5
Table 2. Summary of Guideline Key Action Statements (KAS)
(cont'd)
Statement Action Strength
Treatment (cont'd)
8. Treating
Polysensitized
Patients with
Limited
Allergens
Clinicians may treat polysensitized patients
with a limited number of allergens.
Option
9. Local Reactions
and Allergen
Immunotherapy
Escalation
Clinicians administering allergen
immunotherapy should continue escalation or
maintenance dosing when patients have local
reactions to allergen immunotherapy.
Recommendation
10. Anaphylaxis
Identification
and
Management
e clinician performing allergy skin testing or
administering allergen immunotherapy must
be able to diagnose and manage anaphylaxis.
Strong
recommendation
11. Retesting
During Allergen
Immunotherapy
Clinicians should avoid repeat allerg y testing
as an assessment of the efficacy of ongoing
allergen immunotherapy unless there is a
change in environmental exposures or a loss
of control of symptoms.
Recommendation
12. Duration
for Allergen
Immunotherapy
For patients who are experiencing symptomatic
control with allergen immunotherapy,
clinicians should treat for a minimum duration
of three years, with ongoing treatment duration
based on patient response to treatment.
Recommendation
Table 3: Comparison of SCIT and SLIT Modalities of AIT for AR
SCIT SLIT (tablets) SLIT (aqueous)
Safety Increased risk of local
and systemic reactions
relative to SLIT
Mild local and rare
systemic reactions
Mild local and rare
systemic reactions
Regulatory United States Food and
Drug Administration
(US FDA) Approved
US FDA Approved Not US FDA
approved (off-label)
Administration Regular clinic visits Home aer first dose Home aer first dose
Number of
Allergens
Delivered
Can mirror all selected
allergens
Limited to Grass,
house dust mite
(HDM), or Ragweed
1–10 (debated with
limited evidence)
Efficacy Improved vs SLIT Decreased vs SCIT Decreased vs SCIT
Cost Insurance covered Insurance covered Usually out of pocket
is table is meant to be a quick-reference summary. Variations exist.
