Feature Article

Allergen immunotherapy for allergic respiratory disease

Feature Article

Allergen immunotherapy for allergic respiratory disease

Raymond Mullins, Sandra Vale, Richard Loh

Figures

© winyuu@istockphoto.com   Model used for illustrative purposes only
© [email protected] Model used for illustrative purposes only

Abstract

Patients have access to a wider range of effective immunotherapies for allergic rhinitis (hay fever) and allergic asthma that decrease the severity of symptoms with subsequent allergen exposure and lessen the need for medications – the closest  thing to a ‘cure’ for allergy and an example of ‘personalised medicine’.

Key Points

  • Minimising exposure to allergic triggers and using medication to treat patients with allergic respiratory disease (allergic rhinitis and/or allergic asthma) may provide incomplete relief for allergy symptoms.
  • Allergen immunotherapy aims to reduce or eliminate underlying allergic sensitivity.
  • Emerging evidence shows aeroallergen immunotherapy may reduce the risk of new asthma development as well as improve existing asthma symptoms and need for medication.
  • Immunotherapy options in Australia have expanded, with the availability of standardised allergen tablets for sublingual immunotherapy (SLIT) as well as traditional subcutaneous immunotherapy (SCIT).
  • Assessment of benefit is largely subjective but objective scoring systems are available; repeat allergy testing is not used to assess benefit.
  • To optimise selection of patients and allergens, allergen immunotherapy is usually prescribed and initiated by specialists with training in allergic disease; most injections can be administered by general practitioners and practice nurses who have had training.
  • Barriers to accessing immunotherapy include knowledge of availability, access to specialist services, cost and convenience.