Treatment of allergic rhinitis, more commonly known as nasal and sinus allergies, allergic asthma, and allergy to insect venoms is based on three principles
- Avoidance of causes
- Treatment of symptoms
- Immunotherapy to try to eliminate the allergies
Immunotherapy, or allergy shots, involves injecting very small amounts of the substances causing the allergic reactions and, over time, building up to full immunizing doses.
Traditional immunotherapy procedures consist of once or twice weekly injections of gradually increasing doses. This results in reaching fully effective doses over 3 to 6 months and requires about 20 visits for injections. Once full doses are achieved, maintenance doses are given, usually once a month, for 3 years. Patients usually notice improvement after 3 to 6 months. Approximately 7% of patients have a systemic reaction, approximately 0.5% of injections result in a systemic reaction.
Rush immunotherapy procedures are designed to reach maintenance much faster than can be achieved with traditional immunotherapy. Patients are given allergy medications in advance and over 7 hours the doses are increased to about 1/10th of the full maintenance dose. This avoids the first 17-18 visits for traditional immunotherapy and allows clinical improvement to occur much faster. Full maintenance usually is reached within a month.
- More rapid clinical improvement
- Many fewer visits for injections
- Risks of adverse reactions similar to traditional immunotherapy
Decisions about what form of immunotherapy is best are made depending on an individual patient’s situation and preferences.