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Incidence and risk factors for subcutaneous immunotherapy anaphylaxis: the optimization of safety

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References

  • Fitzhugh DJ, Lockey RF. Allergen immunotherapy: a history of the first 100 years. Curr Opin Allergy Clin Immunol 2011;11:554-9
  • Makatsori M, Calderon MA. Anaphylaxis: still a ghost behind allergen immunotherapy. Curr Opin Allergy Clin Immunol 2014;14:316-22
  • Epstein TG, Liss GM, Murphy-Berendts K, Bernstein DI. AAAAI/ACAAI surveillance study of subcutaneous immunotherapy, years 2008-2012: an update on fatal and nonfatal systemic allergic reactions. J Allergy Clin Immunol Pract 2014;2:161-7
  • Zuberbier T, Bachert C, Bousquet PJ, et al. GA² LEN/EAACI pocket guide for allergen-specific immunotherapy for allergic rhinitis and asthma. Allergy 2010;65:1525-30
  • Cox L, Nelson H, Lockey R, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol 2011;127:1-55
  • Epstein TG, Liss GM, Murphy-Berendts K, Bernstein DI. AAAAI and ACAAI surveillance study of subcutaneous Immunotherapy, Year 3: what practices modify the risk of systematic reactions? Ann Allergy Asthma Immunol 2013;110:274-8
  • Frankland A, Augustin R. Prophylaxis of summer hay fever and asthma: a controlled trial comparing crude grass pollen extract with the isolated main protein components. Lancet 1954;266:1055-8
  • Passalacqua G, Canonica GW. Specific immunotherapy in asthma: efficacy and safety. Clin Exp Allergy 2011;41:1247-55
  • Kim JM, Lin SY, Suarez-Cuervo C, et al. Allergen-specific immunotherapy for pediatric asthma and rhinoconjunctivitis: a systematic review. Pediatrics 2013;131:1155-67
  • Cox L, Larenas-Linnemann D, Lockey RF, Passalacqua G. Speaking the same language: the World Allergy Organization Subcutaneous Immunotherapy Systemic Reaction Grading System. J Allergy Clin Immunol 2010;125:569-74
  • Malling H, Weeke B. Immunotherapy. Position Paper of the European Academy of Allergy and Clinical Immunology. Allergy 1993;48:9-35
  • Calderon MA, Alves B, Jacobson M, et al. Allergen injection immunotherapy for seasonal allergic rhinitis. Cochrane Database Syst Rev 2007;1:CD001936
  • Erekosima N, Suarez-Cuervo C, Ramanathan M, et al. Effectiveness of subcutaneous immunotherapy for allergic rhinoconjunctivitis and asthma: a systematic review. Laryngoscope 2014;124:616-27
  • Malling HJ, Dreborg S, Weeke B. Diagnosis and immunotherapy of mould allergy. V. Clinical efficacy and side effects of immunotherapy with Cladosporium herbarum. Allergy 1986;41:507-19
  • Varney VA, Gaga M, Frew AJ, et al. Usefulness of immunotherapy in patients with severe summer hay fever uncontrolled by antiallergic drugs. BMJ 1991;302:265-9
  • Tabar AI, Arroabarren E, Echechipía S, et al. Three years of specific immunotherapy may be sufficient in house dust mite respiratory allergy. J Allergy Clin Immunol 2011;127:57-63
  • Ewan PW, Alexander MM, Snape C, et al. Effective hyposensitization in allergic rhinitis using a potent partially purified extract of house dust mite. Clin Allergy 1988;18:501-8
  • Bousquet J, Schünemann HJ, Bousquet PJ, et al. How to design and evaluate randomized controlled trials in immunotherapy for allergic rhinitis: an ARIA-GA(2) LEN statement. Allergy 2011;66:765-74
  • Bousquet PJ, Demoly P, Passalacqua G, et al. Immunotherapy: clinical trials–optimal trial and clinical outcomes. Curr Opin Allergy Clin Immunol 2007;7:561-6
