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Immunotherapy

Immunotherapy is an asthma treatment consideration for those whose asthma is exacerbated by allergens (like animal dander), rather than other triggers like viral respiratory infections. It may also be useful for people with nasal symptoms (such as sneezing, stuffy nose).

Immunotherapy is often recommended for people who have developed severe side effects from medication, or when symptoms do not respond well to medication. Immunotherapy may also be helpful for people who have frequent, unavoidable exposure to allergens.

Immunotherapy increases your resistance to allergens and reduces the need for medications. Initially, you will be given shots of weakened solutions of purified allergen extracts 1-2 times per week. As you continue with the shots, the doses will be made progressively stronger. In approximately 3-6 months, your doses will be at the most concentrated, or maintenance, level.

Once your injections are at maintenance level, the frequency of injections will be reduced to every 2-4 weeks. Your doctor will monitor your immune response periodically by skin testing. Treatment will continue for about 3-5 years until your allergic response has been significantly reduced or eliminated.

Sublingual immunotherapy may also be used. This type of treatment involves putting the allergic substances under the tongue, rather than using allergy shots.

Special Considerations
Long-term Process

Immunotherapy is a treatment program that may take 3-5 years to complete. If you are considering this form of treatment, you will need to receive these injections or treatments on a regular schedule. If you miss one or more treatments, there is a risk that your allergen immunity will be compromised, and you may need to begin the process again.

Side Effects

On occasion, some people experience a localized reaction to the shot. This may include itching, redness, or a small swelling in the injection area. These symptoms usually disappear within 1-2 hours.

In very rare instances, a systemic reaction may occur. This might produce symptoms such as sneezing; itching of the eyes, throat, hands, feet; or asthma. This type of reaction usually occurs within twenty minutes of the shot. Your doctor will have you wait at least 20 minutes after receiving an injection to assure that there is no reaction.

Who Should NOT Undergo Immunotherapy

Immunotherapy is not recommended for people who are taking beta-blocker medications. Beta-blocker medications may be prescribed for people who have high blood pressure, heart rhythm problems, or other conditions.

It has not been conclusively determined whether starting immunotherapy is safe during pregnancy. However, it is usually considered safe to continue immunotherapy maintenance treatments during pregnancy as long as it’s approved by your doctor. Immunotherapy is also not recommended for people with weakened immune systems.

When to Contact Your Doctor

Notify your doctor immediately if you notice:

  • Any changes in your allergy reaction—either after an allergy shot or in general
  • Any adverse reactions to the injection
  • Any changes in medications prescribed by another doctor

References:

Huggins J, Looney RJ. Allergen immunotherapy. Am Fam Physician. 2004 Aug 15;70(4):689-696. Available at: http://www.aafp.org/afp/2004/0815/p689.html . Accessed September 13, 2012.

Asthma in adults and adolescents. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated September 7, 2012. Accessed September 13, 2012.

Asthma alternative treatments. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated June 26, 2012. Accessed September 13, 2012.

Mohapatra SS, Qazi M, Hellermann G. Immunotherapy for allergies and asthma: present and future. Curr Opin Pharmacol. 2010;10(3):276-288.

8/27/2013 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Kim JM, Lin SY, Suarez-Cuervo C, et al. Allergen-specific immunotherapy for pediatric asthma and rhinoconjunctivitis: a systematic review. Pediatrics. 2013 Jun;131(6):1155-67.



Last reviewed September 2014 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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