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- Title
Shortened immunotherapy dose‐escalation saves time, but is it safe? A case‐control study comparing the rates of adverse reactions between conventional and fast‐escalation subcutaneous immunotherapy protocols during the induction phase.
- Authors
Herrmann, Ina; Loft, Klaus E.; Olivry, Thierry
- Abstract
Background: Allergen immunotherapy (AIT) is the only intervention believed to change the course of atopic diseases. As dogs appear to have fewer severe adverse events (AEs) compared to people receiving AIT, a prolonged dose‐escalation induction phase might not be needed. Objectives: To report the incidence and characteristics of AEs induced by a fast‐escalation subcutaneous immunotherapy (f‐SCIT) protocol compared to a conventional (c‐SCIT) regimen. Animals: One hundred dogs treated with either f‐ SCIT (Centre 1, 50 dogs) or c‐SCIT (Centre 2, 50 dogs). Methods and materials: A case‐control study retrospectively evaluating AEs during the induction of AIT. We determined the incidence and type of AEs in each SCIT group; we also assessed factors such as self‐limitation and the need for AE‐associated protocol changes. Results: Twelve of 100 dogs (12%) developed a SCIT‐attributable AE during the induction phase, with one dog having a local and 11 having systemic reactions (nine Grade I, two Grade II, none of grades III or IV). Dogs treated with the f‐SCIT had a significantly higher rate of AEs (11 of 50; 22%) compared to those receiving the c‐SCIT (one of 50; 2%). Most of the AEs (10 of 11; 91%) in the f‐SCIT group were mild and self‐limiting. Conclusions and clinical importance: The induction phase of f‐SCIT is simpler, and the maintenance phase is reached faster than that of the c‐SCIT. Despite its higher rate of AEs than with the c‐SCIT regimen, the majority of f‐SCIT‐associated AEs were mild and self‐limiting. Whether or not this f‐SCIT protocol leads to a faster time‐to‐efficacy needs to be determined. Background – Allergen immunotherapy (AIT) is the only intervention believed to change the course of atopic diseases. As dogs appear to have fewer severe adverse events (AEs) compared to people receiving AIT, a prolonged dose‐escalation induction phase might not be needed. Objectives – To report the incidence and characteristics of AEs induced by a fast‐escalation subcutaneous immunotherapy (f‐SCIT) protocol compared to a conventional (c‐SCIT) regimen. Conclusions and clinical importance – The induction phase of f‐SCIT is simpler, and the maintenance phase is reached faster than that of the c‐SCIT. Despite its higher rate of AEs than with the c‐SCIT regimen, the majority of f‐SCIT‐associated AEs were mild and self‐limiting. Whether or not this f‐SCIT protocol leads to a faster time‐to‐efficacy needs to be determined.
- Subjects
IMMUNOTHERAPY; CASE-control method; DERMATOPHAGOIDES; DOGS; DISEASE progression
- Publication
Veterinary Dermatology, 2020, Vol 31, Issue 6, p454
- ISSN
0959-4493
- Publication type
Article
- DOI
10.1111/vde.12892