Allergy immunotherapy: Indications, efficacy, and safety

Although many effective pharmacological therapies are available for patients with allergies, only allergen-specific immunotherapy has been shown to have significant and long-lasting therapeutic and immunomodulatory effects in the management of allergic rhinitis, allergic asthma, and venom hypersensitivity. Standard allergen immunotherapy consists of subcutaneous injections of relevant allergens. It requires a buildup phase during which the dose of the vaccine is increased until a therapeutic (maintenance) level is achieved. This maintenance dose is usually continued for 3 to 5 years, and most patients continue to do well after injections are discontinued. Most patients tolerate immunotherapy well, but local reactions are not uncommon. Immunotherapy should be administered only in a physician s office, because some patients may experience systemic anaphylactic reactions requiring immediate therapy. Even with newer therapies on the horizon, allergen immunotherapy will continue to have an important role in the treatment of allergic diseases.