New Protocol Uses Fewer Allergy Shots For Hay Fever Control Interview with:
Stacy L. Rosenberg, MD
UPMC Montefiore Allergy and Immunology Fellow What is the background for this study?

Dr. Rosenberg: Allergy shots or allergen immunotherapy (AIT) is an effective therapy for allergic rhinoconjunctivitis (hay fever).  Low adherence has been a significant barrier, whereas rush immunotherapy to environmental allergens provides rapid build-up and offers quicker efficacy, which may improve adherence.  However, there have been concerns for increased risk of systemic reactions with rush protocols.  We describe a new protocol for modified rush AIT that offers quicker build-up towards a maintenance dose with improved safety and lower risk of systemic reactions.  We also hypothesize that there are specific characteristics that distinguish patients who develop systemic reactions in the setting of modified environmental rush immunotherapy (MERIT). What are the main findings?

Dr. Rosenberg: Overall, MERIT has a good safety profile.  A subset of patients did develop systemic reactions, which were mild.  Lower BMI was associated with systemic reactions and there was a trend between history of urticaria (hives) and younger age with development of systemic reactions.  Significantly more patients with systemic reactions had allergen extracts containing cat, dust mite, and weed pollen.  Neither gender, asthma, nor anaphylaxis history were associated with an increased risk of systemic reactions. What should clinicians and patients take away from your report?

Dr. Rosenberg: MERIT is a safe protocol for  allergen immunotherapy that allows patients to reach maintenance dosing faster, with fewer weekly shots.  Additionally, with this protocol the patients will experience benefits of AIT sooner compared to traditional AIT.  Finally, we describe the risk factors for systemic reactions which may raise awareness for development and treatment of systemic reactions among healthcare providers. What recommendations do you have for future research as a result of this study?

Dr. Rosenberg: We would like to compare the safety of this protocol with traditional allergen immunotherapy and confirm our findings in a prospective study.  Additionally, we would like to better characterize risk factors responsible for systemic reactions and modify allergy shot protocols accordingly. Thank you for your contribution to the community.


Characteristics of systemic reactions in the setting of modified environmental rush immunotherapy protocol (MERIT)

Stacy L. Rosenberg, MD, Merritt L. Fajt, MD, Russell Traister, MD PhD, Andrej A. Petrov, MD

Abstract Presented at the AAAI Meeting Monday, March 7, 2016

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Stacy L. Rosenberg, MD (2016). New Protocol Uses Fewer Allergy Shots For Hay Fever Control

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