Safety and treatment compliance of subcutaneous immunotherapy: A 30-year retrospective study.
AIT
Allergy
Anaphylaxis
Side effects
Vaccine
Journal
Respiratory medicine
ISSN: 1532-3064
Titre abrégé: Respir Med
Pays: England
ID NLM: 8908438
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
03
07
2019
revised:
08
11
2019
accepted:
19
11
2019
pubmed:
30
11
2019
medline:
9
9
2020
entrez:
29
11
2019
Statut:
ppublish
Résumé
Safety and treatment compliance are still considered important shortcomings of subcutaneous immunotherapy (SCIT). To assess the rate of side effects (SE) to SCIT and treatment compliance at a hospital medically supervised facility. A retrospective review of patients with allergic rhino-conjunctivitis (ARC) with or without asthma, who received SCIT to mites and pollens from 1988 to 2018, was performed. The information was collected from patient's allergen immunotherapy forms that had been prospectically filled in by expert physicians. Two thousand two hundred patients (50.2% males; mean age 29.4 ± 11.7 years) received 3037 SCIT courses. A total of 91,187 injections were given, with a mean SCIT duration of 2.5 ± 1.9 years. Nine hundred fifty-seven patients (43.5%) were compliant as they completed the minimally required treatment duration of 3 years. A total of 1087 SE (1.2% of all injections; 76.8% local reactions) were reported in 513 patients (23.3%). There were 42 anaphylactic reactions (in 29 patients) during the study period; two of these were severe. Adrenalin was administered only once. No anaphylactic shock was reported. Only 39 patients (1.8%) discontinued SCIT because of SE, the majority of whom (24; 61.5%) because of systemic reactions (urticaria, asthma, anaphylaxis). Parietaria vaccines were the most frequently associated to SE. Female gender, number of vaccines administered (2 vaccine vs. 1 vaccine) and year of SCIT inception (1996-2018 vs. 1988-1995) were independently associated to SE. SCIT, although not absolutely free of risk, is safe and well tolerated. There is still room for improvement of treatment compliance.
Sections du résumé
BACKGROUND
Safety and treatment compliance are still considered important shortcomings of subcutaneous immunotherapy (SCIT).
OBJECTIVE
To assess the rate of side effects (SE) to SCIT and treatment compliance at a hospital medically supervised facility.
METHODS
A retrospective review of patients with allergic rhino-conjunctivitis (ARC) with or without asthma, who received SCIT to mites and pollens from 1988 to 2018, was performed. The information was collected from patient's allergen immunotherapy forms that had been prospectically filled in by expert physicians.
RESULTS
Two thousand two hundred patients (50.2% males; mean age 29.4 ± 11.7 years) received 3037 SCIT courses. A total of 91,187 injections were given, with a mean SCIT duration of 2.5 ± 1.9 years. Nine hundred fifty-seven patients (43.5%) were compliant as they completed the minimally required treatment duration of 3 years. A total of 1087 SE (1.2% of all injections; 76.8% local reactions) were reported in 513 patients (23.3%). There were 42 anaphylactic reactions (in 29 patients) during the study period; two of these were severe. Adrenalin was administered only once. No anaphylactic shock was reported. Only 39 patients (1.8%) discontinued SCIT because of SE, the majority of whom (24; 61.5%) because of systemic reactions (urticaria, asthma, anaphylaxis). Parietaria vaccines were the most frequently associated to SE. Female gender, number of vaccines administered (2 vaccine vs. 1 vaccine) and year of SCIT inception (1996-2018 vs. 1988-1995) were independently associated to SE.
CONCLUSION
SCIT, although not absolutely free of risk, is safe and well tolerated. There is still room for improvement of treatment compliance.
Identifiants
pubmed: 31778936
pii: S0954-6111(19)30357-9
doi: 10.1016/j.rmed.2019.105843
pii:
doi:
Substances chimiques
Vaccines
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
105843Investigateurs
Giuseppe Bariletto
(G)
Annamaria Carbonara
(A)
Vito Cataldo
(V)
Elisabetta Damiani
(E)
Elisabetta Di Leo
(E)
Irene Fiorino
(I)
Georgios Kourtis
(G)
Valentina Laudadio
(V)
Filomena Loconte
(F)
Anita Lotti
(A)
Enza Mastromarco
(E)
Saverio Nenna
(S)
Andrea Nico
(A)
Maria Pietrafesa
(M)
Anna Simona Rucco
(AS)
Silvana Strada
(S)
Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest We declare that we have no conflict of interest.