  • Frew AJ, Powell RJ, Corrigan CJ, Durham SR; UK Immunotherapy Study Group. Efficacy and safety of specific immunotherapy with SQ allergen extract in treatment-resistant seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol 2006;117:319-25
  • Dolz I, Martínez-Cócera C, Bartolomé JM, Cimarra M. A double-blind, placebo-controlled study of immunotherapy with grass-pollen extract Alutard SQ during a 3-year period with initial rush immunotherapy. Allergy 1996;51:489-500
  • Bousquet J, Calvayrac P, Guérin B, et al. Immunotherapy with a standardized Dermatophagoides pteronyssinus extract. I. In vivo and in vitro parameters after a short course of treatment. J Allergy Clin Immunol 1985;76:734-44
  • Eifan AO, Akkoc T, Yildiz A, et al. Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial. Clin Exp Allergy 2010;40:922-32
  • Committee on the Safety of Medicines (CSM) in Great Britain. CSM update: desensitising vaccines. Br Med J (Clin Res Ed) 1986;293:948
  • Lockey RF, Benedict LM, Turkeltaub PC, Bukantz SC. Fatalities from immunotherapy and skin testing. J Allergy Clin Immunol 1987;79:660-77
  • Reid MJ, Lockey RF, Turkeltaub PC, Platt-Mills TA. Survey of fatalities from skin testing and immunotherapy. J Allergy Clin Immunol 1993;92:615
  • Bernstein DI, Wanner M, Borish L, et al. Twelve years of survey of fatal reactions to allergen injections and skin testing: 1990-2001. J Allergy Clin Immunol 2004;113:1129-36
  • Moreno C, Cuesta-Herraz J, Fernández-Távora L, et al. Immunotherapy Safety: a prospective multi-centric monitoring study of biologically standardized therapeutic vaccines for allergic disease. Clin Exp Allergy 2004;34:527-31
  • Dursun AB, Oner SF, Misirligil Z. The safety of allergy immunotherapy (IT) in Turkey. J Allergy Clin Immunol 2006;16:123-8
  • Schiappoli M, Ridolo E, Senna G, et al. A prospective Italian survey on the safety of subcutaneous immunotherapy for respiratory allergy. Clin Exp Allergy 2009;39:1569-74
  • Worm M, Moneret-Vautrin A, Scherer K, et al. First European data from the network of severe allergic reactions (NORA). Allergy 2014;69:1397-404
  • Passalacqua G. The use of single versus multiple antigens in specific allergen immunotherapy for allergic rhinitis: review of the evidence. Curr Opin Allergy Clin Immunol 2014;14:20-4
  • Cox L, Aaronson D, Casale TB, et al. Allergy immunotherapy safety: location matters!. J Allergy Clin Immunol Pract 2013;1:455-7
  • Rank MA, Bernstein DI. Improving the safety of immunotherapy. J Allergy Clin Immunol Pract 2014;2:131-5
  • Bernstein DI, Epstein T, Murphy-Berendts K. Surveillance of reactions to subcutaneous immunotherapy injections: year 1 outcomes of the ACAAI and AAAAI collaborative study. Anna Annals Asthma Immunol 2010;104:530-5
  • Kannan JA, Epstein T. Immunotherapy safety: what have to learned from surveillance surveys? Curr Allergy Asthma Rep 2013;13:381-8
  • Winther L, Arnved J, Malling HJ, et al. Side effects of allergen specific immunotherapy. A prospective multi centre-study. Clin Exp Allergy 2006;36:254-60
  • Amin HS, Liss GM, Bernstein DI. Evaluation of near fatal reactions to allergen immunotherapy injections. J Allergy Clin Immunol 2006;117:169-75
  • Rank MA, Oslie CL. Allergen immunotherapy safety: characterizing systemic reactions and identifying factors. Allergy Asthma Proc 2008;29:400-5
  • Zeldin Y, Weiler Z, Magen E, et al. Safety and efficacy of allergen immunotherapy in the treatment of allergic rhinitis and asthma in real life. Isr Med Assoc J 2008;10:869-72
  • Alvarez-Cuesta E, Bousquet J, Canonica GW, et al. Standards for practical allergen immunotherapy. Allergy 2006;61:1-20
  • Mellerup MT, Han GW, Poulsen LK, Malling H. Safety of allergen-specific immunotherapy. Relation between dosage regimen, allergen extract, disease and systemic side-effects during induction treatment. Clin Exp Allergy 2000;30:1423-9
  • Winther L, Malling HJ, Mosbech H. Allergen specific immunotherapy in birch and grass pollen allergic rhinitis. II. Side-effects. Allergy 2002;55:827-35
  • Gastamiza G, Algorta J, Audicana M, et al. Systemic reactions to immunotherapy: influence of allergology of composition and manufacturer. Clin Exp Allergy 2003;33:470-4
  • Mosbech H, Muller U. Side effects of insect venom immunotherapy with standardized: results from an EAACI multicenter study. European academy of allergology and clinical immunology. Allergy 2000;55:1005-10
  • Kim L, Nevis I, Potts R, et al. Patient on subcutaneous allergen immunotherapy are at risk of intramuscolar injections. Allergy Asthma Clin Immunol 2014;10:22
  • Lieberman P. The risk and management of anaphylaxis in the setting of immunotherapy. Am J Rhinol Allergy 2012;26:469-74
  • Confino-Cohen R, Golberg A. Allergen immunotherapy induced biphasic system reactions: incidence, characteristics and outcome: a prospective study. Ann Allergy Asthma Immunol 2010;104:73-8
  • Stokes JR, Casale TB. Allergic rhinitis and asthma: celebrating 100 years of immunotherapy. Curr Opin Immunol 2011;23:808-81
  • Bousquet J, Lockey R, Malling HJ. Allergen immunotherapy: therapeutic vaccines for allergic diseases. A WHO position paper. J Allergy Clin Immunol 1998;102:558-62
  • More DR, Hagan LL. Factors affecting compliance with allergen immunotherapy at a military medical center. Ann Allergy Asthma Immunol 2002;88:391-4
  • Cox L, Compalati E, Kundig T, Larche M. New directions in immunotherapy. Curr Allergy Asthma Rep 2013;13:178-95
  • Fernandez-Tavora L, Justicia JL, Moreno C, et al. Safety evaluation of rapid build-up schedules with IR-standardized allergen extracts for subcutaneous immunotherapy of allergic respiratory diseases. Expert Opin Drug Safety 2010;10:947-55
  • Cox L. Accelerated immunotherapy schedules: review of efficacy and safety. Ann Allergy Asthma Immunol 2006;97:126-37
  • Pfaar O, Leitzbach S, Hormann K, Klimek L. Cluster protocols in SCIT: enough evidence for practical use? Curr Opin Allergy Clin Immunol 2010;10:188-93
  • Bernstein DI, Epstein T. Systemic reactions to subcutaneous allergen immunotherapy. Immunol Allergy Clin North Am 2011;31:241-9
  • Serrano P, Justicia JL, Sanchez C, et al. Systemic tolerability of specific subcutaneous immunotherapy with index-of-reactivity-standardized allergen extracts administered using clustered regimens: a retrospective, observational, multicenter study. Ann Allergy Asthma Immunol 2009;102:247-52
  • Gorska L, Chelminska M, Kuziemski K, et al. Analysis of safety, risk factors and pretreatment methods during rush hymenoptera venom immunotherapy. Int Arch Allergy Immunol 2008;147:241-5
  • Harvey SM, Laurie S, Hilton K, Khan DA. Safety of rush immunotherapy to multiple aeroallergens in an adult population. Ann Allergy Asthma Immunol 2004;92:414-18
  • Temiño VM, Wu P, Konig J, Fahrenholz JM. Safety of multiple aeroallergen rush immunotherapy using a modified schedule. Allergy Asthma Proc 2013;34:255-60
  • Sharkey P, Portnoy J. Rush immunotherapy: experience with a one-day schedule. Ann Allergy Asthma Immunol 1996;76(2):175-80
  • Smits WL, Giese JK, Letz KL, et al. Safety of rush immunotherapy using a modified schedule: a cumulative experience of 893 patients receiving multiple aeroallergens. Allergy Asthma Proc 2007;28:305-9
