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JACI Highlights - October 2009Local reactions do not predict local reactionsLocal reactions are common, occurring in 26% to 82% of patients over a course of immunotherapy. Previous studies demonstrated that a local reaction does not predict a systemic reaction at the next injection. In a new study in the October 2009 issue of The Journal of Allergy and Clinical Immunology, Calabria et al. investigated whether a local reaction predicts a local reaction at the next injection. This 1-year analysis of an electronic immunotherapy database included 360 patients who received 9,678 injections within a clinic that does not dose-adjust for local reactions. A small local reaction was defined as ≥5 mm, and a large local reaction was defined as greater than the size of the patient’s palm (average adult, 80-100 mm). The authors found that 78.3% of patients experienced a small local reaction, while 7.5% had a large local reaction. Of all local reactions followed by another injection, 27.2% were followed by a local reaction. The sensitivity and positive predictive values for a local reaction predicting a local reaction at the next injection were 26.2% and 27.2%, respectively. For large local reactions, 6% were followed by another large local reaction. This study suggests that local reactions do not predict local reactions at the next injection within a clinic that does not dose-adjust for local reactions. “The LOCAL study: local reactions do not predict local reactions in allergen immunotherapy” by Calabria et al. (JACI October 2009 Volume 124 No. 4) |
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