The ACVD task force on canine atopic dermatitis (XXIV): allergen-specific immunotherapy

Allergen-specific immunotherapy (ASIT) has been used for years to treat dog s with atopic dermatitis (AD) and humans with atopic diseases. The efficacy of ASIT has been well documented for humans with respiratory atopic diseas es and stinging insect allergy, but its effectiveness seems more controvers ial for patients with AD. In spite of insufficient evidence derived from ra ndomized controlled trials, multiple open studies and a large body of clini cal observations suggest that ASIT is effective in controlling the clinical signs of dogs with AD. As a result of the scarcity of evidence from contro lled trials, the true efficacy of ASIT, and the optimal protocols for aller gen dose and frequency of injection are currently unknown. Allergen-specifi c immunotherapy nevertheless may be included in the treatment of canine AD because of its potential advantages and limited disadvantages compared to o ther forms of therapy. There is no evidence, however, for the preference of any specific treatment protocol. The predictive value of historical, clini cal and immunologic features related to the efficacy of ASIT in dogs with A D are discussed in this paper. Adverse reactions, and the requirements for monitoring of patients receiving ASIT, then are reviewed and detailed. Fina lly, this review highlights aspects of ASIT where further research and cont rolled studies are needed. (C) 2001 Published by Elsevier Science B.V.