European Survey on Adverse Systemic Reactions in Allergen Immunotherapy (EASSI): a real-life clinical assessment

• DOI: 10.1111/all.13066
• Publication Date: 2016-10-13T06:48:48Z
• Authors: M. A. Calderón; C. Vidal; P. Rodríguez del Río; J. Just; O. Pfaar; A. I. Tabar; I. Sánchez-Machín; P. Bubel; J. Borja; P. Eberle; R. Reiber; M. Bouvier; A. Lepelliez; L. Klimek; P. Demoly
• Keywords: Allergen Immunotherapy; MedDRA; Wheeze; Dander

Outside clinical trials, data on systemic reactions (SRs) due to allergen immunotherapy (AIT) are scarce.A prospective, longitudinal, web-based survey of 'real-life' respiratory practice was conducted in France, Germany and Spain. SRs were recorded coded according the Medical Dictionary for Regulatory Activities (MedDRA) risk factors associated with identified.A total 4316 patients (corresponding 4363 ongoing courses AIT) included. A 109 recorded, 90 (2.1%) presented at least one SR. Most occurred subcutaneous (SCIT) (89%, n = 97). The most frequently reported symptoms urticaria, rhinitis, dyspnoea cough. Respiratory appeared before skin symptoms. during up-dosing phase (75.8%) mild severity (71.6%). Intramuscular adrenaline administered 17 SRs, but only 65% these subsequently classified as anaphylaxis. Independent SCIT follows: use natural extracts (odds ratio, OR) [95% confidence interval (CI)] 2.74 [1.61-4.87], P 0.001), absence symptomatic allergy medications (1.707 [1.008-2.892], 0.047), asthma diagnosis (1.74 [1.05-2.88], 0.03), sensitization animal dander (1.93 [1.21-3.09], 0.006) or pollen (1.16 [1.03-1.30], 0.012) cluster regimens (vs rush) (4.18 [1.21-14.37], 0.023). previous episode anaphylaxis increased (OR CI] 17.35 [1.91-157.28], 0.01).AIT is safe, a low number observed real-life practice. personalized analysis could be used minimize SRs.