[The analysis of factors contributing to the safety and efficacy of rush immunotherapy in bronchial asthma].

ABSTRACT

In order to establish guidelines for the optimal use of rush immunotherapy (RI) in mite-sensitive adult bronchial asthmatics, we clinically analyzed 38 cases treated with RI. In all cases, it was possible to reach a maintenance dose greater than 0.10 ml of 1/10 solution of house dust (HD) within 10 days. Most of the systemic reactions occurred after doses greater than 0.15 ml of 1/10 solution. The patients who showed the maximum size of skin reaction > or = 8 cm were susceptible to systemic reactions. Prior to the occurrence of asthma, most cases complained of some prodrome of airway irritation. The clinical efficacy of RI was significantly lower in patients whose FEV1% was < 70%, and no difference was observed between patients whose maintenance dose was 0.10 ml and those whose maintenance dose was greater than 0.20 ml. These results suggest 1) RI should be performed on patients whose FEV1% is > or = 70%, 2) 0.10 ml of 1/10 solution is an optimal dose, 3) when a local skin reaction is > or = 8 cm in diameter and/or a prodrome of airway irritation occurs, one should be careful when increasing the dosage.