  • Smith WA, Hales BJ, Jarnicki AG, et al. Allergens of wild house dust mites: environmental Der p 1 and Der p 2 sequence polymorphisms. J Allergy Clin Immunol 2001;107:985-92
  • Kahlert H, Grage-Griebenow E, Stüwe HT, et al. T cell reactivity with allergoids: influence of the type of APC. J Immunol 2000;165:1807-15
  • Lüderitz-Püchel U, Keller-Stanislawski B, Haustein D. Risk reevaluation of diagnostic and therapeutic allergen extracts: an analysis of adverse drug reactions from 1991 to 2000. Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitsschutz 2001;44:709-18
  • Subiza J, Feliu A, Subiza JL, et al. Cluster immunotherapy with a glutaraldehyde-modified mixture of grasses results in an improvement in specific nasal provocation tests in less than 2. 5 months of treatment. Clin Exp Allergy 2008;38:987-94
  • Casanovas M, Martin R, Jimenez C, et al. Safety of an ultra-rush immunotherapy build-up schedule with therapeutic vaccines containing depigmented and polymerized allergen extracts. Int Arch Allergy Immunol 2006;139:153-8
  • Brehler R, Klimek L, Pfaar O, et al. Safety of a rush immunotherapy build-up schedule with depigmented polymerized allergen extracts. Allergy Asthma Proc 2010;31:31-8
  • Fernandez-Tavora L, Moreno C, Martin S, et al. The optimal immunotherapy cluster schedule in clinical practice. J Investig Allergol Clin Immunol 2003;13:193-201
  • Serrano P, Algorta J, Martinez A, et al. Prospective safety study of immunotherapy administered in a cluster schedule. J Investig Allergol Clin Immunol 2004;14:312-19
  • Pfaar O, Mösges R, Hörmann K, Klimek L. Safety aspects of cluster-immunotherapy with semi-depot allergen extracts in seasonal allergic rhinoconjunctivitis. Eur Arch Otorhinolaryngol 2010;267:245-50
  • Casale TB, Stokes JR. Immunotherapy: what lies beyond. J Allergy Clin Immunol 2014;133:612-19
  • Powell RJ, Frew AJ, Corrigan CJ, et al. Effect of grass pollen immunotherapy with Alutard SQ on quality of life in seasonal allergic rhinoconjunctivitis. Allergy 2007;62:1335-8
  • Kramer MF, Heath MD. Aluminium in allergen-specific subcutaneous immunotherapy–a German perspective. Vaccine 2014;32(33):4140-8
  • CHMP Safety Working Party response to the PDCO regarding Aluminium Hydroxide contained in Allergen Products. (EMA/CHMP/381064/2010). Available from: www.ema.europa.eu/ [Last accessed 15 October 2014]
  • Rosewich M, Lee D, Zielen S. Pollinex Quattro: an innovative four injections immunotherapy in allergic rhinitis. Hum Vaccin Immunother 2013;9:1523-31
  • Patel P, Salapatek AM. Pollinex Quattro: a novel and well-tolerated, ultra short-course allergy vaccine. Expert Rev Vaccines 2006;5:617-29
  • Borgonovo L, Piconi S, Fusi A, et al. A case of anaphylaxis to Pollinex® Quattro MPL-4. Eur Ann Allergy Clin Immunol 2014;46:46-8
  • Lin MS, Tanner E, Lynn J, Friday GAJr. Nonfatal systemic allergic reactions induced by skin testing and immunotherapy. Ann Allergy 1993;71:557-62
  • Justicia JL, Barasona MJ, Serrano P, et al. Predicting patients at high-risk of systemic reactions to cluster allergen immunotherapy: a pilot prospective observational study. J Investig Allergol Clin Immunol 2007;17:386-92
  • Iglesias-Cadarso A, Hernandez-Weigand P, Reano M, et al. A prospective safety study of allergen immunotherapy in daily clinical practice. Allergol Immunopathol 2004;32:278-83
  • Da Veiga SP, Liu X, Caruso K, et al. Systemic reactions associated with subcutaneous allergen immunotherapy: timing and risk assessment. Ann Allergy Asthma Immunol 2011;106:533-7
  • Nichani JR, de Carpentier J. Safety of sublingual grass pollen immunotherapy after anaphylaxis. J Laryngol Otol 2009;123:683-4
