title: Safety of subcutaneous immunotherapy with inhalant allergen extracts: a single-center 30-year experience from Turkey.
abstract: BACKGROUND
  Although subcutaneous allergen immunotherapy (SCIT) is effective in allergic rhinitis (AR) and asthma, it carries a risk of local and systemic adverse reactions.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the rates and clinical characteristics of local and systemic reactions (LR and SR), and to identify their relation of demographic features, allergen extracts and diagnosis.
  
  
  METHODS
  This study analyzed the administration of SCIT from 1983 to 2013; involving 1816 patients affected by allergic asthma and/or AR.
  
  
  RESULTS
  The rates of SR from SCIT were 0.078% per injection and 9% per patient. According to the World Allergy Organization 2010 grading system, 91 grade 1 reactions (44%), 67 grade 2 reactions (32.3%), 33 grade 3 reactions (16%) and 16 grade 4 reactions (7.7%) were seen. There was no fatal outcome from any of the SRs. Risk factors for a SR included: aluminium-adsorbed extract, pollen-containing vaccines, large LR and recurrent (≥2) LRs. The total LR rates were 0.062% per injection and 5.2% per patient; the small LR rates were 0.027% per injection and 2.3% per patient, and the large LR rate were 0.035% per injection and 2.9% per patient. Female gender, depot extracts, calcium phosphate-adsorbed extract and pollen vaccines were identified as risk factors for LR.
  
  
  CONCLUSIONS
  The analysis of our data over a 30-year period confirmed that SCIT with inhalant allergens conducted strictly according to the standard protocols and when administrated by experienced staff is a safe method of treatment with only a few side-effects.
authors: Division of Immunology and Allergic Diseases, Gulhane Military Medical Academy and Medical School , Ankara , Turkey and.
authors: Ozgur
authors: O
authors: Kartal
authors: Mustafa
authors: M
authors: Gulec
authors: Zafer
authors: Z
authors: Caliskaner
authors: Ugur
authors: U
authors: Musabak
authors: Osman
authors: O
authors: Sener
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D012189:Retrospective Studies
chemical_list: D000485:Allergens
keywords: Inhalant allergens; local reaction; risk factors; subcutaneous allergen immunotherapy; systemic reaction