Specific Immunotherapy
Subcutaneous-specific immunotherapy

The importance of subcutaneous immunotherapy (SCIT) and how it is administered

Importance

Subcutaneous immunotherapy (SCIT) is the best-studied route of administration for specific immunotherapy. The allergen extract is injected subcutaneously into the extensor side of the upper arm. Most data in support of the efficacy and safety and mechanism of action of specific immunotherapy have been obtained from subcutaneous SIT.

How it is administered

SCIT therapy consists of an initial phase during which the allergen dose is increased from injection to injection, and a maintenance phase during which a constant dose of allergen is administered at longer intervals. Treatment should only be started when the patient is asymptomatic or almost asymptomatic. Natural allergen exposure should be avoided during the initial phase, and minimised throughout treatment. Patients with a history of asthma are recommended to have regular airway function tests (such as peak flow measurements) before each treatment [1].

In patients with seasonal airway allergies, preseasonal treatment, started early enough before the anticipated pollination, is usually sufficient. However, SCIT may also be administered perennially in these allergies, using a reduced dose during pollination [2]. Patients with allergies to perennial allergens such as mites should be treated all year round.

REFERENCES:
[1] Sennekamp J, Fuchs T, Hornung B, Kersten W, Klimek L, Leupold W, et al. Empfehlungen zur praktische Durchführung der spezifischen Immuntherapie mit Allergenen (Hyposensibilisierung). Ärzteverband Deutscher Allergologen e.V. (ÄDA). Aktualisierte Fassung 2002. Abgestimmt mit der Deutschen Gesellschaft für Allergologie und klinische Immunologie (DGAI). Allergo J 2002;11:332-8.
[2] Kleine-Tebbe J, Bufe A, Ebner C, Eigenmann P, Friedrichs F, Fuchs T, et al. Die spezifische Immuntherapie (Hyposensibilisierung) bei IgE-vermittelten allergischen Erkrankungen. Leitlinie der Deutschen Gesellschaft für Allergologie und klinische Immunologie (DGAKI), des Ärzteverbandes Deutscher Allergologen (ÄDA), der Gesellschaft für Pädiatrische Allergologie und Umweltmedizin (GPA), der Österreichischen Gesellschaft für Allergologie und Immunologie (ÖGAI) und der Schweizerischen Gesellschaft für Allergologie und Immunologie (SGAI). Allergo J 2009;18:508-37.