BACKGROUND: Little data in the literature exist concerning patients with certain underlying medical conditions who receive allergen subcutaneous immunotherapy (SCIT). OBJECTIVE: To survey allergists' experience with SCIT in patients with medical conditions considered to impose an elevated risk for untoward outcomes. METHODS: A Web-based survey was conducted among members of the American Academy of Allergy, Asthma & Immunology to query about their experience with SCIT in patients with certain medical conditions. RESULTS: There were 1085 replies (21% response), of whom, 86% were U.S. based, 51% were suburban, 31% were academic, 42% were medium-sized practices, and 54% had >15 years' experience. In responders' opinion, SCIT was "contraindicated" in patients with the following: acquired immune deficiency syndrome (AIDS) (48%), cancer (and still receiving active treatment) (33%), severe asthma (32%), and a history of transplantation (30%). Even so, survey responders collectively gave SCIT to >2400 patients for each of these conditions: severe asthma, coronary artery disease, cancer in remission, and autoimmune disorders; and to ≥5400 patients with hypertension and ≥4100 women who became pregnant. The experience of colleagues with these patients rarely resulted in major problems (i.e., activation of underlying disease, systemic reactions to SCIT, or SCIT discontinuation), with the exception of severe asthma (12.5%), initiation of SCIT during pregnancy (5.4%), and AIDS (4.2%). For most other conditions, it was ≤1.5% (e.g., continue during pregnancy, cancer in remission, history of transplantation, positive human immunodeficiency virus and no AIDS). CONCLUSION: According to the experience of a large group of practicing allergists, the American Academy of Allergy, Asthma & Immunology members, few medical conditions seemed to pose an elevated risk for untoward outcomes from SCIT. Because these are survey results, prospective research might yield even more solid data.
BACKGROUND: Little data in the literature exist concerning patients with certain underlying medical conditions who receive allergen subcutaneous immunotherapy (SCIT). OBJECTIVE: To survey allergists' experience with SCIT in patients with medical conditions considered to impose an elevated risk for untoward outcomes. METHODS: A Web-based survey was conducted among members of the American Academy of Allergy, Asthma & Immunology to query about their experience with SCIT in patients with certain medical conditions. RESULTS: There were 1085 replies (21% response), of whom, 86% were U.S. based, 51% were suburban, 31% were academic, 42% were medium-sized practices, and 54% had >15 years' experience. In responders' opinion, SCIT was "contraindicated" in patients with the following: acquired immune deficiency syndrome (AIDS) (48%), cancer (and still receiving active treatment) (33%), severe asthma (32%), and a history of transplantation (30%). Even so, survey responders collectively gave SCIT to >2400 patients for each of these conditions: severe asthma, coronary artery disease, cancer in remission, and autoimmune disorders; and to ≥5400 patients with hypertension and ≥4100 women who became pregnant. The experience of colleagues with these patients rarely resulted in major problems (i.e., activation of underlying disease, systemic reactions to SCIT, or SCIT discontinuation), with the exception of severe asthma (12.5%), initiation of SCIT during pregnancy (5.4%), and AIDS (4.2%). For most other conditions, it was ≤1.5% (e.g., continue during pregnancy, cancer in remission, history of transplantation, positive human immunodeficiency virus and no AIDS). CONCLUSION: According to the experience of a large group of practicing allergists, the American Academy of Allergy, Asthma & Immunology members, few medical conditions seemed to pose an elevated risk for untoward outcomes from SCIT. Because these are survey results, prospective research might yield even more solid data.
Authors: Désirée Larenas-Linnemann; Noel Rodríguez-Pérez; Jorge A Luna-Pech; Mónica Rodríguez-González; María Virginia Blandón-Vijil; Blanca E Del-Río-Navarro; María Del Carmen Costa-Domínguez; Elsy Maureen Navarrete-Rodríguez; Carlos Macouzet-Sánchez; José Antonio Ortega-Martell; César Fireth Pozo-Beltrán; Alan Estrada-Cardona; Alfredo Arias-Cruz; Karen Guadalupe Rodríguez Galván; Herson Brito-Díaz; María Del Rosario Canseco-Raymundo; Enrique Emanuel Castelán-Chávez; Alberto José Escalante-Domínguez; José Luis Gálvez-Romero; Javier Gómez-Vera; Sandra Nora González-Díaz; María Gracia Belinda Guerrero-Núñez; Dante Daniel Hernández-Colín; Alejandra Macías-Weinmann; David Alejandro Mendoza-Hernández; Néstor Alejandro Meneses-Sánchez; María Dolores Mogica-Martínez; Carol Vivian Moncayo-Coello; Juan Manuel Montiel-Herrera; Patricia María O'Farril-Romanillos; Ernesto Onuma-Takane; Margarita Ortega-Cisneros; Lorena Rangel-Garza; Héctor Stone-Aguilar; Carlos Torres-Lozano; Edna Venegas-Montoya; Guillermo Wakida-Kusunoki; Armando Partida-Gaytán; Aída Inés López-García; Ana Paola Macías-Robles; María de Jesús Ambriz-Moreno; Amyra Ali Azamar-Jácome; Claudia Yusdivia Beltrán-De Paz; Chrystopherson Caballero-López; Juan Carlos Fernández de Córdova-Aguirre; José Roberto Fernández-Soto; José Santos Lozano-Sáenz; José Joel Oyoqui-Flores; Roberto Efrain Osorio-Escamilla; Fernando Ramírez-Jiménez; Daniela Rivero-Yeverino; Eric Martínez Infante; Miguel Alejandro Medina-Ávalos Journal: World Allergy Organ J Date: 2020-08-21 Impact factor: 4.084
Authors: C Pitsios; M Tsoumani; M B Bilò; G J Sturm; P Rodríguez Del Río; R Gawlik; F Ruëff; G Paraskevopoulos; E Valovirta; O Pfaar; M A Calderón; P Demoly Journal: Clin Transl Allergy Date: 2019-09-11 Impact factor: 5.871