Immunotherapy in adults and seniors – clinical aspects

Specific allergen immunotherapy (SIT) is a broadly used and highly effective therapeutic method of treating respiratory allergies and insect venom allergy (venom immunotherapy – VIT). Specific allergen immunotherapy is generally recommended for adults > 60, but the age criterion does not apply to VIT since venom allergy is a life-threatening condition. The frequency of the occurrence of anaphylactic events during SIT is comparable in both groups of younger and older patients, but if the events do occur, they tend to be more severe in the latter group. The higher risk of a severe anaphylactic reaction occurring in older patients > 50 results, among other things, from an apparent or clinically asymptomatic ischaemic heart disease. Another factor that may exacerbate the anaphylaxis in SIT in individuals > 50 is taking medication of b- and ACE blockers. Discontinuation of these drugs prior to SIT requires a calculation of the benefits of conducting SIT counterweighted by the risk of discontinuing cardiological treatment. SLIT, as a safer method, is preferred for SIT in older patients.