Allergy & Asthma Care Information - Immunotherapy
GOALS OF IMMUNOTHERAPY
Allergen-specific immunotherapy, also known as “allergy shots”, is a process by which immune cells are re-educated to become tolerant of allergens to which an individual is sensitized: i.e. pollens, animal danders, house dust mites, and molds. Some prefer to use the term “desensitization” to describe this process. The immune system has a natural ability to build up a tolerance to common proteins such as self-proteins, particularly when these proteins are present in high quantity. The same kind of tolerance can be induced to allergens through a series of allergy shots. This is achieved by injecting small quantities of the actual proteins (allergens) subcutaneously over a period of 3-5 years. Specific allergic sensitivities are identified by skin testing. Shot extracts are then mixed in a patient-specific fashion, customized to meet the needs of each individual. The immunotherapy (“allergy shots”) option is considered on an individual basis, according to history of allergic disease, skin test results, and each individual’s preferences and goals. Ongoing studies (including recent studies at our site) are evaluating the safety and efficacy of sublingual (oral) immunotherapy as an option for select individuals who have certain allergies. This modality is not yet approved by the FDA, though may gain approval in the future. We are able to provide information regarding whether an individual would be a candidate for this option in the future.
INDICATIONS FOR IMMUNOTHERAPY
- Inability to control symptoms with conventional allergy and asthma medications combined with avoidance measures.
- Symptoms are well controlled only with many medications over long periods of time, such that management is difficult and inconvenient.
- Medications required to control symptoms have unacceptable side effects or excessive costs.
- Allergic problems have potential serious complications (e.g. otitis media, sinusitis, asthma) or interfere with daily activities (sleep, work, school etc.).
EFFICACY OF IMMUNOTHERAPY
The medical literature suggests that significant reductions in symptoms can be expected during immunotherapy in at least 9 out of 10 patients. Immunotherapy can often be discontinued after 4-5 years of once-monthly maintenance dosing. Studies show that at least 2/3 of patients will experience many years of continued symptom relief even after stopping, provided at least 3-5 years of high dose shots are received.
SCHEDULE OF IMMUNOTHERAPY
- Building Phase – Initially, allergy injections are given once or twice weekly for approximately 9-16 weeks. After this period, injections are given monthly (“maintenance phase,” see next paragraph). Some patients choose to get two or three sets of allergy shots at each build up visit at 20 minute intervals with the lower strength doses to allow a more rapid buildup to high effective doses. During the building phase, the dose of allergen extract can be increased even if you miss one week, but if you miss 3 or 4 weeks, the previous dose is repeated. Missing over 4-5 weeks will require a decrease in your dose. Please try to come in at least weekly while building doses and at least monthly if on maintenance doses. It is always fine to come in early or more frequently, which may further stabilize allergies.
- Maintenance Phase – While it typically takes 2-4 months, it can take up to one year for immunotherapy to reach maximum effectiveness. Symptoms may continue through your first allergy season on injections. For this reason, the decision on the effectiveness of the immunotherapy is not made until you have gone through two years of allergy seasons. Typically, at least 90% of patients experience noticeable and significant improvement at this point, often leading to large reductions in medication requirements. Progress will be reevaluated on an annual basis.
If you would like additional detailed information on immunotherapy, contact us and make an appointment at our clinic.
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Located in Medford, Oregon with satellite offices in Grants Pass, Ashland, and Klamath Falls, the Allergy and Asthma Center of Southern Oregon, PC offers exceptional care for patients with allergies and asthma.
Allergy & Asthma Information
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