Immunotherapy

• Injection Immunotherapy is given by syringe with the needle put under the patient’s skin (subcutaneous)
• To start, a very small dose is given. Each injection has a higher amount and/or concentration of the allergen until a top (maintenance) dose is achieved.
• The increasing doses are usually given weekly for about 16-18 weeks. After this, the top doses can be more spread out, given 6-8 weekly.
• Injection immunotherapy must be given for at least 3 years to be fully effective, and stopping it half way or “taking a break” means that it may be less effective or not work at all.
• People having injection immunotherapy are getting the very thing to which they are allergic as an injection under the skin, so it does have a risk of both big and minorsmall side effects. Because of this, it must be given by someone with experience and after each injection the person needs to stay at the doctors clinic or office for at least half an hour to make sure no bad reactions occur.
• Injection Immunotherapy is used mostly for bee and wasp allergy, but can also be used for severe hayfever.

• In oral immunotherapy the doctor gives you the substance that you are allergic to in a drop that you put under your tongue (sublingual) every day to try to get your body to become less sensitive to the allergy.
• This treatment needs a lot of dedication because the drops are taken every day for at least 2 to 3 years.
• Oral immunotherapy has much fewer side effects than injection immunotherapy.
• Because of this, the “top dose” is given immediately with no need to increase the doses slowly. This first dose must be given in the doctor’s office to make sure it is being done properly and to look for the rare side effects. After this the drops are taken at home.
• Oral immunotherapy is often preferred for people with hayfever because it has less side effects and requires much fewer visits to the doctors rooms. On the other hand, because immunotherapy requires the doses to be taken really regularly, an advantage of injection immunotherapy is that the doctor knows whether doses have been given properly.

Which patients benefit?

• Immunotherapy does not work in all patients with allergies.
• It is the only treatment that can cure people with bee or wasp venom allergy.
• It works best when the patient is allergic to only one allergen, rather than lots of allergens.
• It is particularly effective for people who have severe allergy to house dust mites or pollens.
• It may also be given to carefully selected patients with severe allergy to cats, dogs and horses.
• Patients with multiple allergies do not usually respond well to immunotherapy.
• Allergy tests should be performed, and people must be avoiding their allergen carefully before immunotherapy is even considered.
• It is important to be carefully evaluated by a doctor experienced in treating allergies, and using immunotherapy before immunotherapy is started.