NDLI: The LOCAL Study: Local reactions do not predict local reactions in allergen immunotherapy.

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The LOCAL Study: Local reactions do not predict local reactions in allergen immunotherapy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Calabria, Christopher W. Coop, Christopher A. Tankersley, Michael S.
Description	Country affiliation: United States Author Affiliation: Calabria CW ( Department of Allergy and Immunology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, TX 78236, USA. christopher.calabria@lackland.af.mil)
Abstract	BACKGROUND: Although previous immunotherapy studies have demonstrated that a local reaction does not predict a systemic reaction, no study has investigated whether a local reaction predicts a local reaction. OBJECTIVE: To determine whether a local reaction predicts a local reaction at the next immunotherapy injection. METHODS: A retrospective analysis of an electronic immunotherapy database over a 12-month period was performed at a single site that did not dose-adjust for local reactions. Total injections, small local reactions (less than or equal to the size of patient's palm), large local reactions (LLRs; larger than the patient's palm), systemic reactions, and whether a local reaction was followed by a local reaction were recorded. RESULTS: Between August 2005 and July 2006, 360 patients received a total of 9678 injections. Of all patients, 78.3% had at least 1 local reaction, and 7.5% had an LLR. The total local reaction rate was 16.3% (1574/9678), the small local reaction rate was 15.9% (1536/9678), and the LLR rate was 0.4% (38/9678). Of all local reactions followed by another injection, 27.2% were followed by a local reaction. The sensitivity and positive predictive value for a local reaction predicting a local reaction at the next injection were 26.2% and 27.2%, respectively. In contrast, the specificity for the absence of a local reaction predicting the absence of a subsequent local reaction was 85.5%. For LLRs, only 6.0% were followed by another LLR; the sensitivity, positive predictive value, and specificity were 5.2%, 6.0%, and 99.6%, respectively. CONCLUSION: In a clinic that does not dose-adjust for local reactions, local reactions do not predict local reactions at the next immunotherapy injection.
File Format	HTM / HTML
ISSN	00916749
e-ISSN	10976825
Journal	Journal of Allergy and Clinical Immunology
Issue Number	4
Volume Number	124
Language	English
Publisher	Elsevier
Publisher Date	2009-10-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Immunology Allergens Adverse Effects Desensitization, Immunologic Hypersensitivity Therapy Administration & Dosage Dose-response Relationship, Immunologic Immunology Injections, Subcutaneous Prognosis Retrospective Studies Sensitivity And Specificity
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Immunology

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