Iranian Journal of Allergy, Asthma and Immunology 2016. 15(2):112-121.

Efficacy of Sublingual Immunotherapy with Dermatophagoides Pteronyssinus: A Real-life Study
Tomic-Spiric Vesna, Dizdarevic Denisa, Jankovic Slavenka, Burazer Lidija, Barac Aleksandra, Bolpacic Jasna, Djuric Vojislav, Peric-Popadic Aleksandra, Aleksic Aleksandra, Bogic Mirjana

Abstract


Sublingual allergen immunotherapy (SLIT) is considered to be safer and more convenient than subcutaneus immunotherapy. SLIT trials with house dust mites involving patients with allergic rhinitis (AR) and asthma reported discordant results. The aim of the study was to investigate the clinical efficacy and safety of SLIT with Dermatophagoides pteronyssinus (D.pt) extract produced in Serbia and patient’s satisfaction through open-label trial. Adult patients with allergic rhinitis were randomized into two groups: one received drugs and SLIT, while other received only drugs. Symptom score (SS), medication score (MS) and cumulative score (CS), skin prick tests (SPT) and serum level of D. pt specific IgE were assessed. One year after, the patients were re-evaluated. In total, 61 patients were enrolled in the study, but 52 of them were analyzed at the end of the year. CS (29.3%, p<0.001) and MS (54.3%, p<0.05) reduced significantly in the SLIT group. There was a significant improvement of MS and CS in the SLIT compared to control group (p<0.001 and p<0.05 respectively). There was no significant improvement of SS as well as specific slgE. Patients in the SLIT group were more satisfied with treatment (p<0.001). The incidence of mild adverse reaction was 38.4%. Specific lgG was not done. One year SLIT with D.pt extract was clinically efficient treatment in AR patients.


Keywords


Allergic rhinitis; Asthma; Dermatophagoides pteronyssinus; Efficacy; Sublingual Immunotherapy

Full Text:

PDF

References


1. Canonica GW, Bousquet J, Casale T, Lockey RF, Baena- Cagnani CE, Pawankar R, et al. Sublingual immunotherapy: World Allergy Organization Position Paper 2009. Allergy 2009; 64(91):1-59.

2. Jacobsen L, Niggemann B, Dreborg S, Ferdousi HA, Halken S, Høst A, et al. Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy 2007; 62(8):943–8.

3. Canonica GW, Cox L, Pawankar R, Baena-Cagnani CE, Blaiss M, Bonini S, et al. Sublingual immunotherapy: World Allergy Organization position paper 2013 update. World Allergy Organ J 2014; 7(1):6.

4. Radulovic S, Calderon MA, Wilson D, Durham S.Sublingual immunotherapy for allergic rhinitis. Cochrane Database Systematic Reviews 2010; 12:CD002893.

5. Compalati E, Passalacqua M, Bonini M, Canonica GW.The efficacy of sublingual immunotherapy for house dust mites respiratory allergy: results of a GA(2)LEN meta- analysis. Allergy 2009; 64(11):1570-9.

6. Calamita Z, Saconato H, Pela AB, Atallah AN. Efficacy of sublingual immunotherapy in asthma: systematic review of randomized-clinical trials using the Cochrane collaboration method. Allergy 2006; 61(10):1162–72.

7. Lin SY, Erekosima N, Kim JM, Ramanathan M, Suarez- Cuervo C, Chelladurai Y, et al. Sublingual immunotherapy for the treatment of allergic rhinoconjunctivitis and asthma: a systematic review. JAMA 2013; 309(12):1278-88.

8. Calderon MA, Casale T, Nelson H, Demoly P. An evidence-based analysis of house dust mite allergen immunotherapy:A call for more rigorous clinical studies. J Allergy Clin Immunol 2013; 132(6):1322-36.

9. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA2LEN and AllerGen). Allergy 2008; 63(86):8–160.

10. Global Initiative for Asthma Management and Prevention.NHLBI/WHO Workshop report. GINA Guidelines. Bethesda, MD: National Heart, Lung and Blood Institute, Update from NHLBI/WHO Workshop Report 1995; Revised 2006.

11. Marogna M, Spadolini I, Massolo A, Canonica GW, Passalacqua G. Randomized controlled open study of sublingual immunotherapy for respiratory allergy in real- life: clinical efficacy and more. Allergy 2004;59(11):1205–10.

12. Guerra L, Compalati E, Rogkakou A, Pecora S, Passalacqua G, Canonica GW. Randomized open comparison of the safety of SLIT in a no-updosing and traditional updosing schedule in patients with Parietaria allergy. Allergol Immunopathol (Madr) 2006; 34(2):82–3.

13. Irani C, Abi Saleh R, Jammal M, Haddad F. High-dose sublingual immunotherapy in patients with uncontrolled allergic rhinitis sensitized to pollen: a real-life clinical study. Int Forum Allergy Rhinol 2014; 4(10):802-7.