  • Ridolo E, Montagni M, Bonzano L, et al. Arguing the misconceptions in allergen-specific immunotherapy. Immunotherapy 2014;6:587-95
  • Unsel M, Ardeniz FO, Mete N, et al. Are ACE inhibitors really safe in the patients receiving venom immunotherapy? Asthma Allergy Immunol 2012;101:100-3
  • Senna G, Caminati M, Canonica GW. Safety and tolerability of sublingual immunotherapy in clinical trials and real life. Curr Opin Allergy Clin Immunol 2013;13:656-62
  • Roy SR, Sigmon JR, Olivier J, et al. Increased frequency of large local reactions among systemic reactors during subcutaneous allergen immunotherapy. Ann Allergy Asthma Immunol 2007;99:82-6
  • Nelson BL, Dupont LA, Reid MJ. Prospective survey of local and systemic reactions to immunotherapy with pollen extracts. Ann Allergy 1986;56:331-4
  • Tankersley MS, Butler KK, Butler WK, Goetz DW. Local reactions during allergen immunotherapy do not require dose adjustment. J Allergy Clin Immunol 2000;106:840-3
  • Kelso JM. The rate of systemic reactions to immunotherapy injections is the same whether or not the dose is reduced after a local reaction. Ann Allergy Asthma Immunol 2004;92:225-7
  • Lin SY, Erekosima N, Suarez-Cuervo C, et al. Allergen-specific immunotherapy for the treatment of allergic rhinoconjunctivitis and/or Asthma. Comparative effectiveness review. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013. Report No.: 13-EHC061-EF. AHRQ Comparative Effectiveness Reviews
  • Calabria CW, Stolfi A, Tankersley MS. The REPEAT study: recognizing and evaluating periodic local reactions in allergen immunotherapy and associated systemic reactions. Ann Allergy Asthma Immunol 2011;106:49-53
  • Yukselen A, Kendirli SG, Yilmaz M, et al. Effect of one-year subcutaneous and sublingual immunotherapy on clinical and laboratory parameters in children with rhinitis and asthma: a randomized, placebo-controlled, double-blind, double-dummy study. Int Arch Allergy Immunol 2012;157:288-98
  • Keles S, Karakoc-Aydiner E, Ozen A, et al. A novel approach in allergen-specific immunotherapy: combination of sublingual and subcutaneous routes. J Allergy Clin Immunol 2011;128:808-15
  • Ohashi Y, Nakai Y, Murata K. Effect of pretreatment with fexofenadine on the safety of immunotherapy in patients with allergic rhinitis. Ann Allergy Asthma Immunol 2006;96:600-5
  • Massanari M, Nelson H, Casale T, et al. Effect of pretreatment with omalizumab on the tolerability of specific immunotherapy in allergic asthma. J Allergy Clin Immunol 2010;125:383-9
  • Iglesias-Cadarso A, Hernandez-Weigand P, Reano M, et al. Risk factors for systemic reactions to allergen-specific subcutaneous immunotherapy. J Investig Allergol Clin Immunol 2010;20:621-2
  • Cochard MM, Eigenmann PA. Sublingual immunotherapy is not always a safe alternative to subcutaneous immunotherapy. J Allergy Clin Immunol 2009;124:378-9
  • Schubert R, Eickmeier O, Garn H, et al. Safety and immunogenicity of a cluster specific immunotherapy in children with bronchial asthma and mite allergy. Int Arch Allergy Immunol 2009;148:251-60
  • Pfaar O, Klimek L, Fischer I, et al. Safety of two cluster schedules for subcutaneous immunotherapy in allergic rhinitis or asthma patients sensitized to inhalant allergens. Int Arch Allergy Immunol 2009;150:102-8
  • Zhang L, Wang C, Han D, et al. Comparative study of cluster and conventional immunotherapy schedules with dermatophagoides pteronyssinus in the treatment of persistent allergic rhinitis. Int Arch Allergy Immunol 2009;148:161-9

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