title: Safety and efficacy of allergen immunotherapy in the treatment of allergic rhinitis and asthma in real life.
abstract: BACKGROUND
  Subcutaneous allergen immunotherapy is effective in treating allergic airway disease. Disadvantages include immediate local and systemic adverse reactions and poor compliance.
  
  
  OBJECTIVE
  To obtain real-life efficacy and safety data through a prospective observational study of SIT in the allergist's office.
  
  
  METHODS
  We prospectively collected data from all patients with a diagnosis of allergic rhinitis and/or asthma and a specific immunoglobulin E-mediated sensitization to one or more aeroallergens who began SIT during the 2 year period 1 January 2005 to 31 December 2006. As part of the routine immunotherapy care patients were asked to complete a disease activity questionnaire before and yearly during the treatment. The primary outcome measure was the combined rhinitis and asthma symptoms scores. Data from patients completing at least 1 year of immunotherapy were analyzed.
  
  
  RESULTS
  Altogether, 133 enrolled patients with a mean age of 22.7 years completed at least 1 year of SIT. The allergic rhinitis and asthma disease activity score decreased from a mean of 8.1 to 3.3 (rhinitis) and from 4.8 to 2.4 (asthma) on a 10 cm visual analogue scale after 1 year of SIT (P < 0.001 for all comparisons). Rhinitis medication use in all patients and asthma medication use in asthmatics decreased significantly. Mild local adverse reactions were almost universal. There were 11 patients (8%) who developed 14 immediate systemic, mild to moderate reactions. All reactions were successfully treated in the clinic; none required additional observation or hospitalization.
  
  
  CONCLUSIONS
  In the hands of experienced allergists subcutaneous allergy immunotherapy is a safe and efficacious option for patients with allergic rhinitis and asthma.
authors.affiliation: Allergy Service, Clalit Health Services, Barzilai Medical Center, Ashkelon, Israel.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Zeldin
authors.forename: Zeev
authors.initials: Z
authors.lastname: Weiler
authors.forename: Eli
authors.initials: E
authors.lastname: Magen
authors.forename: Liran
authors.initials: L
authors.lastname: Tiosano
authors.forename: Mona I
authors.initials: MI
authors.lastname: Kidon
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D012720:Severity of Illness Index; D012882:Skin Tests; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult