title: Effect of pretreatment with fexofenadine on the safety of immunotherapy in patients with allergic rhinitis.
abstract: BACKGROUND
  Allergen-specific immunotherapy, although not a cure, remains the only treatment available that can alter the natural course of an allergic disease. However, the risk of allergen specific immunotherapy-related systemic reactions (SRs), reported to occur in approximately 1% to 14% of patients and which can range from mild to fatal in seriousness, represents a barrier to implementing this unique and effective treatment option.
  
  
  OBJECTIVE
  To explore the possibility that pretreatment with the H1-antihistamine fexofenadine could prevent the occurrence of severe SRs induced by immunotherapy in Japanese patients with allergic rhinitis.
  
  
  METHODS
  In this open-label, multicenter study, 134 patients receiving immunotherapy for allergic rhinitis were randomized 1:1 to a group receiving pretreatment with fexofenadine hydrochloride (60 mg) 2 hours before immunization injection (n = 67) or to a control group receiving no pretreatment (n = 67). Patients were further grouped into those who received cedar pollen immunotherapy and those who received dust mite immunotherapy.
  
  
  RESULTS
  Pretreatment with fexofenadine 2 hours before immunotherapy significantly reduced the occurrence of severe SRs (P = .03), significantly increased the proportion of patients receiving cedar pollen immunotherapy who achieved the target maintenance dose (TMD) (P = .03), and significantly reduced the length of time to attain the TMD (P = .047 and P = .003 for patients receiving cedar pollen and dust mite immunotherapy, respectively).
  
  
  CONCLUSIONS
  This study suggests a novel role for fexofenadine in enhancing the safety of immunotherapy and increasing the proportion of patients achieving the TMD.
authors: Ishikiriseiki Hospital, Osaka, Japan. ohsymcr@circus.ocn.ne.jp
authors: Yoshihiro
authors: Y
authors: Ohashi
authors: Yoshinori
authors: Y
authors: Nakai
authors: Kiyotaka
authors: K
authors: Murata