A survey of allergen specific immunotherapy in korea

Background; Allergen-specific immunotherapy (SIT) has been used as the only curative and specific treatment for allergic diseases. There have been no data on SIT in Korea. Therefore, we carried out a survey to observe the prescription pattern of allergy specialists in Korea.

Methods; All 690 members of the Korean Academy of Asthma, Allergy, and Clinical Immunology received an e-mail attaching a questionnaire on SIT, and were required to return the answers. All returned answers were recruited between August 2009 and September 2009.

Results; The response rate was 21.0%. Among them, 42.8% was physicians, 32.4% was pediatricians, and 20.7% was otolaryngologists. Only 69% of respondents performed SIT in practice. The methods used to detect causative allergens were skin prick test (46.1%) and serologic tests (44.1%) such as immunoCAP and MAST. The limitations to  to start SIT in their own practice were lack of equipment (21%) and practical experience (15.8%), no necessary because pharmacotherapy alone was enough to treat (14.5%), no good profit (14.5%), and its risks for adverse reactions (13.2%). The target diseases for SIT were allergic rhino-conjunctivitis (46%), allergic asthma (38%), and atopic dermatitis (10%). Ninety-two allergic specialists (82%) performed SIT via subcutaneous route (SCIT) and 18% via sublingual route (SLIT). The allergens used for SCIT were house dust mites (42.5%), pollens (31.3%), and animal dander (10.2%). Twenty-eight (30%) doctors have experienced anaphylactic reaction during SCIT. About 40% of doctors have experienced any adverse reaction including local reactions during SLIT.

Conclusion; In Korea, 69% of allergy specialists performed SIT in practice. The prevalence of SCIT was 82% and SLIT was 18%. Lack of equipment and practical education were critical barrier to performing SIT in doctors. Therefore, proper practical educations to update information on SIT will be necessary for allergy specialists.