Local and Systemic Reactions due to Subcutaneous Allergen Immunotherapy: Our Single-Center 5-Year Experience

Year 2022, Volume: 17 Issue: 1, 1 - 8, 21.03.2022

Gökhan Aytekin , Eray Yıldız , Fatih Çölkesen , Şevket Arslan , Ahmet Çalışkaner

https://doi.org/10.17517/ksutfd.839958

Cited By: 1

Abstract

Aim: Subcutaneous allergen immunotherapy (SCIT) currently represents the only disease-modifying therapeutic option for the treatment of allergic rhinitis/conjunctivitis, asthma, and venom sensitization. Although SCIT represents a fairly safe therapeutic option in the hands of experienced physicians and centers, it may also be associated with certain adverse effects. In this study, we describe the local and systemic adverse effects in our adult patients undergoing immunotherapy over a 5-year period in an effort to define the causative factors.
Materials and Methods: A total of 4413 injections administered to 119 patients (58 female, 61 male) were analyzed.
Results: A total of 119 patients with a mean age of 33.7 ± 12 years were included (Female: 58, 48%; Male: 61, 51.3%). In the total population of 119 patients, 6 (5%) developed local reactions, 21 (17.7%) developed large local reactions, and 9 (7.6%) had systemic reactions. Of all injections administered throughout the study period, 0.14% were associated with local reactions, 0.48% with large local reactions, and 0.20% with systemic reactions. Four patients with systemic reactions (44.4%) required epinephrine injection. Patients who did or did not develop adverse effects were significantly different with regard to IgE levels and eosinophil counts (p=0.001 and p=0.002). There was a significant difference between the rates of total adverse reactions developing during the build-up or maintenance phase (p=0.025).
Conclusion: Clinicians’ awareness regarding the local, large local, and systemic reactions associated with SCIT should be improved, and clinicians should be more careful during the immunotherapy, especially in the build-up phase, for adverse events.

Keywords

allergen immunotherapy, adverse reactions, anaphylaxis, venom

Supporting Institution

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Project Number

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Thanks

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Subkutan Allergen İmmunoterapiye Bağlı Lokal ve Sistemik Reaksiyonlar: 5 yıllık Tek Merkez Deneyimimiz

Abstract

Amaç: Subkutan alerjen immünoterapisi (SKIT) alerjik rinit / konjonktivit, astım ve venom duyarlılığının tedavisi için hastalık modifiye edici tek terapötik seçenektir. SKIT, deneyimli merkezlerde ve deneyimli hekimlerince uygulandığında oldukça güvenli bir tedavi yöntemi olsa da, enjeksiyonlar sırasında veya sonrasında bazı olumsuz yan etkilere ve lokal veya sistemik reaksiyonlara neden olabilir. Biz bu çalışmada, son 5 yılda, immünoterapi uygulanan yetişkin hastalarımızda gelişen lokal ve sistemik yan etkileri tanımlamayı ve bu yan etkilere neden olan faktörleri ortaya koymayı amaçladık.
Gereç ve Yöntemler: 5 yıllık sürede, 119 hastaya (58 kadın, 61 erkek) uygulanan toplam 4413 enjeksiyon analiz edildi.
Bulgular: Yaş ortalaması 33.7 ± 12.0 yıl olan toplam 119 hasta çalışmaya dahil edildi (Kadın: 58, % 48; Erkek: 61, % 51.3). 119 hastalık çalışma popülasyonunun, 6'sında (% 5.0) lokal reaksiyonlar, 21'inde (% 17.7) geniş lokal reaksiyon ve 9'unda (% 7.6) sistemik reaksiyon gelişti. Tüm enjeksiyonların % 0.14'ü lokal reaksiyon, % 0.48'i geniş lokal reaksiyon ve % 0.20'si sistemik reaksiyonla ilişkiliydi. Sistemik reaksiyon gelişen dört hastada (% 44.4) epinefrin uygulaması gerekti. Yan etki gelişen veya gelişmeyen hastalar arasında IgE düzeyleri ve eozinofil sayıları açısından anlamlı fark vardı (p = 0.001 ve p = 0.002). Doz artış döneminde ve idame aşamasında gelişen advers reaksiyon oranları arasında anlamlı bir fark vardı (p = 0.025).
Sonuç: Klinisyenlerin, SKIT ile ilişkili lokal, geniş lokal ve sistemik reaksiyonlarla ilgili farkındalığı arttırılmalı ve klinisyenler özellikle doz artışı döneminde adverse olaylar açısından daha dikkatli olmalıdır.

Keywords

allerjen immünoterapi, advers reaksiyon, anafilaksi, venom

Project Number

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