What is the role of immunotherapy in the treatment of allergic rhinitis (hay fever)?

Updated: Dec 26, 2018
  • Author: Javed Sheikh, MD; Chief Editor: Michael A Kaliner, MD  more...
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A considerable body of clinical research has established the effectiveness of high-dose allergy shots in reducing symptoms and medication requirements. [60] Success rates have been demonstrated to be as high as 80-90% for certain allergens. It is a long-term process; noticeable improvement is often not observed for 6-12 months, and, if helpful, therapy should be continued for 3-5 years. Immunotherapy is not without risk because severe systemic allergic reactions can sometimes occur. For these reasons, carefully consider the risks and benefits of immunotherapy in each patient and weigh the risks and benefits of immunotherapy against the risks and benefits of the other management options.

  • Indications: Immunotherapy may be considered more strongly with severe disease, poor response to other management options, and the presence of comorbid conditions or complications. Immunotherapy is often combined with pharmacotherapy and environmental control.

  • Administration: Administer immunotherapy with allergens to which the patient is known to be sensitive and that are present in the patient's environment (and cannot be easily avoided). The value of immunotherapy for pollens, dust mites, and cats is well established. [61, 62, 63, 64, 65] The value of immunotherapy for dogs and mold is less well established. [60, 61]

  • Contraindication: A number of potential contraindications to immunotherapy exist and need to be considered. Immunotherapy should only be performed by individuals who have been appropriately trained, who institute appropriate precautions, and who are equipped for potential adverse events.

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