Rush Immunotherapy
Immunotherapy, or allergy shots, offers the only potential cure for allergic rhinitis, allergic conjunctivitis, allergic asthma and venom allergy. Unlike medications that simply cover up allergic symptoms, allergy shots are the only therapy to change how a person’s body deals with allergies. You would think, therefore, that everyone would want to do allergy shots. Unfortunately, allergy shots can be inconvenient for many people because they involve a significant time commitment (typically going to the allergist’s office once to twice a week initially), and may take months before they start working.Rapid build-up schedules for allergy shots are used by some allergists in order to achieve a higher dose of allergy shots faster, which results in benefit of the shots sooner. These schedules also result in a person getting to a “maintenance dose” faster, as well as being able to come into the allergist’s office less often for allergy shots once this maintenance dose is achieved. There are two types of rapid build-up schedules –- rush immunotherapy and cluster immunotherapy.
Rush immunotherapy involves giving a person multiple allergy shots over a period of many hours to days, achieving a maintenance dose (or near-maintenance dose) in a very short amount of time. After the initial period of rush immunotherapy, a person is able to come into the allergist’s office typically only once a week for the next many weeks, then even less often. People undergoing rush immunotherapy also achieve benefit from allergy shots much faster, usually within a few weeks.
Unfortunately, rush immunotherapy results in allergic reactions in a large percentage of people, so various medications (such as antihistamines and corticosteroids) are often given in order to prevent or minimize these reactions. A person undergoing rush immunotherapy should be prepared to spend at least a couple of days in the allergist’s office, receiving many allergy shots over this time.
Cluster immunotherapy involves giving two or more allergy shots at each visit, usually spaced apart by 20 to 30 minutes or so. This procedure is performed once or twice a week, and also allows for a person to get to their maintenance dose much quicker. While some studies have shown that cluster immunotherapy results in higher rates of allergic reactions than traditional schedules for allergy shots, other studies show no difference for rates of allergic reactions. Some allergists recommend medications, such as antihistamines, to minimize these reactions during cluster immunotherapy, while others do not.
Both rush and cluster immunotherapy offer an alternative to traditional schedules for allergy shots, allowing a person to achieve higher doses of allergy shots much quicker, and therefore get benefit sooner. However, both forms probably result in an increased rate of allergic reactions, particularly for rush immunotherapy. And, both are more of a time commitment up front, with rush immunotherapy typically taking a full day (or more), and cluster immunotherapy taking an hour or more for every visit initially.
Rush and cluster immunotherapy are commonly used for people with venom allergy. This allows for quicker protection against allergic reactions to future insect stings, and may actually be a safer way to treat people with venom allergies who have had problem with allergic reactions to their allergy shots.
Often, allergists have typical ways of giving allergy shots to their patients, and they tend to offer this typical build-up style to all of their patients. Most allergists don’t simply give their patients the choice of build-up schedule. If you are interested in pursuing one of these rapid build-up schedules, contact several allergists in your area to find one who is experienced in these procedures.
Learn more about allergy shots.
Source:
Cox L. Advantages and Disadvantages of Accelerated Immunotherapy Schedules. J Allergy Clin Immunol. 2008;122:432-4.
DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.
