Three years of specific immunotherapy may be sufficient in house dust mite respiratory allergy - 10/08/11
, Esozia Arroabarren, MD b, Susana Echechipía, MD, PhD a, Blanca E. García, MD, PhD a, Santiago Martin, MS c, María J. Alvarez-Puebla, MD, PhD a
Reprint requests: Ana I. Tabar, MD, PhD, Department of Allergy, Hospital Virgen del Camino, CS Conde Oliveto, Plaza de la Paz s/n, 31002 Pamplona, Spain.Abstract |
Background |
Specific immunotherapy (SIT) duration for respiratory allergy is currently based on individual decisions.
Objective |
To evaluate the differences in clinical efficacy of SIT as a result of the duration between the current recommended limits (3-5 years).
Methods |
A 5-year prospective, controlled clinical trial of SIT blind until the first year and randomization to a 3-year (IT3) or 5-year (IT5) course was conducted. Of the 239 patients with respiratory allergy caused by D pteronyssinus initially included, 142 completed 3 years of SIT with good compliance. Twenty-seven controls were included at the third year. Efficacy of SIT after 3 (T3) and 5 (T5) years was assessed by using clinical scores, visual analog scales (VASs), rhinitis (RQLQ) and asthma (AQLQ) quality of life questionnaires, skin tests, and serum immunoglobulins.
Results |
At T3, significant reductions were observed in rhinitis (44% in IT3 and 50% in IT5; P < .001), asthma (80.9 % in IT3 and 70.9% in IT5; P < .001) scores, VAS (P < .001 in both), RQLQ (P < .001 in both) and AQLQ (P < .001 in both). At T5, the clinical benefit was maintained in both groups, and IT5 patients presented additional decreases (19%; P = .019) in rhinitis scores. At Tf, specific IgG4 measurements were lower in IT3 (P = .03) without detecting differences in IT5. An increase in asthma score of 133% was the only difference observed in controls.
Conclusion |
Clinical improvement is obtained with 3 years of D pteronyssinus SIT. Two additional years of SIT add clinical benefit in rhinitis only.
Le texte complet de cet article est disponible en PDF.Key words : Specific immunotherapy, duration, quality of life, asthma, rhinitis, house dust mite, clinical efficacy, compliance, children, immunotherapy relapses
Abbreviations used : AQLQ, HDM, IT3, IT5, RQLQ, SIT, T0, T1, T3, T5, VAS
Plan
| Supported by a research grant from the Regional Government of Navarra. |
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| Disclosure of potential conflict of interest: S. Martin is an employee of ALK-Abelló and helped in the design and analysis of the study. The rest of the authors have declared that they have no conflict of interest. |
Vol 127 - N° 1
P. 57 - janvier 2011 Retour au numéro
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