Q:

9/6/2012
What is the latest practice parameter guidelines regarding allergen immunotherapy (AIT) for patients w/ severe air-born allergies, and who are on 2 or more beta-blockers? My assumption is it still will be a relative contraindication.

A:

Thank you for your inquiry.

For your convenience, copied below is the summary statement regarding the use of beta-blockers during aeroallergen immunotherapy. This was copied from the most recent Immunotherapy Parameters (1). This Parameter is of course available to you free of charge online via the website of the Joint Council of Allergy, Asthma, and Immunology (www.jcaai.org). The paragraph subsequent to this summary statement discussed the nuances underlying this recommendation.

Thank you again for your inquiry and we hope this response is helpful to you.

Beta-Blockers and ACE inhibitors Summary Statement 37: Exposure to beta-adrenergic blocking agents is a risk factor for more serious and treatment- resistant anaphylaxis. Concomitant use of beta-blockers and allergen immunotherapy should be carefully considered from an individualized risk/benefit standpoint and incorporate the patient’s preferences in the medical decision- making process.

Source: Allergen immunotherapy: A practice parameter third update: The Journal of Allergy and Clinical Immunology Vol. 127, Issue 1, Supplement, Pages S1-S55.

Reference:
1.Cox L, Nelson H, Lockey R, et al. Allergen immunotherapy: a practice parameter, third update. The Journal of Allergy and Clinical Immunology, January 2011; Volume 127 (1), Supplement, page S1-S55.

Sincerely,
Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology