Nextmune Immunotherapy Treatment Service
Immunotherapy is the treatment that targets the root cause of allergies, rather than just managing the symptoms.
It is tailored to each individual patient based on the results of our allergy tests. Once we identify what the dog, cat, or horse is allergic to, a personalised treatment can be developed to keep the allergy under control. Symptoms are significantly reduced—and in many cases, may be completely eliminated. With a proven efficacy of 75% and an excellent safety profile, immunotherapy is suitable for long-term use. The treatment works by gradually introducing small doses of the allergens, which stimulates the immune system and helps build long-term tolerance. This process not only reduces allergic reactions but also changes the course of the disease itself. Immunotherapy is the only therapy that modifies the underlying allergic condition while also relieving symptoms. Consistent adherence to the treatment plan is essential for success and will lead to faster recovery and long-lasting allergy relief.
Allergy Treatment for Companion Animals
Atopic dermatitis is one of the most common and frustrating conditions seen in veterinary dermatology. It leads to chronic itching, inflammation, and skin infections. While many treatment options exist to manage the clinical signs of atopic dermatitis, immunotherapy stands out as the only treatment that addresses the root cause of the disease. As veterinarians, it’s crucial to understand the importance of treating atopic dermatitis with the only causal approach available: immunotherapy. This method is not just another treatment option but the foundation of effective, long-term management of allergic patients.
The Basics of Atopic Dermatitis
Atopic dermatitis is a hypersensitivity reaction caused by environmental allergens, such as dust mites, pollen, mold, and certain foods. The condition is driven by the immune system's exaggerated response to these allergens. While clinical signs (itching, redness, and skin lesions) can be managed with symptomatic medications such as corticosteroids, oclacitinib, lokivetmab, cyclosporine, etc, these do not treat the underlying immune dysfunction.
Immunotherapy: The Only Causal Treatment for AD
Immunotherapy works by reprogramming the immune system to stop overreacting to environmental allergens. This is the only treatment option that targets the root cause of the disease, providing long-term relief and improved quality of life for pets suffering from atopic dermatitis.
How Does Immunotherapy Work?
- Allergen Identification: Immunotherapy begins with identifying the specific allergens causing the allergic reactions in each patient. This can be achieved through PAX serum testing (IgE testing) or intradermal skin testing.
- Gradual Desensitization: Once allergens are identified, immunotherapy involves administering gradual doses of these allergens. Over time, the immune system becomes less reactive to these allergens, reducing the inflammatory response and the clinical signs of atopic dermatitis.
- Tailored Treatment: Immunotherapy is highly individualized, making it a superior approach for managing allergic patients. By specifically targeting the allergens a pet is sensitive to, we ensure a more effective and efficient treatment plan.
Why Should Every Atopic Patient Be Placed on Immunotherapy?
1. Causal Treatment with Long-Term Benefits
Unlike symptomatic therapies, immunotherapy is the only causal treatment that targets the immune response itself. By addressing the root cause of atopic dermatitis, immunotherapy helps reduce the frequency and intensity of allergic flare-ups, leading to better long-term control of the disease. Pets that undergo immunotherapy often experience lasting remission or significantly reduced clinical signs.
2. Reduces Reliance on Symptomatic Medications
Long-term use of corticosteroids, cyclosporine, and other immunosuppressive drugs comes with significant risks, including side effects like weight gain, gastrointestinal issues, and increased susceptibility to infections. Immunotherapy offers a safe alternative that reduces or eliminates the need for these medications over time, improving the overall health of the pet.
3. Improved Quality of Life for Patients
Atopic dermatitis can severely affect a pet's quality of life, causing constant itching, discomfort, and secondary infections. Immunotherapy helps control the underlying allergic reactions, reducing the chronic pruritus and inflammation that make pets miserable. Many patients experience a significant improvement in their quality of life, with fewer flare-ups, reduced itching, and healthier skin.
A study assessing the quality of life (QoL) in allergic cats treated with allergen-specific immunotherapy (ASIT) was conducted. The study aimed to evaluate whether ASIT improves QoL compared to symptomatic treatments alone. The findings indicated that cats receiving ASIT experienced significant improvements in various aspects of QoL, including reduced disease severity, better behavior and mood, and less disruption to daily activities. Additionally, owners of these cats reported lower treatment costs and reduced emotional distress. In contrast, cats not treated with ASIT showed no significant improvement in QoL measures. (Kotnik, T. 2023).
This study highlights the effectiveness of ASIT in enhancing the QoL of allergic cats and underscores the importance of considering ASIT for managing atopic dermatitis in veterinary practice.
4. Safety and Tolerability
Compared to some systemic treatments, immunotherapy is highly safe and well-tolerated, even for long-term use. The risk of adverse effects is much lower, and immunotherapy is an ideal treatment for pets that need ongoing management for their allergies. There are very few side effects, and those that do occur (e.g., mild local swelling at the injection site) are typically temporary and manageable.
5. Sustained Remission
One of the key advantages of immunotherapy is that it offers long-term relief. While other treatments may need to be continually adjusted to control flare-ups, immunotherapy often leads to sustained remission.
6. Cost-Effective in the Long Run
While the initial cost of allergen testing and immunotherapy may seem higher than traditional treatments, the long-term benefits often outweigh the initial investment. By reducing the need for frequent visits, and other symptomatic treatments, immunotherapy is a cost-effective solution in the long run. It also improves overall outcomes, reducing the likelihood of chronic flare-ups or secondary infections.
7. Scientific Validation
Immunotherapy has been clinically validated through numerous studies and is considered the gold standard for the treatment of atopic dermatitis in both human and veterinary medicine. It is the only treatment proven to induce immunologic tolerance, thus reducing allergic symptoms permanently or for extended periods.
