title: Allergy immunotherapy safety: location matters!
abstract: Allergy immunotherapy is a highly effective therapy that has been used in the treatment of allergic rhinitis, asthma, and venom allergy for over a century. Subcutaneous immunotherapy (SCIT) is currently the only US Food and Drug Administration approved form of allergy immunotherapy. In this commentary, we address the safety issues that surround the location of care of SCIT administration in a supervised medical facility versus in the home or other medically unsupervised facility. Although analysis of the data suggests that SCIT has an excellent safety profile, we believe that this safety is largely due to the safety measures that are implemented when SCIT is administered in a medically supervised setting with appropriate staff and equipment to immediately recognize and treat anaphylaxis. In the home or medically unsupervised setting, the preinjection health assessment may not be adequate and access to immediate emergency medical treatment is unlikely to occur. We strongly urge all health care providers to adhere to the current Allergy Immunotherapy Practice Parameter recommendations and that patients be appropriately assessed before and monitored after allergy immunotherapy injections in a medically supervised facility.
authors.affiliation: President, American Academy of Allergy, Asthma, and Immunology (AAAAI), Milwaukee, Wis.
authors.forename: Linda
authors.initials: L
authors.lastname: Cox
authors.affiliation: Executive Director, Joint Council of Allergy, Asthma, and Immunology (JCAAI), Palatine, Ill.
authors.forename: Donald
authors.initials: D
authors.lastname: Aaronson
authors.affiliation: Executive Vice President, American Academy of Allergy, Asthma, and Immunology (AAAAI), Milwaukee, Wis. Electronic address: tbcasale@creighton.edu.
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Casale
authors.affiliation: President, Joint Council of Allergy, Asthma, and Immunology (JCAAI), Palatine, Ill.
authors.forename: Richard
authors.initials: R
authors.lastname: Honsinger
authors.affiliation: President, American College of Allergy, Asthma, and Immunology (ACAAI), Arlington Heights, Ill.
authors.forename: Richard
authors.initials: R
authors.lastname: Weber
mesh_terms: D001249:Asthma / Q000628:therapy*; D003888:Desensitization, Immunologic; D006801:Humans; D007279:Injections, Subcutaneous; D017410:Practice Guidelines as Topic; D065631:Rhinitis, Allergic / Q000628:therapy*; D014481:United States
keywords: Allergy immunotherapy; Anaphylaxis; Desensitization; Subcutaneous immunotherapy; immunologic