Allergy Immunotherapy is performed by highly trained specialists for many reason but a significant one is the increased risk of serious adverse reaction and anaphylaxis. Given the inherent risks involved in administering immunotherapy there is a rising number of Allergists who are prescribing Allergoids due to their stated ‘low allergenicity’ and relatively short up dosage time (ranging from 1 Day to 2 weeks depending on the protocol).
Allergoids are created when intact allergens are modified with either glutaraldehyde or formaldehyde, which their makers claim reduces the allergenicity whilst preserving the T-cell activation, thus achieving the aim of immunotherapy whilst reducing the inherent risk.
Unfortunately the clinical evidence does not support their marketed claims and, in the case of allergoids created through glutaraldehyde modification, the end results may be no better than a placebo.
The three papers linked here all contain data from studies comparing allergoids created by modifying intact allergens (with glutaraldehyde, formaldehyde or both types) to the use of intact allergens. We have provided a brief summary of the studies below but they all have one finding in common, that the low allergenicity observed when administering treatment was linked to low immunogenicity.
The risk is clear, widespread reduction in efficacy for patients will lead to an erosion of trust in the effectiveness of allergy vaccines and the public health segment we all work in.