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Treatment Philosophy for
Inhalant Allergy—
Key Concepts
George F. Kroker MD FACAAI
David Morris M.D.
Copyright 2014 Allergy Associates of La Crosse
Inhalant Allergy Treatment
 Immunotherapy (SCIT or SLIT) is the
only therapy considered to be diseasemodifying for the treatment of inhalant
allergy
Copyright 2014 Allergy Associates of La Crosse
Why Treat Inhalant Allergy?
The LCM Philosophy
 Simple avoidance often not possible
 Immunotherapy is only diseasemodifying tool available
 Helps stop the atopic march in children
 Important part of total load
 Improves quality of life
Copyright 2014 Allergy Associates of La Crosse
Inhalant Allergy Axioms
 Inhalant Allergies may affect any mucosal


system—respiratory, gastrointestinal, vaginal, as
well as dermal
Different allergy conditions require different
dosing schedules to achieve optimum results
Inhalant allergy should never be viewed in
isolation, but as part of a bigger picture in the
allergy patient
Copyright 2014 Allergy Associates of La Crosse
Total Load Concept
Copyright 2014 Allergy Associates of La Crosse
The La Crosse Protocol
 Clinical efficacy
 Used in treating multiple patients over
many years
 Safety
 Versatility
 Cost-effectiveness
 Supported by medical literature
Copyright 2014 Allergy Associates of La Crosse
AAOA & La Crosse Protocols:
Comparisons--Experience
AAOA
Protocol
La Crosse
Protocol
Clinical
Experience
6 years (approx)
40+ years
Number of
Patients Rx’ed
Several
thousand(?)
140,000+
patients (2013)
Dose/Frequency
Hi dose
Low Frequency
Lower Dose
Higher
Frequency
Copyright 2014 Allergy Associates of La Crosse
AAOA & La Crosse Protocols:
Comparisons--Comprehensiveness
AAOA
Protocol
Initial Dose
La Crosse
Protocol
Standard, based
on qualitative
testing
Delayed inhalant Not in Protocol
Food Allergy Rx
Optimized with
IDT
Number of
Antigens
Not limited to <10
Copyright 2014 Allergy Associates of La Crosse
Limited to <10
In Protocol
AAOA & La Crosse Protocols:
Comparisons--Versatility/Safety
AAOA
Protocol
La Crosse
Protocol
Protocol Flexibility “One Size Fits All” “A Family of
dosing Protocols”
Safety
Higher risk of side Lower risk of side
effects
effects
Cost
Higher cost for
Lower cost for
larger antigen amt lower antigen amt
Copyright 2014 Allergy Associates of La Crosse
The La Crosse Method is a
Family of Dosing Protocols
 Protocol for multiple inhalant/food
allergies (“threshold dosing”)
 Protocol for monosensitized pollen
allergy (“hi dose preseasonal”)
 Protocol for delayed onset allergy
 Protocol for treating food anaphylaxis
Copyright 2014 Allergy Associates of La Crosse
Thank you
Copyright 2014 Allergy Associates of La Crosse
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