title: Factors affecting time required to reach maintenance dose during subcutaneous immunotherapy.
abstract: BACKGROUND
  Subcutaneous immunotherapy (SCIT) demands a significant time commitment on the part of the patient, especially during the escalation period when weekly visits are required. Many patients refuse or discontinue treatment in spite of the demonstrated clinical efficacy of SCIT. Understanding the factors that affect the length of the escalation phase would allow for counseling of patients, which may improve patient compliance. The aims of this study were to determine the mean time required to reach maintenance dose during conventional protocol SCIT and to identify factors that significantly affect the time required to reach maintenance dose.
  
  
  METHODS
  We conducted a retrospective chart review of 55 patients (total of 79 treatment vials) who began SCIT between January 2007 and December 2010 and reached maintenance dose. The effect of demographic data, medical and social history, and SCIT allergen data on the time required to reach maintenance dose were examined using bivariate and multivariate analyses.
  
  
  RESULTS
  The mean time to maintenance dose for the 79 treatment vials was 240.2 days (range, 76-720 days). Males (mean 294.7 days) took significantly longer than females (mean 205.1 days) to reach maintenance dose (p = 0.007). Asthmatics (mean 285.5 days) took significantly longer than nonasthmatics (mean 218.0 days) to reach maintenance dose (p = 0.008). Age also significantly affected the length of the escalation phase; each additional year of age was associated with an increase in 3.9 days needed to reach maintenance dose (p = 0.002).
  
  
  CONCLUSIONS
  Gender, asthma, and age significantly impact the time required to reach maintenance dose during SCIT.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, NY, USA. Djourdy@med.miami.edu
authors.forename: Deya N
authors.initials: DN
authors.lastname: Jourdy
authors.forename: William R
authors.initials: WR
authors.lastname: Reisacher
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001249:Asthma / Q000209:etiology / Q000276:immunology / Q000628:therapy*; D002648:Child; D003888:Desensitization, Immunologic; D054796:Drug Dosage Calculations; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000276:immunology / Q000628:therapy*; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult