The patient's local physician was asked to find out more about the patient's current frequency of Bronchial asthma episodes along with ensuring current proper asthma management with inhalers/rota-halers ( technique, dose, cleaning) along with ensuring general allergen avoidance.
- Vasumathi Sriganesh Injection allergen immunotherapy for asthma
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001186.pub2/abstract
Immunotherapy reduces asthma symptoms and use of asthma medications and improves bronchial hyper-reactivity. One trial found that the size of the benefit is possibly comparable to inhaled steroids. The possibility of local or systemic adverse effects (such as anaphylaxis) must be considered.Injection allergen immunotherapy for asthma - The Cochrane Library - Abramson - Wiley Online Libraryonlinelibrary.wiley.comAbramson MJ, Puy RM, Weiner JM. Injection allergen immunotherapy for asthma. Coc...See More 
Rakesh Biswas Thanks Vasu for this excellent full text link. With a NNT of 3 and an NNH of 9 i am still undecided. Would appreciate other inputs on how would/should one proceed to make a clinical decision as to this patient's requirement. Dr Urmila Pillai, Sanjiban hospital, would appreciate your comments here and thanks also for personally examining our previous patient posted here in tabula.
Manu Mathew There are so many analyses in the review, and so we should consider as many of them as possible while making a judgement. Several of the analyses clearly favors immunotherapy, especially those relating to Asthma and its medications. Reactions are generally expected for this treatment, and so is a relative risk in favour of control for this outcome; however most studies arent contributing data for this outcome.
Rakesh sir, could you list the outcomes most important for your patient from the review
This would be a good example of making a judgement after balancing harms and benefits using quantitative estimates..
Urmila Pillai Hi
In this context before going for anti allergen management I would like to ensure the proper asthma management ( technique, dose, cleaning, general allergen avoidance etc). As such indication for immunotherapy in this case is not clear and it's not a very safe and cost effective method in children as per my knowledge.
Regards
Urmila
