Rush immunotherapy: Faster relief for tough allergy symptoms

Allergies are a constant struggle for millions of people nationwide, and Texans know the resulting misery is nothing to sneeze at. Our state is home to six of the nation’s 100 worst metro areas for allergies, as compiled by the Allergy and Asthma Foundation of America in its 2016 Fall Allergy Capitals rankings, with Dallas-Fort Worth in the 23rd spot.

People who have bad seasonal or year-round allergies feel miserable. Many of my patients find relief through over-the-counter or prescription medications, such as antihistamines, corticosteroids, eye drops, decongestants, and other options. But for some people, these just aren’t enough. That’s when we start discussing allergy shots – regular injections given to build up the immune system’s tolerance for allergens and reduce symptoms.

One of the drawbacks of allergy shots is that they involve a time commitment, and it’s hard to keep coming week after week when you’re not feeling the results right away. We can speed up the process of helping you feel better with a technique called rush immunotherapy. This approach reduces the initial period of allergy shots from about six months to about six weeks. I’ve been involved in researching this technique, and it’s an advanced, effective way to get people the relief they need – fast.

How does rush immunotherapy work?

Rush immunotherapy’s main benefit is shortening what we call the buildup phase of allergy shots. We use these shots to treat seasonal allergens, such as grass and tree pollens, along with year-round allergens, such as pet dander and molds. The shots aren’t effective against food allergies, such as tree nuts and shellfish.

Once we’ve done skin testing to find out exactly what you’re allergic to, we create a serum that combines your specific allergens. Then we dilute that serum so we can start with a very low dose.

In traditional allergy immunotherapy, patients come in every week for a shot, then every two weeks, then every three weeks, and eventually once a month while we continually increase the strength of the injections. Each time, patients have to wait 30 minutes after receiving the shot to make sure they’re not going to have an allergic reaction. After four to six months, we reach the maximum dose, also called the maintenance dose. Maintenance shots then continue once a month for three to five years as we train the immune system to not react as strongly to these allergens.

In rush immunotherapy, we start three days ahead of the first office visit by having you take a combination of medications to lower the immune system’s response. My patients take:

• Antihistamine
• H2 blocker (which is another kind of antihistamine, such as Zantac)
• Leukotriene receptor antagonist, such as Singulair
• Prednisone, a corticosteroid

This four-way treatment of the immune system lets us make a lot of headway in the buildup phase on the first day of allergy shots. You’ll come in for a half-day, and we give a series of shots, quickly building up the dosage. After that first day, you’ll still have to come in weekly for a while, but we’re often able to reduce the normal buildup phase of four to six months down to just four to six weeks. After that, maintenance shots continue for three to five years, as in the standard treatment method.

Who is a good candidate for rush immunotherapy?

I’ve been a big fan of rush immunotherapy for a long time, and I was part of a team that researched and published a journal article on it during my fellowship. What I’ve found is that nearly everyone who’s a candidate for allergy shots can benefit from this treatment method as long as the doctor is comfortable with the procedure. Some providers are hesitant to recommend rush immunotherapy to patients with severe symptoms. In my experience, these patients often have the most to gain from the protocol because we’re able to get them relief quicker.

I do caution my patients that the risk of having an allergic reaction to an allergy shot is a little higher during the rush protocol. However, because we keep you here for observation after each injection, we’re able to provide quick treatment. And even if you have a reaction on the first day, we still can shave months off the process even if we can’t complete the full rush protocol.

I might not recommend rush immunotherapy for very young children. That’s mainly because shots can be scary for kids. Having to get many shots on the first day could be traumatizing for them and make it harder for them to deal with needles later. That’s something parents can talk over with their child’s allergist.

It’s important to see a board-certified allergist like me whenever you’re considering options for allergy treatment. Although rush immunotherapy was first developed in the mid-1990s, it’s not widely known among doctors who don’t focus strictly on allergy care.

For most patients, rush immunotherapy is a great alternative to traditional allergy shots. It can help you feel better faster and save time in the process. Request an appointment with one of our allergists to find out if rush is a good option for you.