Implementing Immunotherapy in Your Practice
- Allergen Testing: Begin by conducting thorough allergy testing to identify the environmental triggers causing the immune reaction in your patients. PAX test is the only and first molecular allergen-based test in veterinary medicine, the current standard in both human and veterinary allergology. Read more.
- Initial Treatment Phase: The initial phase typically involves administering injections with gradually increasing doses of allergens. The goal is to build tolerance, so the pet’s immune system gradually adapts to the allergens. This phase requires close monitoring to ensure the patient’s response is as expected.
- Maintenance Phase: Once the pet reaches the optimal desensitization level, the treatment moves into a maintenance phase, where injections are administered at less frequent intervals, typically every 4 weeks
- Follow-Up and Monitoring: Regular follow-ups are essential to assess the effectiveness of the immunotherapy and make any necessary adjustments to the treatment plan. Some pets may require modifications to their allergen profile or dosing schedule.
Immunotherapy is the only causal treatment for atopic dermatitis in pets, offering long-term relief and improved quality of life by directly addressing the immune system’s hypersensitivity to allergens. By incorporating immunotherapy into your practice, you can provide your patients with a scientifically proven, safe, and effective solution that reduces their reliance on symptomatic medications and helps manage the chronic nature of atopic dermatitis. This is primarily relevant when considering that most atopic patients are diagnosed at an early age.
As veterinary professionals, it is our responsibility to provide the best care possible, and immunotherapy is the most effective tool we have to treat atopic dermatitis at its core.
How Effective Is This Treatment?
How To Administer Treatment
Step 1
Upon arrival, refrigerate and store the vial upright at 35-44°F(2-7°C).
Step 2
When ready to inject the treatment, bring the allergen extract to room temperature.
Step 3
- Holding the vial upside down and draw the correct dosage into the syringe.
- Ensure no air bubbles are present. If air bubbles appear, gently flick the syringe and depress hte plunger slightly to release them bubbles.
- Lift the skin on the back of patient’s neck creating a “tent”.
- Insert the needle at the base of the tent, just beneath the skin’s surface.
- Withdraw the plunger slightly, if no blood is present, inject the allergens.
Step 4
- Gently massage the injection site.
- Praise the patient to keep them calm.
- Return the vial to the refrigerator immediately.
- Always monitor the patient for 45 minutes after injection as a precaution.
About Injection Schedule
Initial Treatment
3 vials (green, blue, red) of increasing concentrations to be administered over a 9 month period using the dosing schedule below
Maintenance Treatment
This maintainace treatment should be started after completion of the inital treatment set. Each vial (red), is at the same concentration as Vial C in the inital treatment set, but is administered over approximately 8 months using the dosing schedule below .
About Injection Immunotherapy...
Immunotherapy injections have been used in both human and veterinary medicine for decades with great success.
Pros:
- History of proven success.
- Injection workd up to once a month.
Cons:
- Requires using needles.
- Requires the extract to be at room temperature.
Possible reactions with injections immunotherapy:
- Reactions can be range from mild irritation at the injection site to local or generalized hives.
- Systemic reactions include lethargy, vomiting, or diarrhea.
- Anaphylaxis is extremly rare.
Shots are administered over a 9-month period in increasing doses and gradually increasing concentrations. The 3 vials of increasing concentration are supplied directly by Nextmune on a prescription basis to the testing veterinarian. The initial 9-month period of hyposensitization is followed by monthly maintenance shots.
Sublingual Treatment
How Effective Is This Treatment?
How To Administer Treatment
Step 1
Upon arrival, refrigerate and store the product upright at 35-44°F(2-7°C). lt is not necessary to bring to room temperature.
Important note: DO NOT fed or give water to the pet 30 minutes before or 10 minutes after adminstration.
Step 2
Prime the pumper by depressing it several times with short, firm bursts until allergen is released consistently.
Step 3
Rest the dispensing arm of the pump on the lower teeth near the front or side of the mouth. with the tip placed over the teeth. To administer, depress the pump fully and quickly so that the correct dosage is released into the mouth (preferably under the tongue.)
Repeat for a total of :
- 2 squirts for pets under 22 lbs (<10 kg)
- 3 squirts for pets over 22 lbs (>10kg).
Sublingual Dosage Schedule
| Patient Weight | Dose |
|---|---|
| Less than 10 kg (<22Ibs) | 2 squirts once daily |
| Greater than 10 kg (>22Ibs) | 3 squirts once daily |
PLEASE NOTE: Please store upright and refrigerated at 35-44°F (2-7°C)
About Sublingual Immunotherapy...
Sublingual immunotherapy is a great solution for pet parents who prefer a needle free option and/ or have pets that have had issues tolerating immunotherapy injections in the past. Proper and consistent administration are the key to success with sublingual immunotherapy.
Pros:
- Simple administration between the cheek and gums.
- Sublingual treatment is more concentrated; therefore, the animal may see results sooner.
- There is less IgE in the mouth, so there is a lower risk of reaction.
- Glycerin, one of the liquid bases used in this treatment, is sweet, so the animal may perceive it as a treat.
Cons:
- Requires daily administration.
- No food or drink 30 minutes before and 10 minutes after sublingual immunotherapy.
- It may be difficult to determine whether the pet has received the correct dosage.
Possible reactions with sublingual immunotherapy:
- Reactions may include pruritus, face rubbing, gastrointestinal issues, an itchy mouth, or lethargy.
- Systemic reactions are extremely rare and have not been documented.
If you have any concerns about your pet’s health or any treatment, please do not hesitate to consult your veterinarian, who can provide personalized care and recommendations. Thank you.