Allergy shots win over EpiPen in study

By Amy Norton

NEW YORK (Reuters Health) - A new study suggests that people with insect-sting allergies prefer treatment with allergy shots over having to carry emergency medication with them at all times.

In a study of 193 adults with allergies to yellow-jacket venom, researchers found that those treated with allergy shots -- known as immunotherapy -- were almost universally happy with the therapy.

The same was not true of people whose sole treatment was to carry an EpiPen, an auto-injector filled with medication that halts severe allergic reactions; the device has to be carried at all times to be used in an emergency.

Study participants who carried the EpiPen for a year often said it was "inconvenient" and "troublesome," and some said they would be afraid to use it if they ever suffered a sting.

In fact, more than three quarters preferred to receive immunotherapy after carrying an EpiPen for a year, the study authors report in the Journal of Allergy and Clinical Immunology.

The implication is that patients should more often be offered immunotherapy, and not just an EpiPen, lead study author Dr. Joanne N.G. Oude Elberink, of the University Hospital of Groningen in the Netherlands, told Reuters Health.

Immunotherapy has long been used for certain types of allergies, including systemic reactions to insect stings. It's designed to prevent future reactions by helping the immune system develop a tolerance for the allergy-triggering substance. This is done by exposing the body to tiny amounts of the substance over time.

The treatment generally requires weekly allergy shots at first, followed by monthly shots for several years.

Still, patients in the current study largely felt the effort was worth it. Of the 94 subjects randomly assigned to immunotherapy or the EpiPen, more than 91 percent in the immunotherapy group were "positive" or "extremely positive" about it one year later, the researchers found. Only 48 percent of study participants who were assigned to carry an EpiPen felt this way.

After a year of carrying the device, 78 percent of all of the patients said they preferred to start immunotherapy.

EpiPen users who are dissatisfied with the remedy, or who often forget to carry it with them, should ask their doctors about immunotherapy, Elberink advises.

"This study," she explained, "shows that immunotherapy improves the quality of life of these patients in contrast to an adrenaline auto-injector, and that they do not experience this therapy as a burden."

The burden of suffering a severe allergic reaction that requires emergency treatment could be much greater, Elberink noted.

SOURCE: Journal of Allergy and Clinical Immunology, September 2006.