EVALUATION OF THREE ALLERGEN SPECIFIC IMMUNOTHERAPY METHODS Standard Injection RUSH Injection Sublin - PowerPoint PPT Presentation

1 / 17
About This Presentation
Title:

EVALUATION OF THREE ALLERGEN SPECIFIC IMMUNOTHERAPY METHODS Standard Injection RUSH Injection Sublin

Description:

Richard Herrscher M.D. FACAAI. Clinical Faculty U.T. ... Mite. 1:20w/v. 1:20w/v. 100k BAU/ml. strength. Mold. Weed. Grass. Allergen. SCHEDULE PERFORMANCE ... – PowerPoint PPT presentation

Number of Views:191
Avg rating:3.0/5.0
Slides: 18
Provided by: richardh7
Category:

less

Transcript and Presenter's Notes

Title: EVALUATION OF THREE ALLERGEN SPECIFIC IMMUNOTHERAPY METHODS Standard Injection RUSH Injection Sublin


1
EVALUATION OF THREE ALLERGEN SPECIFIC
IMMUNOTHERAPY METHODSStandard Injection RUSH
Injection Sublingual
  • Abstract 54
  • Richard Herrscher M.D. FACAAI
  • Clinical Faculty U.T. Southwestern Medical Center
    Dallas, Texas
  • Medical Director AIR Care P.A.

2
BACKGROUND
  • RUSH immunotherapy - one day schedule
  • Started using RUSH in 2000 based on description
    by Sharkey P, Portnoy J. Ann Allergy
    199676175-80
  • Little is known how this schedule compares to
    standard immunotherapy in terms of efficacy.
  • SLIT (sublingual immunotherapy)
  • Started using SLIT in 2003 based on evidence from
    European studies reviewed by Canonica and
    Passalacqua JACI 2003111437-48
  • Very little data using U.S. extracts.

3
PURPOSE and METHODS
  • Purpose of Study
  • To evaluate how alternative schedules of RUSH and
    SLIT compare to standard injection immunotherapy
    (SCIT) in terms of
  • Compliance - patient acceptance
  • Clinical efficacy
  • Safety

4
PURPOSE and METHODS
  • Methods
  • Observational study. Data collection began in
    2005.
  • Evaluated all patients starting immunotherapy
    from July 2003 through December 2004.
  • Data collection is ongoing.
  • Efficacy data collected prospectively with
    attempt to collect 6, 12 and 24 month time
    points.
  • Efficacy evaluated by patient questionnaire
  • Symptom and Medication reduction scores
  • 5 point scale 0 - 25 - 50 - 75 - 100

5
RUSH INJECTION SCHEDULE
  • One - day RUSH protocol
  • Very similar to previously described protocols
  • Sharkey P, Portnoy J. Ann Allergy 199676175-80
  • Harvey SM, Laurie S, Hilton K, Khan DA. Ann
    Allergy Asthma and Immunology 200492414-9
  • 38 systemic reaction rate during rush protocol

6
RUSH INJECTION SCHEDULE
7
SLIT SCHEDULE
8
ALLERGEN EXTRACTS/DOSE
9
SCHEDULE PERFORMANCE Patients Achieving
Maintenance Doses
11
110
1100
11000
Vial dilution
Std. SCIT
100
6 months
50
RUSH SCIT
100
SLIT
12 months
50
100
24 months
50
10
SCHEDULE PERFORMANCECumulative Allergen Dose
Std. SCIT
RUSH
SLIT
6 months
12 months
24 months
11
COMPLIANCE DATAupdated
  • All patients starting IT July-03 thru Dec-04

12
UPDATED EFFICACY DATAPatient starts July 2003 -
Dec 2004
Std. SCIT
RUSH
SLIT
75
P.03
Medication/ Symptom Reduction Score
P.001
50
50
43.1
34.9
34.7
28.1
21.4
25
Med/ Sx
lt 12 months therapy
gt 12 months therapy
13
EFFICACY DATAPatient starts July 2003 - May 2005
75
Std. SCIT
RUSH
SLIT
56.0
P.015
P.025
Medication/ Symptom Reduction Score
46.5
50
43.1
39.9
41.4
33.9
28.4
29.2
23.2
25
Med/ Sx
6 months
12 months
24 months
14
SAFETY DATA
15
SYSTEMIC REACTIONSmoderate - severe
RUSH
SLIT
Std.SCIT
16
SUMMARY
  • SLIT
  • Much safer than injection therapy.
  • Making it feasible for home administration.
  • Extends immunotherapy to group unable to comply
    with office injections
  • Is not a completely benign therapy

17
SUMMARY
  • SLIT
  • Efficacy appears equal to standard injections.
  • Optimal dosing? 15X cumulative injection dose
    performed well in our patients.
  • RUSH
  • More efficacious early on (0-18 months), higher
    compliance, more systemic reactions.
Write a Comment
User Comments (0)
About PowerShow.com