Comparison of Standard, Cluster, and Rush Allergy Immunotherapy Buildup Protocols.
Comparison of Standard, Cluster, and Rush Allergy Immunotherapy Buildup Protocols.
复制标题
标准、集群和 Rush 过敏免疫治疗建立方案的比较。
DOI：
10.1016/j.jaip.2023.06.028
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Kelso,JohnM
中科院分区：
文献类型：
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作者：
Lee,MichaelC;Puglisi,LeahB;Kelso,JohnM
BackgroundAllergy immunotherapy (AIT) involves a dose-escalation phase following 1 of 3 protocols: standard, cluster, or rush. Although the cluster and rush protocols have been shown to decrease the time to reach maintenance dosing, there is a lack of direct comparison between the protocols.ObjectiveThis study aimed to evaluate the differences in time to maintenance dosing and occurrence of adverse reactions among the dose-escalation protocols.MethodsA retrospective observation study of patients on AIT was conducted. Patients were categorized as participating in the standard, cluster, or rush buildup protocols. Patients on the rush protocol, unlike the standard and cluster protocols, were required to receive prednisone, montelukast, cetirizine, and famotidine on the rush day and first 2 weekly injections thereafter. Variables analyzed include patient demographics, time until maintenance dosing, rate of adverse reactions, treatments required for reactions, and AIT formulation.ResultsData were reviewed on 237 patients on the standard (n = 41), cluster (n = 122), and rush (n = 74) protocols. The maintenance dose was achieved faster with the rush (16.50 weeks) and cluster (19.33 weeks) buildup protocols than the standard (31.09 weeks) protocol (P< .001). There was no statistically significant difference between time to maintenance dosing when comparing the cluster and rush protocols (P= .322). Despite pretreatment with the rush protocol, the rate of systemic reactions was the same for the standard (9.76%), cluster (9.84%), or rush (14.86%) buildup protocols (P= .526).ConclusionPatients on the cluster buildup protocol for AIT achieved maintenance dosing in a comparable time frame as the rush protocol with a similar rate of systemic reactions and without the need for the pretreatment required with rush immunotherapy.
