Regional Specific Allergen Immunotherapy - thoughts?

RE: Regional Specific Allergen Immunotherapy - thoughts?

Judith Joyce — Sat, 13 Jun 2020 06:35:03 GMT

Also an independent UK first opinion and referral dermatologist, I would like to add a few comments to Mark’s

My experience of ASIT is as a valuable tool in treating derm. patients. Not only the clinical effect of ASIT itself, (other studies show similar good results) but the frequent re-examinations required for treatment are a major asset for reassessing cases, controlling flare factors (ectoparasites, pyoderma, seasonal flares, etc) and refining adjunctive treatments. Also, the owners who self select for ASIT are very committed to their pets treatment and will monitor progress and follow treatment plans (including topical treatments) assiduously.

There is so much information and discussion about allergen selection (European vs American, how many allergens to include, etc) and test modalities from labs and elsewhere that it becomes confusing but, if you haven't already seen it, a good independent source of information - the guidelines of the International Committee on Allergic Diseases of Animals - is accessible online.

Allergy testing has been used for a long time now and has developed significantly with published evidence to support it. Although it was tempting to try generic immunotherapy in earlier days - serology tests were still developing and many intradermal test kits were expensive for low case numbers and not so easy to use - there is little evidence to support generic immunotherapy and it might not be easy to defend.

RE: Regional Specific Allergen Immunotherapy - thoughts?

Beats — Thu, 11 Jun 2020 11:22:53 GMT

Thanks, Mark!

18% "good/excellent" with non-individualised regional allergens doesn't sound great (and perhaps much more realistic than the 59% "good/excellent" in the linked paper above).

I'll have a look for that study you mention as sounds very interesting and very encouraging results for individually-tailored immunotherapy too.

RE: Regional Specific Allergen Immunotherapy - thoughts?

Mark Craig — Thu, 11 Jun 2020 10:54:18 GMT

As an independent UK veterinary dermatologist with many patients (dogs, cats, horses) on long-term immunotherapy, based on intradermal testing and/or serology, and clinical history, I see the procedure as a useful long-term way to manage environmental allergies, significantly reducing the need for rescue drugs and the number of pyoderma flares. In human medicine, it can alter the course of the disease and reduce the number of future sensitisations. Immunotherapy is thought to be most effective when tailored to the patient, taking into account clinical history and allergy test results. Clinical response to immunotherapy was much better in one study of atopic dogs when allergen selection was based on allergy testing (70% good to excellent responses) rather than standard regional allergens (18%) Although clinical response appears to be independent of whether allergen selection is based on intradermal or serological testing, one study has suggested slightly better results if both procedures are considered.