according to their |
| their symptoms, but others may relapse after | | | | individual needs. |