What is immunotherapy

Improved quality of life

Personalized medicine

Based on allergen extracts

Ability to modify the course of allergic diseases

What are the benefits?

What types are there?

Important information

What is immunotherapy?

Immunotherapy with allergy vaccines or allergen extracts is recognized by experts in the field as the only treatment that can alter the natural history of respiratory allergic diseases.1

This treatment aims to reduce the body's hypersensitivity response to substances that cause allergies.

Immunotherapy is recommended for respiratory allergies caused by substances such as pollen, house dust mites, mold fungi and animal dander, as well as for hypersensitivity to bee and wasp stings.

The treatment begins by administering the substance that causes the allergy (allergen) to the body in increasing doses. Once a certain maximum dose is reached, this dose is usually continued for 3 to 5 years.

Today, immunotherapy application varies depending on factors such as the purpose of treatment, the type of allergen extracts used, and the route of administration. Therefore, your doctor will determine the most appropriate treatment protocol for you.

Since there are different products and modes of administration, it is important to familiar with the available types of immunotherapy and understand the differences between them.

What are the benefits? 2

With allergy immunotherapy, the patient gradually develops tolerance to the administered allergens. This results in a reduction or complete disappearance of the symptoms experienced upon natural exposure to these substances.

The gradual improvement in symptoms (such as sneezing, watery eyes, wheezing or shortness of breath) also reduces the need for medications (antihistamines, eye drops, bronchodilators, etc.) used to control these symptoms.

Effects of allergen immunotherapy

Short-term effect (reduction in symptoms and decreased need for allergy medications)

Long-term effect (a persistent effect that can continue for years even after the end of treatment, and in some cases lifelong immunity)

Complete elimination or significant reduction of allergic symptoms.

Controlling the natural history of allergic diseases:
- Preventing the development of bronchial asthma in children with allergic rhinitis
- Preventing the emergence of new allergies

Immunotherapy Administration Methods and Treatment Phases

The two most commonly used routes of administration in immunotherapy are subcutaneous (under the skin injection) and sublingual (under the tongue) methods. Treatment usually consists of two phases: initial and maintenance. The initial phase refers to the period during which doses are gradually increased, while the maintenance (or continuation) phase refers to the period in which the reached maximum dose is administered at regular intervals. 3

SUBCUTAN (Subcutaneous injection)

Initial treatment:

Administration is usually weekly, depending on the type of product. If it is desired to reach the maintenance dose early, multiple doses in one day or all doses can be administered in one or several days.

Maintenance (continuation) treatment:

It consists of repeating the maximum dose reached in the initial treatment, usually at monthly intervals. In some cases for patients with pollen allergy, treatment is stopped for one year and resumed the following year after the end of the pollination period.

The administration should be done in a health center to treat possible reactions. After injection of the extract, the patient should stay at the center for at least 30 minutes.

SUBLINGUAL (Available as drops, sprays or tablets)

Initial treatment:

It consists of applying the sublingual spray/drop/tablet every day and increasing the dose every day.

With some products, as with SULGEN, no initial treatment is required. A maintenance dose is administered directly from the first day.

Maintenance (continuation) treatment:

It is usually administered daily, but there are also forms that can be given every other day or five days a week. In SULGEN, 2 puffs are administered daily.

The safety of sublingual treatment allows in some cases to starting directly with the maintenance dose. The patient can self-administer these extracts at home.

Important information for the patient4

 (Subcutaneous immunotherapy)

  • Local reactions may occur at the injection site, and in rare cases, general (systemic) reactions can also be observed.
  • It should be administered in a healthcare facility (polyclinic, health center, hospital, specialist doctor's office, etc.) and never at the patient's home. It is important to follow the intervals between injections as indicated on the patient follow-up card.
  • Store in the refrigerator at 2-8˚C (should not come into contact with the inner walls of the refrigerator and must be placed on the shelves with some space around it). Do not freeze (freezing will render the product unusable, and a new one will need to be obtained).
  • Administration of the extract should be postponed if the following conditions are observed:
    - You are having an asthma attack.
    - You have a fever or respiratory infection (with flu-like symptoms such as malaise, muscle pain, joint pain, chills or shivering).
    - You have hepatitis, mononucleosis, active tuberculosis or a similar infectious disease.
    - You have received an attenuated live virus vaccine within the last 7-10 days.
  • Be sure to inform us if you have been prescribed any other medication for different condition, as some medications may be contraindicated with vaccination.
  • It is recommended to avoid physical activity for at least two hours after the treatment has been administered.
  • Immunotherapy is usually a long-term treatment method. The duration of treatment varies between 3 and 5 years.
References

1. Tabar Purroy A.I., Serrano Delgado P., Beitia Mazuecos J.M., Núñez Acevedo B. Types of immunotherapy. Immunotherapy with allergens. In: SEAIC, AstraZeneca, editors. Review on Allergology. Tomo I. 2ª ed. Madrid; 2017. p. 1195-1209.


2. Guardia Martínez P., Moreno Aguilar C. Las vacunas contra la alergia o inmunoterapia. In: José Manuel Zubeldia, Mª Luisa Baeza, Ignacio Jáuregui, Carlos J. Senent. Libro de las enfermedades alergénicas de la fundación BBVA. 2.ª ed. Bilbao: Editorial Nerea, S.A.; 2012. p. 445- 452.


3. SEAIC: Sociedad Española de Alergología e Inmunología Clínica (cited November 21, 2009). Available at: https://www.seaic.org/pacientes/procedimientos-terapeuticos


4. Immunotherapy follow-up chart. SEAIC (Spanish Society of Allergology and Clinical Immunology)

For more information about allergies, you can check out our content titled “What is Allergy?"
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