Safety and Patient Selection
Table 2. Indications for Allergen Immunotherapy in Patients With Allergic Rhinitis, Allergic Conjunctivitis, or Asthma
ÎAllergen immunotherapy should be considered for patients who have demonstrable evidence of specific IgE antibodies to clinically relevant allergens. The decision to begin allergen immunotherapy might depend on a number of factors, including but not limited to:
> patient's preference/acceptability > adherence > medication requirements > response to avoidance measures > adverse effects of medications > coexisting allergic rhinitis and asthma; and > possible prevention of asthma in patients with allergic rhinitis
ÎPotential indication: atopic dermatitis, if associated with aeroallergen sensitivity
ÎIndications for allergen immunotherapy in patients with reactions to Hymenoptera stings:
> patients with a history of a systemic reaction to a Hymenoptera sting (especially if such a reaction is associated with respiratory symptoms, cardiovascular symptoms, or both) and demonstrable evidence of clinically relevant specific IgE antibodies;
> patients > 16 years with a history of a systemic reaction limited to the skin and demonstrable evidence of clinically relevant specific IgE antibodies (patients ≤ 16 years of age who present with a history of only cutaneous symptoms to Hymenoptera stings usually do not require immunotherapy); and
> adults and children with a history of a systemic reaction to imported fire ant and demonstrable evidence of clinically relevant specific IgE antibodies.
ÎPotential indication: for large local reactions in patients who have frequent and disabling large local reactions.
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