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Subcutaneous immunotherapy with high-dose cat and dog extracts: a real-life study

Uriarte SA1, Sastre J1,2,3

1Department of Allergy, Fundación Jimenez Diaz, Madrid
2CIBERES, Instituto Carlos III, Madrid
3Department of Medicine, Universidad Autónoma de Madrid, Madrid

J Investig Allergol Clin Immunol 2020; Vol. 30(3)
doi: 10.18176/jiaci.0415

Background: There are scarce efficacy data on immunotherapy administered to patients with cat or dog allergy.
Objetive: We aimed to evaluate the safety and efficacy of subcutaneous immunotherapy (SCIT) in patients with allergy to these two animals.
Methods: Consecutive patients with rhinitis and/or asthma related to sensitization to cat or dog were included in a pragmatic, real-life, prospective observational study. All patients had specific IgE to cat and/or dog. Using an infusion pump (IP), SCIT was administered over 3 sessions as part of a rush protocol, followed by monthly administration over 12 months. Data were gathered on adverse events and clinical outcomes, pulmonary function, FeNO, rhinitis and asthma symptoms, quality of life (QoL), asthma control test (ACT), and visual analog scale (VAS) at baseline, 6, and 12 months.
Results: Sixty-six patients were included: 38 females, 46 allergic to cat and 20 to dog, with ages ranging from 9 to 59 years. During the up-dosing phase, in which IP was used, 8.1% of doses elicited a systemic reaction (SR) and 5.4% caused a local reaction (LR), while 9.3% of doses administered during the maintenance phase (i.e. without IP) developed a SR, and no LRs were recorded. A significant improvement in FEV1, rhinitis and asthma symptoms and results of QoL questionnaires, use of medication, VAS, and ACT was observed at 6 months and continued at month 12. Clinical improvement with cat extract was significantly higher than with dog.
Conclusions: High-dose SCIT has substantial clinical value in many cat and dog allergic patients. 

Key words: Cat, Dog, Allergy, Rhinitis, Asthma, Allergen immunotherapy