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Allergists Caution Against Misinterpretation of Immunotherapy Study Results MILWAUKEE, Jan. 31, 1997 -- Allergists from the American Academy of Allergy, Asthma and Immunology (AAAAI) are concerned that physicians, their patients and the general public are not aware of all of the facts about the study on immunotherapy in asthmatic children which was published yesterday in the New England Journal of Medicine (A Controlled Trial of Immunotherapy for Asthma in Allergic Children. Adkinson NF, et al., 1997; 336:324-31). "Immunotherapy is the only treatment available today that has the potential to suppress the allergic mechanism and to reduce the underlying cause of allergic asthma," said Philip Fireman, M.D., AAAAI President. "Many other studies have unequivocally shown that properly administered immunotherapy reduces both asthma symptoms and the need for concomitant medications." Dr. Fireman added it would be unfortunate if the results of the NEJM study were interpreted to indicate that immunotherapy is not helpful in the management of asthma. The AAAAI has reviewed the study and finds that the article was carefully executed by an excellent group of allergist investigators. There were some conditions applied to the study that may explain why the findings disagree with many other studies which have demonstrated that immunotherapy in allergic asthma is both effective and beneficial. In this study, children in both the immunotherapy and placebo groups did very well, with remissions experienced by 31 percent of the subjects. While those children receiving immunotherapy did somewhat better than the control group, the differences were not statistically significant. Patients were carefully monitored and were seen by a physician every 2-3 weeks throughout the study, with an astounding 90 percent compliance rate. The patients were provided with continuous, effective, expert care by the allergists. According to the AAAAI Executive Committee, that care, combined with extensive patient education, allergen avoidance techniques, monitoring, and appropriate use of effective medications available for the treatment of asthma, led to improvement in their disease. The further addition of immunotherapy helped, but did not achieve statistical significance. In addition, while the patients received adequate doses of allergens, and demonstrated appropriate immunologic responses to those allergens, many critical allergens were not employed. In real life, patients receiving immunotherapy receive a wide variety of perennial and seasonal allergens to which they are allergic, and which were not included in this study. "We believe this study confirms that expert asthma care provided by allergists results in excellent improvements in asthma, and in many instances this care can induce a remission in asthma symptoms," said Dr. Fireman. "This study clearly shows that the excellent medications available today are effective at managing asthma symptoms, when used appropriately by knowledgeable allergists." The AAAAI believes that proper management of asthma includes identifying the underlying causes for asthma, educating the patient in allergen avoidance techniques and employing pharmacotherapy appropriately. Immunotherapy is appropriate in those patients who have unequivocal allergic disease, cannot adequately avoid the allergens to which they are sensitive, and are not adequately managed pharmacologically. "We believe that this approach to asthma management will result in both short-range and long-range improvement in patients' asthma," said Dr. Fireman. "This approach is consistent with real life situations and today's medical climate." The AAAAI is the largest national medical specialty organization representing allergists, clinical immunologists and allied health professionals with an interest in allergic diseases. Established in 1943, the Academy has more than 5,400 members in the United States, Canada and 41 other countries. E-mail this page to a friend or colleague! To print, use this version