14. Wilson DR, Lima MT, Durham SR. Sublingual immunotherapy for allergic rhinitis: systematic review and meta-analysis. Allergy 2005; 60(1):4-12.

15. Radulovic S, Wilson D, Calderon M, Durham S.Systematic reviews of sublingual immunotherapy. Allergy 2011; 66(6):740–52.

16. Walker SM, Durham SR, Till SJ, Roberts G, Corrigan CJ, Leech SC, et al. British Society for Allergy and Clinical Immunology. Immunotherapy for allergic rhinitis. Clin Exp Allergy 2011; 41(9):1177-200.

17. Burazer L, Vučković O, Gavrović M, Ćirković T. Allergic diseases – an increasing health problem in Serbia and Montenegro. Summer Course Aerobiology and Environment, Madeira, Portugal, 2004.

18. Valovirta E, Lheritier-Barrand M, Tauleigne L, et al.Patients’ perceptions and experience of house dust mite allergy in a European survey. European Respiratory Disease 2012; 8(2):123-128.

19. Calderon MA, Cox L, Casale TB, Moingeon P, Demoly P.Multiple-allergen and single-allergen immunotherapy strategies in polysensitized patients: looking at the published evidence. J Allergy Clin Immunol 2012;129(4):929-34.

20. Ciprandi G, Cadario G, Valle C, Ridolo E, Verini M, Di Gioacchino M, et al. Sublingual immunotherapy in polysensitized patients: effect on quality of life. J Investig Allergol Clin Immunol 2010; 20(4):274-9.

21. Calderon M, Mosges R, Hellmich M, Demoly P. Towards evidence-based medicine in specific grass pollen immunotherapy. Allergy 2010; 65(4):420-34.

22. Marogna M, Spadolini I, Massolo A, Berra D, Zanon P, Chiodini E, et al. Long-term comparison of sublingual immunotherapy vs inhaled budesonide in patients with mild persistent asthma due to grass pollen. Ann Allergy Asthma Immunol 2009; 102(1):69-75.

23. Marogna M, Spadolini I, Massolo A, Canonica GW, Passalacqua G. Long lasting effects of sublingual immunotherapy according to its duration: a 15-year prospective study. J Allergy Clin Immunol 2010;126(5):969–75.

24. Canonica GW, Baena-Cagnani CE, Bousquet J, et al.Recommendations for standardization of clinical trials with Allergen Specific Immunotherapy for respiratory allergy. A statement of a World Allergy Organization (WAO) taskforce. Allergy 2007; 62(3):317–24.

25. Malling HJ. Sublingual immunotherapy: efficacy –methodology and outcome of clinical trials. Allergy 2006;61(81):24–8.

26. Hirsch T, Sahn M, leupold W. Double blind placebo controlled study of sublingual immunotherapy with house dust mite extracts in children. Pediatr Allergy Immunol 1997; 8(1):21-7.

27. Cox LS, Linnemann DL, Nolte H, Weldon D, Finegold I, Nelson HS. Sublingual immunotherapy: A comprehensive review AAAAI/ACAAI Task force report. J Allergy Clin Immunol 2006; 117(5):1021-35.

28. Akdis CA, Barlan IB, Bahceciler N, Akdis M.Immunological mechanisms of sublingual immunotherapy. Allergy 2006; 61(81):11-4.

29. Francis JN, James LK, Paraskevopoulos G, Wong C,Calderon MA, Durham SR, et al. Grass pollen immunotherapy: IL-10 induction and suppression of late responses precedes IgG4 inhibitory antibody activity. J Allergy Clin Immunol 2008; 121(5):1120-5.

30. Ciprandi G, Fenoglio D, Cirillo I, Vizzaccaro A, Ferrera A, Tosca MA, et al. Induction od interleukin 10 by sublingual immunotherapy for house dust mites: a preliminary report. Ann Allergy Asthma Immunol 2005;95(1):38-44.

31. Pham-Thi N, Scheinmann P, Fadel R, Combebias A, Andre C. Assesment of sublingual immunotherapy efficacy in children with house dust mite-induced allergic asthma optimaly controlled by pharmacologic treatment and mite-avoidance measures. Pediatr Allergy Immunol 2007; 18(1):47-57.

32. Lue KH, Lin YH, Sun HL, Lu KH, Hsieh JC, Chou MC.Clinical and immunologic effects of sublingual immunotherapy in asthmatic children sensitized to mites: a double-blind, randomized placebo- controled study. Pediatr Allergy Immunol 2006; 17(6):408-15.

33. Cox L. Sublingual immunotherapy and allergic rhinitis.Curr Allergy Asthma Rep 2008; 8(2):102-10.


Refbacks

  • There are currently no refbacks.


Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.