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Alergologia Polska - Polish Journal of Allergology
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3/2023
vol. 10
 
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abstract:
Original paper

Role of premedication to prevent reactions in cluster immunotherapy

Müge Olgaç
1
,
Semra Demir
2
,
Derya Ünal
2
,
Raif Coşkun
3
,
Bahaauddin Çolakoğlu
2
,
Suna Büyüköztürk
2
,
Aslı Gelincik

  1. Division of Immunology and Allergic Diseases, Seyrantepe Hamidiye Etfal Research Hospital, Istanbul, Turkey
  2. Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
  3. Division of Immunology and Allergic Diseases, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
Alergologia Polska – Polish Journal of Allergology 2023; 10, 3: 180–186
DOI: https://doi.org/10.5114/pja.2023.131707
Online publish date: 2023/09/30
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Introduction:
The clinical efficacy of allergen immunotherapy is well documented, but the treatment always involves a risk of adverse reactions. Although premedication is not routinely performed, it has been shown to reduce the adverse reactions.

Aim:
To evaluate the contribution of premedication to prevent hypersensitivity reactions during cluster immunotherapy.

Material and methods:
253 patients receiving a total of 290 cluster immunotherapy protocols to house dust mites, pollens, and venoms were recruited in the study. Patients were randomized into 5 groups according to the premedication status as follows: daily antihistamine, antihistamine only 2 h prior to injections, daily montelukast, combination of montelukast and antihistamine and the control group including patients without premedication. Patients were followed during up-dosing and maintenance phases of immunotherapy. Systemic and local reactions were reported.

Results:
Most of the patients were female (61.7%), the most frequent allergen was house dust mites (56.9%). 67.2% of patients had premedication and 20.6% of patients had reactions during the up-dosing phase. Reactions were more frequent in patients who received pollen immunotherapy. The total frequency of the hypersensitivity reaction was significantly higher in the control group. When evaluated seperately, local reactions were more frequently observed in the control group, while no difference in the frequency of systemic reactions was detected.

Conclusions:
Our study suggests that the reaction risk is increased in pollen immunotherapy. Premedication does not seem to prevent the frequency or severity of systemic reactions. However premedication, daily AH intake in particular, decreases the frequency of local reactions.

keywords:

premedication, allergen immunotherapy, systemic hypersensitivity reactions, local hypersensitivity reaction, cluster immunotherapy, antihistamine



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