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Subcutaneous allergen immunotherapy (SCIT) is effective for relieving allergic rhinitis, asthma, and stinging insect hypersensitivity and is the only available treatment that has disease-modifying effects; however, SCIT also comes with risk for systemic allergic reactions (SRs). Before 2002, 1 fatal reaction to SCIT occurred in every 2 to 2.5 million injections in North America — an average of 3 or 4 deaths annually. To determine whether practice guidelines issued since 2002 have lowered risk for SCIT-related SRs, investigators examined survey data on 23.3 million injections between 2008 and 2012 reported by nearly 4000 North American allergists.
During 4 years, one fatality occurred; SRs were reported for 0.1% of injection visits, of which …