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Allergen Immunotherapy

Purpose

Your individualized course of allergy shots (immunotherapy) is designed to decrease your allergic sensitivities. The vast majority of allergic patients (80-90%) will experience substantial reductions in their symptoms over time (months to years). Many also reduce or eliminate the need for other medications. Together with avoidance of offending allergens and medication allergy shots represent one of the recommended treatments for allergic rhinitis, allergic conjunctivitis, atopic dermatitis and asthma. Allergy shots are not useful for food/drug allergies or non-allergic conditions like infections.

Treatment Duration

The length of a treatment course varies on a case by case basis but in general a course requires 3 to 5 years of maintenance treatment for completion. Initially there is a build-up phase where the injections are given more frequently but as the High Dose, or maintenance dose, is reached the frequency of injections may be adjusted. The total duration of therapy can vary considerably from patient to patient. During your treatment you will be re-evaluated frequently by your physician. These visits will occur at least annually.

Schedule of Administration

Your series of injections begins at a low dose selected by your physician based on your skin test results and history. Over time the shots build gradually until you reach your High Dose. This High Dose is called the maintenance dose and you will stay on it for the duration of your treatment course unless it is changed by your physician. Maintenance therapy can be continued if you are pregnant BUT notify your OAAC physician when you become pregnant.

The build-up phase of the allergy shots can occur in different formats. Your physician will help you decide which is right for you. Most common is the weekly building schedule. Various accelerated schedules include: 2 or 3 time a week shots, clusters of several shots given on the same day and finally RUSH therapy where many injections are given on one day and then weekly shots follow until you are at your High Dose. RUSH therapy is associated with significantly more side effects (see below) and is not for every patient. However, it does bring you to the High Dose level in a month rather than slowly over many months. This is an advantage for some patients.

Safety

All allergy shots carry some risks for severe anaphylactic reactions. Therefore the injections need to be administered in a medical facility under medical supervision on a regular basis. Weekly or twice weekly shots from our clinic carry a risk of anaphylaxis of 0.015 to 0.02% of injections compared to nationally published risks of 0.1 to 0.3% of injections. RUSH therapy carries a nationally published risk of almost 40% of shots whereas our RUSH risk is closer to 10% of injections. This marked increase in risk however makes RUSH therapy unacceptable for many patients.

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Food Allergy Facts and Figures – From Kids with Food Allergies and the Asthma and Allergy Foundation of America

May is Asthma and Allergy Awareness Month

What Is a Food Allergy?

  • A food allergy occurs when the body’s immune system sees a certain food as harmful and reacts by causing symptoms. This is an allergic reaction.
  • Foods that cause allergic reactions are called allergens.
  • Allergic reactions can involve the skin, mouth, eyes, lungs, heart, gut, and brain.
  • Mild and severe symptoms can lead to a serious allergic reaction called anaphylaxis [anna-fih-LACK-sis]. This reaction usually involves more than one part of the body and can worsen quickly.
  • Anaphylaxis must be treated right away with epinephrine to provide the best chance for improvement and prevent serious, potentially life-threatening complications.

How Common Are Food Allergies?

  • As of 2021, about 20 million people have food allergies in the U.S.
    • About 16 million (6.2%) U.S. adults have food allergies.
    • About 4 million (5.8%) U.S. children have food allergies.
  • In 2021, 7.6% of non-Hispanic Black children had food allergies, compared to 5.5% of non-Hispanic white children.
    • Food allergy has increased among U.S. children over the past 20 years, with the greatest increase in Black children.
  • Children with food allergies are two to four times more likely to have asthma or other allergic diseases.

What Are the Most Frequent Food Allergens?

  • Nine foods cause most food allergy reactions in the United States:

 o Milk

o Egg

o Peanut

o Tree nut (for example, almonds, walnut, pecans, cashews, pistachios)

o Wheat

o Sesame

o Soy

o Fish (for example, bass, flounder, cod)

o Shellfish (for example, crab, shrimp, scallop, clams)

  • Sesame is a rising food allergy. It impacts an estimated 1 million people in the United States.6 It was declared a major allergen in the United States in 2021.

What Is Anaphylaxis?

  • Anaphylaxis is a severe, potentially life-threatening allergic reaction. Not all allergic reactions are anaphylaxis.
  • Symptoms of anaphylaxis usually involve more than one part of the body such as the skin, mouth, eyes, lungs, heart, gut, and brain.
  • Symptoms of anaphylaxis can include:
    • Skin: hives (often very itchy), flushed skin, or rash
    • Mouth: swelling of the lips, tongue, and throat; tingling or itchy feeling in the mouth
    • Lungs: shortness of breath, trouble breathing, coughing, or wheezing o Heart: dizziness, lightheadedness, loss of consciousness, low blood pressure, shock o Stomach: cramps, vomiting, diarrhea
  • Each year in the U.S., it is estimated that anaphylaxis to food results in 90,000 emergency room visits.
    • From 2006-2015, emergency room visits from food-induced anaphylaxis in infants and toddlers more than doubled

How Are Food Allergies Managed and Treated?

  • Although new treatments are being developed, there is currently no cure for food allergies.
  • Not eating the food allergen is the primary way to prevent a reaction.
  • People with food allergies should carefully read food ingredient labels and always ask about ingredients before eating food prepared by other people.
  • Epinephrine is the first line of treatment for anaphylaxis.
  • People with food allergies should always have epinephrine with them.
  • If a person is having anaphylaxis, they should:
    • Follow their Anaphylaxis Action Plan
    •  Use their epinephrine
    •  Get emergency medical care to ensure symptoms resolve

 Are Food Allergies Outgrown?

  • Milk, egg, wheat, and soy allergies are often outgrown. Most people do not outgrow peanut, tree nut, fish, and shellfish allergies.

The post Food Allergy Facts and Figures – From Kids with Food Allergies and the Asthma and Allergy Foundation of America appeared first on Oklahoma Allergy and Asthma Clinic.

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