Background: Unlike conventional immunotherapy, Cluster immunotherapy achieves maintenance dose in weeks along with omalizumab. However, safety of this method needs to be confirmed before wide spread application. Methods: We have designed open label observational study, to achieve maximum tolerance dose (MTD) in duration of six weeks with cluster Immunotherapy in immunologically significant sensitive patients to house dust mites in perennial rhinitis & Bronchial asthma. Results: With Combined omalizumab (anti-IgE) and cluster Immunotherapy, maintenance maximum tolerance dose (MTD) of 1000/ml achieved in 3 visits in 36 days (> 1month) in 9 patients without an IgE mediated adverse systemic reaction. Cluster Immunotherapy in 40 patients is efficacious, well tolerated than conventional immunotherapy of 4 months of single Allergen Injection as maintenance maximum tolerance dose (MTD) of 1000 - AU achieved in more than 75% in 4 visits of 46 days duration but 20% of patients in cluster Immunotherapy develop grade II/III adverse systemic reaction. Conclusion: Combined omalizumab (Anti - IgE) and cluster Immunotherapy is safe, effective and gives more rapid relief of symptoms.

• Cluster immunotherapy

• Immunotherapy

• Omalizumab

Kathuria PC, Rai M (2021) Observational Study by Accelerated Schedules of Cluster Allergen Immunotherapy with House Dust Mites in Pa tients with Allergic Rhinitis & Bronchial Asthma. JSM Allergy Asthma 5(1): 1028.

MTD: Maximum Tolerance Dose; SCIT: Subcutaneous Immunotherapy; D. farinae: Dermatophagoides farina; D. pteronyssinus: Dermatophagoides pteronyssinus; Anti-IgE: Anti Immunoglobulin E

The burden of allergic disease is increasing day by day. Approximately 20-30 % people of India are affected by one or other allergic disease. In Indian population prevalence of allergic rhinitis is around 3.5% [1].

Immunotherapy targeted against specific allergen is the proven disease modifying treatment strategy used to treat condition like allergic rhinitis, allergic asthma etc. In immunotherapy, allergen extracts are given in increasing doses subcutaneously at weekly interval until the Maximum Tolerance Dose (MDT) is achieved. This process helps in desensitizing the allergic individual and increase tolerance against specific allergen. Cluster immunotherapy is another form of immunotherapy in which injection of allergen extract is injected at shorter interval as compared to conventional therapy. The conventional Subcutaneous Immunotherapy (SCIT) is a slow treatment that often leads to poor compliance or discontinuation of treatment. Accelerated Immunotherapy build up schedules may provide a safe alternative to conventional build up schedules to achieve Immuno-tolerance without a significant increase in risks [2]. However, safety of cluster immunotherapy needed to be confirmed before widespread utilization of this method. Therefore, we have designed an observational single center study to find out the safety of cluster immunotherapy in patient with allergic rhinitis and asthma.