Do Allergy Shots Work?
CHICAGO– Allergy shots have been used for almost a century to treat patients with allergic rhinitis or asthma. But does this form of immunotherapy really work–or is it, as some critics have claimed, no better than placebo? Several new meta-analyses suggest that immunotherapy–with specific standardized and potent extracts–improves allergy and asthma symptoms, reduces medication needs in some patients with allergen-triggered asthma and allergic rhinitis, and prevents the progression of allergic rhinitis. It may even reduce costs for some patients. However, careful patient selection is the key to maximizing the benefits from immunotherapy. Although immunotherapy has been a hallmark of care among allergists for decades, considerable controversy remains regarding its clinical efficacy and economic consequences, especially in patients with asthma.
Finegold: Allergy immunotheraphy not only makes symptoms go away, it can truly help prevent the amplification of the disease into asthma and decreases the number of allergies. What about side effects or bad reactions? Finegold: Bad reactions are extremely rare, but we do want patients to stay in the doctor’s office for at least 30 minutes to make sure there isn’t a bad reaction. Most people will have a mild reaction, a little soreness, swelling. Are there any precautions I should take before getting an allergy shot? Finegold: Beta-blockers should be avoided because they can interfere with epinephrine. But antidepressants are not a problem. How much of an improvement will I see? Finegold: If doctors choose these people correctly and administer it correctly, 90 to 95 percent improve. Probably most people – about one-third of allergy sufferers – don’t get shots. Allergists only see the tip of the iceberg.
