RUSH Immunotherapy

Presented at the
American College of Allergy, Asthma & Immunotherapy
November, 2006

Allergy sufferers get symptom relief sooner using a procedure of rapid build-up to their allergy shot (immunotherapy) maintenance dose. A half day protocol is effective and safe as reported by Joseph T. Inglefield, III, M.D. of Hickory and William Smits, M.D. of Fort Wayne Indiana at the 52nd annual scientific meeting of the American College of Allergy, Asthma, & Immunology meeting in Philadelphia on November 12.

The RUSH procedure reduces the conventional length of time (months) it takes to reach a maintenance dose. An injection of diluted allergens is given every fifteen minutes during a half day protocol after pretreating each patient with several medications for 72 hours. Patients are required to return in one week to begin weekly injections at their maintenance level. Two percent of the 1865 patients in the report had mild systemic reactions (dizziness, nausea, headache, etc.). One patient experienced anaphylaxis and recovered with treatment.

Not all allergists offer the rapid procedure, but Dr. Inglefield’s practice in Hickory specializes in this innovative method of RUSH immunotherapy. He has used the RUSH technique over a 10-year period, treating patients ranging in ages from 3-68 years old. “We have a very low reaction rate and rarely have a systemic reaction. Carefully selecting patients, premedication to reduce reactions, and monitoring during the procedure all contribute to its safety.”

Allergy shots work by vaccinating against inhaled or stinging insect allergens. Small amounts of a patient’s allergen(s) are injected in gradually increasing doses. Exposure to allergens in controlled amounts, alters the body’s response to allergic triggers. Symptom relief does not begin until after reaching a maintenance dose and maximum relief occurs as the patient continues on a regular schedule of allergy shots.

Immunotherapy helps patients who have allergic rhinitis, allergic asthma, allergic sinus disease, or certain allergic skin conditions better tolerate inhaled substances triggering allergy symptoms. Patients taking RUSH immunotherapy are able to benefit earlier and reduce medications sooner than patients on the conventional method of reaching a maintenance dose.

Rapid desensitization

Rush procedure gives relief from allergies quicker than conventional allergy shots

Dr. Inglefield presents a paper on rapid desensitization November 5, 2000 at the American College of Allergy, Asthma & Immunology Annual Meeting in Seattle, Washington.

Rapid desensitization reduces the time it takes to get help from allergen immunotherapy or allergy shots. Dr. Inglefield has established a protocol for rapid desensitization that includes carefully selecting patients, premedication, in-office monitoring, and one-half day initial build-up period. Patients build-up to an effective dose during a half-day in his office rather than the months conventional allergy shots take for a patient to reach a maintenance dose. It greatly shortens the time patients have to wait for conventional allergy shots to relieve their symptoms.

Hickory Allergy & Asthma Clinic has successfully treated almost 400 patients safely and effectively over a four-year period with the rush procedure. The clinic offers rush and conventional methods to its patients.

Studies have shown that immunotherapy gives long-term improvement as it changes the way the immune system responds to allergens.  Rapid desensitization is an exciting procedure as it builds on an already well-established treatment for allergies called immunotherapy and referred to as allergy shots.  Rapid desensitization and conventional allergy shots treat allergy symptoms such as runny nose, watery, red and itchy eyes, nasal and sinus congestion, coughing, headaches, shortness of breath, chest tightness, and wheezing.

Dr. Inglefield has been selected as one of the few featured oral abstract presenters at the annual meeting of the American College of Allergy, Asthma & Immunology (ACAAI) for the last several years. The ACAAI is a professional organization of allergists with members around the world. The 2000 annual meeting is in Seattle, Washington from November 3-8.

Long-term benefits
of grass-pollen immunotherapy

The study, reported in the New England Journal of Medicine shows that symptoms can be greatly diminished for at least three years following immunotherapy treatment. NEJM 1999;341:468-475, 522-524

What are the results of the study?
Results indicate that individuals with grass-pollen allergies, who went through a complete course of immunotherapy treatment for those allergies, experienced "prolonged clinical benefits" for at least three years after discontinuing the allergy shots.

This study shows that taking a complete series of "allergy shots" for grass-pollen allergies can provide relief that lasts, at least, three years after the treatment is over.  This is great news for those who are hit hard by grass-pollen allergies.

How was the study done?
For three years, a researcher at the National Heart and Lung Institute in London and his colleagues followed 32 patients who had received grass-pollen immunotherapy for at least three years.  During the three year period of the study, grass-pollen allergy symptoms did not return in the group of patients who had received treatment.

How significant is this study?
The study, ". . . provides the best evidence to date that allergen immunotherapy has long-term, perhaps permanent benefits," said N. Franklin Adkinson, Jr., M.D., of John Hopkins School of Medicine.

Article adapted from American Academy of Allergy, Asthma and Immunology Communication for Patients, August 1999.

©1999