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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.

Recent News

Oklahoma City Ranks Ninth for Most Challenging Cities for Asthma
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Oklahoma City Ranks Ninth for Most Challenging Cities for Asthma

AAFA’s 2021 Asthma Capitals™ Report Lists Most Challenging Cities to Live in the U.S. with Asthma; Oklahoma City takes ninth place for 2021

The Asthma and Allergy Foundation of America (AAFA) recently rolled out its 2021 Asthma Capitals™ report. The report coincided with World Asthma Day, part of National Asthma and Allergy Awareness Month. AAFA’s Asthma Capitals™ report analyzes data from the 100 largest cities in the United States to determine its ranking. Allentown, Pennsylvania takes the top spot as the most challenging place to live for asthma in the 2021 report. Oklahoma City was ranked ninth and Tulsa was 24th.

The ranking is based on three criteria: asthma prevalence, emergency department visits for asthma, and deaths due to asthma. The report also highlights risk factors including poverty, air pollution, access to specialists, pollen counts, medicine use, smoking policies, and the rate of uninsured residents in an area. AAFA previously identified existing “Asthma Belts” which continue to have a grip on the eastern half of the nation, however two western cities – Tucson, Arizona and Fresno, California, are also listed in the top 20 cities for this year’s report. The top 20 Asthma Capitals™ for 2021 are: 1. Allentown, Pennsylvania 2. Baltimore, Maryland 3. Richmond, Virginia 4. Milwaukee, Wisconsin 5. New Haven, Connecticut 6. Cleveland, Ohio 7. Philadelphia, Pennsylvania 8. Dayton, Ohio 9. Oklahoma City, Oklahoma 10. Tucson, Arizona 11. Worcester, Massachusetts 12. Springfield, Massachusetts 13. Columbus, Ohio 14. Birmingham, Alabama 15. Detroit, Michigan 16. Louisville, Kentucky 17. Hartford, Connecticut 18. Boston, Massachusetts 19. Fresno, California 20. Greensboro, North Carolina. To see the complete 100-city list, visit asthmacapitals.com.

“AAFA produces the Asthma Capitals report and similar research to help improve the lives of the estimated 25 million Americans living with asthma. It’s important to highlight areas which deserve our urgent attention and collective action. This includes the pressing need to develop more programs and policies that will effectively help us reduce stark disparities in asthma based on race, gender, income and where people live,” said Kenneth Mendez, CEO and president of AAFA. “This report also supports the need for climate action. Air pollution, extreme weather patterns, and natural disasters fueled by climate change continue to have a worsening impact on Americans living in certain communities. This is not only a critical area of investigation, but signals exactly where work needs to be done for those with the greatest needs.”

The report also calls attention to the role of the COVID-19 pandemic in determining the rankings. This includes some changes in health outcomes and risk factors like pollen exposure, medicine use, and emergency room visits. In 2020, fewer people experienced pollen allergies due to COVID-19 restrictions, recommendations to stay indoors, and other preventative measures like mask wearing. As a result, use of long-term asthma medicines were also down along with fewer people heading to hospital emergency rooms for asthma.

“The pandemic, economic recession, climate crisis, and racial injustice all had a significant impact on the asthma community in 2020. Despite some varying factors, asthma remains a serious public health threat with an average of 10 people dying each day. At AAFA, we reiterate that’s 10 too many. Most of these tragedies are preventable,” said Melanie Carver, chief mission officer at AAFA. “Stakeholders, policy makers, health officials, communities and individuals around the nation can use this information to join us in our mission to save lives.”

“It’s been an especially challenging year for allergies so far with high pollen and mold spore counts along with high allergy alert days,” said Oklahoma Allergy & Asthma Clinic Board-certified allergist Dr. Laura Chong. “All of these can be triggers for increases in asthma attacks too. It is important to get an evaluation to figure out your triggers and the best strategy to help optimize control of your asthma.”

The 2021 Asthma Capitals™ report is an independent research project of AAFA made possible in part by support from the Pharmaceutical Care Management Association (PCMA) Foundation. For the latest AAFA news and resources go to aafa.org.

The post Oklahoma City Ranks Ninth for Most Challenging Cities for Asthma appeared first on Oklahoma Allergy and Asthma Clinic.

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