Literature review: Immunotherapy - Twitter summary from 2014 #ACAAI meeting

Dr Hal Nelson discussed new literature on immunotherapy.

Comparison of SLIT and SCIT - Clin Exp Allergy 44:417. Take home message: SCIT shows significant and more profound effect than SLIT by symptoms and humoral biomarkers.

AAAAI/ACAAI Study of SCIT 2008-2012 - JACI in Practice 2014;2:161. From 2008-12, 27-49% of AAAAI/ACAAI members responded to surveys, representing 23.3 million injection visits. In Bef 2002 study, there were 3.4 fatal reactions per year from SCIT, from 2008-2012 there was just 1 fatal reaction from SCIT. That was in an asthmatic with comorbidities. Dr Nelson laments that the survey participation rate has declined in recent years.

Esophageal hypereosinophilia induced by grass SLIT - JACI 133: 1482. A 23-yo male was on previous HDM SLIT but had dysphagia 1 month after starting grass SLIT tablet, biopsy showed 18-24 eos/hpf. Once grass SLIT stopped (and patient continued HDM SLIT), symptoms and biopsy findings normalized. There was another case of EoE with another SLIT for birch/alder/hazelnut - Case Rep GI 7:363.

House Dust Mite (HDM) sublingual tablet from Denmark - Mosbech JACI. Dose unknown (trade secret?) but looked at ICS use and asthma control. Only highest dose of the tablet ("6 DU") significantly reduced dose of ICS but other study parameters did not differ.

Ragweed SLIT for Allergic rhinoconjunctivitis - JACI 133:751. This is a Phase III study using product with a higher dose than ragweed tablets or other forms of SLIT. This liquid ragweed product reduced symptoms/medication scores by 20% and was associated with only 12% incidence of local adverse reactions.

This is a Twitter summary from 2014 #ACAAI meeting. The post is a part of series. See the rest here:

The Twitter summary was made possible by @MatthewBowdish

Several allergists did a great job posting updates from the 2014 meeting of the #ACAAI. I used the website “All My Tweets” to review the tweets. For comparison, here are the tweets from previous #ACAAI meetings (scroll down the page for the past years):

Mechanisms of allergen-specific immunotherapy (click to enlarge the image). The diagram is based on: Mechanisms of allergen-specific immunotherapy. Akdis CA, Akdis M. J Allergy Clin Immunol. 2011 Jan;127(1):18-27.

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