Effect of premedication on side effect frequency in patients to whom immunotherapy is applied
Effect of premedication on side effect frequency in patients to whom immunotherapy is applied
Aim: In this study we aimed to investigate whether there are differences in terms of the frequency and severity of side effects in patients to whom premedication were given/or not before the application of subcutaneous allergen specific immunotherapy.Material and method: Patients receiving subcutaneous allergen-specific immunotherapy in our clinic between October 2014 and October 2015 were evaluated for side effects. In patients to whom subcutaneous allergen-specific immunotherapy was applied and reaction was occurred against this therapy; allergen type, reaction intensity and duration, and also use of premedication were recorded. When the patients were assessed in terms of side effects; edema and/or erythema from 2 to 5 cm, which were beginning within the first 24 hours in the injection site. That was defined as ‘local reaction’ and edema and/or erythema, if it was greater than 5 cm defined as ‘broad local reaction’.Results: Total of 101 patients, to whom allergen specific immunotherapy was applied, were included. In a year of the study; total of 660 injections were applied to 101 patients and reaction to injections were observed in 31 injections (4.6%). Reaction was observed in 20 individuals (19.8%). No significant difference was found between premedicated and non-premedicated groups in terms of the percentage of side effects and risk of side effects (p >0.59).Conclusion: In our study; patients with or without premedication were compared in terms of side effect frequency. In premedication group; ratio of local reaction was found to be low (20%). It was thought that premedication could reduce local reactions but did not prevent extensive local reaction. There was no difference when comparing the side effect frequency between the two groups.
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- 1.
Allergen immunotherapy: a practice parameter. american academy of allergy, asthma and immunology. american college of allergy, asthma and immunology. Ann Allergy Asthma Immunol 2003;90:1-40.
- 2.
Bousquet J, Lockey R, Malling HJ, et al. World Health Organization Position Paper . Allergen immunoterapi:Therapeutical vaccinesfor allergic diseases.Allergy 1998;53:3-4.
- 3.
Matsui EC, Eggleston PA. Immunotherapy for allergic disease. In :DYM Leung, HA Sampson, RS Geha , SJ Szefler, et al. Pediatric Allergy, Principles and Practise. St. Louis: Mosby 2003;277-85.
- 4.
Nelson HS, Immunothrapy for inhalant allergens. In: Adkinson NF ,Yunginger JW, Buse WW, et al. Middleton’sAllergy, Principles and Practice. 6th edition. Philadelphia: Mosby; 2003;3.
- 5.
Keskin Ö. Pratik Yönleriyle Allerjen–Spesifik İmmünoterapi. Asthma Allergy Immunol 2008;6:25-37
- 6.
Canıtez Y, Öztürk R, Sapan N. Alerjen Spesifik İmmunoterapide Lokal ve Sistemik Reaksiyonlar. Güncel Pediatri 2007;5:92-5.
- 7.
Cox L, Nelson H, Lockey R, et al. Allergen immunotherapy: a practice parameter third update J Allergy Clın Immunol 2011;127:S1-55.
- 8.
Yavuz ST, Tuncer A. İmmunoterapi. Katkı Pediatri Dergisi 2013;35:239-51.
- 9.
Cox L, Larenas-Linnemann D, Lockey RF, et al. Speaking the same language:the World Allergy Organization Subcutaneous Immunotherapy Systemic Reaction Grading System. J Allergy Clin Immunol 2010;125:569-574.e7.
- 10.
Stewart GE 2nd ,Lockey RF. Systemic reactions from allergen immunotherapy. J Allergy Clin Immunol 1992;90:567-78.
- 11.
Lockey RF, Benedict LM, Turkeltaub PC, et al. Fatalities from immunotherapy (IT) and skin testing (ST). J Allergy Clin Immunol 1987;79:660-77.
- 12.
Reid MJ, Locley RF, Turkeltaub PC, et al. Survey of fatalities from skin testing and immunotherapy 1985-1989. J Allergy Clin Immunol 1993;92:6-15.
- 13.
Winter L, Malling HJ, Mosbech H. Allergen-specific immunotherapy in birch-and grass- polen allergic rhinitis, II: Side effects. Allergy 2000;55:827-35.
- 14.
Nelson BL, Dupont LA, Reid MJ. Prospective survey of local and systemic reactions to immunotherapy with polen extract. Ann Allergy 1986;56:331-4.
- 15.
Tankersley MS, Butler KK, Butler WK, et al. Lokal reactions during allergen immunotherapy do not require dose adjusment. J Allergy Clin Immunol 2000;106:840-3.
- 16.
Can D, Demir E, Tanaç R, et al. Immediate adverse reactions to immunotherapy. J İnvest Allergol Clin Immunol 2003;13:177-80.
- 17.
La Shell MS, Calabria CW, Quinn JM. Imported fire ant field reaction and immunotherapy safety characteristics: the IFACS study. J Allergy Clin Immunol 2010;125:1294-9.