Immunotherapy: SCIT (“allergy shots”) and SLIT - Twitter summary from 2013 #AAAAI meeting

This summary was compiled from the tweets posted by allergists/immunologists who attended the 2013 annual meeting of the American Academy of Allergy Asthma and Immunology (AAAAI) (see the list at the end). The tweets were labeled #AAAAI. The text was edited and modified by me.

There have been 83 fatalities reported from SCIT over 39 years. One confirmed fatality from SCIT from 2008-2012 period.

Uncontrolled asthma, dosing error and pollen season are risk factors for fatal reactions from SCIT. Reducing SCIT doses during pollen season associated with significantly less severe reactions.

NO FATALITIES reported from SLIT. Oral, throat and ear pruritus are most common AEs from SLIT. These AEs started in the first week of SLIT, but resolved within 1 week in many.
There is potentially increased risk of reaction to SLIT in those with previous reaction to SCIT.

AIT (allergen immunotherapy) can be called a "profound treatment failure" because of low adherence. Less than 20% of patients who initiated AIT completed a 3 yr course.

In children, there are mean savings of $401 after starting SCIT. In children, vs. non-SCIT treated, SCIT treated patients had a median decrease in health care costs over $1500.

Same decrease was seen in adults. Mean savings of $4000 in kids and $4400 in adults. The data are in press in JACI.

Allergen Immunotherapy saves healthcare dollars: http://www.jacionline.org/article/S0091-6749(12)02641-3/abstract

Unfortunately, SCIT was received by few who needed it and had high rates of discontinuation with wide variations by demographics.

SLIT is less effective than SCIT

SLIT poster showed 43% reduction of symptoms vs. placebo for short ragweed SLIT after only 8-10 weeks of treatment (Creticos et al.). Ragweed SLIT tablet showed 27% symptom reduction with higher dosage.

Grass SLIT tablet studies have shown 20% symptom improvement in adults and 26% in kids. 5 grass SLIT tablet led to 28% in symptoms.

Overall, it looks like a 20-30% decrease in symptoms occurs rather quickly with SLIT.

SCIT is better than SLIT In decreasing symptoms BUT adherence of SLIT may be higher. If the patient isn't using the treatment, does it matter if it’s effective?

There are 7 cross-reactive allergen families; tropomyosin, serum albumin, non-specific lipid transfer protrein, PR10, profilin, thaumatin-like protein, carbohydrate cross-reactive determinant.

If you were mixing an IT extract to cover all grasses in US you would mix the following: Johnson, Bermuda, Timothy.

Timothy grass SLIT will be approved next year and will cover all northern grasses.

Protease content of mold and cockroach extracts are 100 times higher than pollens and dust mites. Don't mix pollen, animal, dust mites with fungi and cockroach. Mixing American cockroach and mold even in 50% glycerin may result in subtherapeutic levels of fungi in the vial.

Media-Fill Test video by JAACI: http://bit.ly/YykPQG

Intra lymphatic allergen injection is less painful than venous blood draw.

Allergists are on Twitter - follow them

Allergists increased Twitter use 470% in one year - 25 allergists reached 250,000 individuals from the 2012 #AAAAI meeting (see the references here). This summary was compiled from some of the tweets posted by the following allergists:

https://twitter.com/ananth720
https://twitter.com/DrYesimDem
https://twitter.com/AsthmaBuddy

This is a list of the allergists who used Twitter to post updates from the 2013 #AAAAI meeting. The list is open for edit, please feel free to add your own info.



I would strongly encourage you to post updates on Twitter from the CME conferences that you are planning to attend in the future. Here is how to do it: Twitter for Physicians: How to use Twitter to keep track of the latest news and scientific meetings, and share information with colleagues and patients.

Disclaimer: The text was edited, modified, and added to by me. This is one of a series of posts that will be published during the next few weeks.

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