1009 AAAAI Survey on Allergen Immunotherapy (AIT) in Patients withSpecific Medical Conditions

Friday, 13 December 2013
Michigan Ballroom (Westin - Michigan Avenue)

Désirée Larenas-Linnemann, MD, FAAAAI, Dist. Intl FACAAI , Hospital Médica Sur, Mexico City, Mexico

David Hauswirth, MD, FAAAAI , The Ohio State University, The Ohio State University Medical Center, Columbus, OH

Christopher Calabria, MD, FAAAAI , Dilley Allergy and Asthma, Helotes, TX

Lawrence Sher, MD, FAAAAI , Peninsula Research Associates, Rolling Hills Estates, CA

Matthew Rank, MD, FAAAAI , Mayo Clinic, Rochester, MN

Background: Little data exists on AIT in patients with specific medical conditions. In this context the experience of practicing allergists might yield very useful information.

Methods: A survey (Surveymonkey®) was sent out to all AAAAI members to explore their experience with AIT in patients with specific medical conditions. Results are expressed descriptively.

Results: 1061 of the 5148 (20.6%) surveys were sent back. Practice characteristics: 86% US-based, 44% urban, 51%  suburban and 5% rural with a third of all responders working in an academic setting. 54% of the surveyed mentions clinical experience of more than 16 years with an even distribution over small, middle and large practices. Next we mention the specific medical conditions with percentages of allergists who have treated/would treat/contraindicates AIT in patients with the condition. These data are followed by number of patients with the condition that did receive AIT and (%) of their treating allergists that referred major problems: severe asthma 58/10/32%, 3270 (12.3%); hypertension 87/9/4%, 4979 (0.6%); coronary artery disease 66/16/18%, 2866 (2.4%); arrhythmias 53/24/23%, 1852 (1.9%); cerebro-vascular disease  44/33/23%, 1255 (1.5); cancer, in remission 69/25/7%, 2378 (0.6%); cancer, stable, but still under treatment 36/32/33%, 687 (3.6%); history of bone marrow transplantation 13/57/30%, 139 (0.9%), history of a solid organ transplantation 15/55/30%, 181 (2.4%); infected with human immune-deficiency virus, but not yet AIDS 25/47/28%, 409 (1.3%), AIDS 12/40/48%, 174 (5.3%), autoimmune disease in stable stage 62/26/12%, 2306 (1.9%).

Conclusions: CaRem, HIV seropositivity, hypertension or a history of transplantation seem to pose little additional risk to SCIT administration, as opposed to the augmented risk of severe asthma, AIDS and starting SCIT during pregnancy.