Ever wondered whether Immunotherapy is worthwhile
or just a lot of trouble for questionable results?
Dr Sheldon Spector is one of the most preeminent and
respected internationally known allergists in the field. In an interview
with our staff he answers your questions on Immunotherapy.
Immunotherapy
Q. What exactly is Immunotherapy?
A. Immunotherapy is commonly known as " getting allergy shots".
It is the process of administering by injection increasing amounts
of substances a patient is allergic to , such as pollen and dust
mite, with the aim to eventually build tolerance to these substances
and prevent them from causing symptoms. Immunotherapy is especially
useful against substances that are difficult to avoid such as pollen
or dust mites.
Q. Is Immunotherapy a "cure"?
A. Immunotherapy is not a cure but can significantly lessen symptoms
caused by specific substances. For example, a person with allergic
rhinitis may no longer react to Bermuda grass or Olive trees but
will always have a higher tendency than the general population
of manifesting allergic symptoms to other substances.
Q. Does Immunotherapy mean I would
no longer suffer from allergies?
A. Immunotherapy improves symptoms to substances contained in the
immunotherapy injections to different degrees. For example, some
patients with cat allergy may no longer have symptoms around cats
while others will need much less medication to prevent symptoms.
Q. Are there different types of Immunotherapy?
A. Yes. Immunotherapy is given most commonly to improve symptoms from
aeroallergens ( inhaled allergens ). Venom immunotherapy is given
to patients who have experienced systemic or life-threatening reactions
to stinging or biting insects.
Q. What is the success rate of Immunotherapy?
A. Studies showing the effectiveness of immunotherapy ,show that roughly
8 out of 10 patients benefit from immunotherapy.
Q. Does Immunotherapy work better
for one kind of allergy more than another?
A. Immunotherapy has been shown to be effective in allergies to
pollen, cats, dogs, molds, dust mites as well as stinging insects.
Immunotherapy is not effective for food allergies.
Q. Are there different types of Immunotherapy?
When I go to a doctor are they all going to use the same formulas?
A. Although there are community mixes that include common substances
from a specific region, the most effective formulas or mixtures
are made especially for the patient to include all specific substances
or allergens he or she is allergic to.
Q. How long does Immunotherapy take?
A. Immunotherapy is usually given for three to five years for long-term
benefit.
Q. Is there a chance that I could
go through all this trouble and it make no difference?
A. Improvement in symptoms is usually observed in most patients
after 6 months to 1 year of immunotherapy. It is not effective in
all patients and if no improvement is seen within the first year,
the allergist may decide to stop or change the therapy.
Q. If I went through Immunotherapy
would I still need to use HEPA filters and the like and take special
environmental precautions in my house?
A. Yes. While the body is developing tolerance to allergens by increasing
doses of immunotherapy, it is advisable to continue avoidance measures
such as HEPA filters or dust mite covers to increase the chances
of successful immunotherapy.
Q. I have an HMO as medical insurance.
Do HMOs pay for this kind of treatment?
A. Most HMOs today consider immunotherapy effective and pay for
at least part of the treatment. Please check with your HMO to find
out specific policies.
Q. How bad do your allergies need
to be before your insurance will pay for it?
A. Most insurance companies will pay for immunotherapy if your primary
care doctor refers you to an allergist and the allergist recommends
immunotherapy as part of your treatment. Even patients with mild
symptoms may be recommended immunotherapy to avoid worsening
of symptoms, if they cannot avoid the things they are allergic to,
such as pets or specific native trees.
Q. If Immunotherapy has such a good
success rate why doesn't everyone do it instead of taking medication
and spending a ton of money on allergy control products?
A. The time and commitment involved in starting and undergoing
immunotherapy is still seen as an obstacle by many patients looking
for a "quick fix". In time , more and more patients realize
that the long term benefits of immunotherapy are much better than
being on medications for the rest of their life.
Q. Any future new developments in
Immunotherapy that I should be aware of? I heard of a cat vaccine
that was due to be released and then it seems to have disappeared-any
update on that?
A. The promising "catvax" vaccine is still being studied.
It is being touted as a fast-acting vaccine that would induce tolerance
in allergic patients after only about 6 injections as opposed to
the two to three year conventional cat immunotherapy.
With grateful acknowledgement to Drs. Spector and
Tan in this interview.
Dr. Spector's web site together with his partner Dr. Tan and bibliographies
are at Calallergy.com
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First Published: January, 2000
Updated: September 2003
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