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Usefulness of specific immunotherapy in patients with severe perennial allergic rhinitis induced by house dust mite: a double-blind, randomized, placebo-controlled trial

Usefulness of specific immunotherapy in patients with severe perennial allergic rhinitis induced by house dust mite: a double-blind, randomized, placebo-controlled trial
Usefulness of specific immunotherapy in patients with severe perennial allergic rhinitis induced by house dust mite: a double-blind, randomized, placebo-controlled trial
Objectives To evaluate the effectiveness of specific immunotherapy (SIT) in patients with severe house dust mite (HDM)-induced perennial allergic rhinitis using diary cards and objective endpoints.
Patients and Methods Thirty-six adult patients were selected with moderate to severe allergic rhinitis due to HDM allergy uncontrolled by regular anti-allergic drugs. Twenty-eight patients completed the study, 22 of these patients also had mild asthma. Subjects were stratified for HDM sensitivity on the basis of their 4-week diary card score and the size of their immediate and late-phase skin reaction to HDM. The groups were well matched for all relevant parameters. Patients were randomized to receive active preparation (Alutard®-SQ, ALK, Dermatophagoides pteronyssinus extract) or an identical placebo preparation. Increasing doses were administered until the maintenance dose was reached. This dose was then given once a month for 12 months.
Results Clinical efficacy was evaluated by symptom medication diary cards recorded for 4 weeks after 12 months of continuous treatment and compared with pre-treatment scores. Skin test reactivity was re-measured after 12 months of treatment to HDM, cat dander and codeine phosphate. After 1 year of treatment, the actively treated group showed a 58% reduction in diary card symptom scores (P<0.002) and a 20% reduction in the use of rescue medication. The placebo group had a 32% reduction in symptom scores (P=NS), but no reduction in rescue medication requirements. The active group showed 36% reduction in skin prick test sensitivity to D. pteronyssinus (P=0.006), while the placebo group values were unchanged. Skin reactivity to codeine was unchanged in both groups. No significant adverse reactions to SIT were encountered.
Conclusions One year of SIT for D. pteronyssinus in patients with poorly controlled rhinitis (±mild asthma) produced clinically useful improvement as shown by symptom–medication diary cards and reductions in immediate skin reactions compared with placebo treatment.
0954-7894
1076-1082
Varney, V.A.
3a642d83-ee31-4e58-b05f-2d172c9b6be0
Tabbah, K.
a513baf4-ef17-46f7-bee6-db686b638847
Mavroleon, G.
acf74d0a-cb1e-409f-be55-3955598ccd71
Frew, A.J.
c00e9630-a5f0-44b3-add0-44b68836bbcb
Varney, V.A.
3a642d83-ee31-4e58-b05f-2d172c9b6be0
Tabbah, K.
a513baf4-ef17-46f7-bee6-db686b638847
Mavroleon, G.
acf74d0a-cb1e-409f-be55-3955598ccd71
Frew, A.J.
c00e9630-a5f0-44b3-add0-44b68836bbcb

Varney, V.A., Tabbah, K., Mavroleon, G. and Frew, A.J. (2003) Usefulness of specific immunotherapy in patients with severe perennial allergic rhinitis induced by house dust mite: a double-blind, randomized, placebo-controlled trial. Clinical & Experimental Allergy, 33 (8), 1076-1082. (doi:10.1046/j.1365-2222.2003.01735.x).

Record type: Article

Abstract

Objectives To evaluate the effectiveness of specific immunotherapy (SIT) in patients with severe house dust mite (HDM)-induced perennial allergic rhinitis using diary cards and objective endpoints.
Patients and Methods Thirty-six adult patients were selected with moderate to severe allergic rhinitis due to HDM allergy uncontrolled by regular anti-allergic drugs. Twenty-eight patients completed the study, 22 of these patients also had mild asthma. Subjects were stratified for HDM sensitivity on the basis of their 4-week diary card score and the size of their immediate and late-phase skin reaction to HDM. The groups were well matched for all relevant parameters. Patients were randomized to receive active preparation (Alutard®-SQ, ALK, Dermatophagoides pteronyssinus extract) or an identical placebo preparation. Increasing doses were administered until the maintenance dose was reached. This dose was then given once a month for 12 months.
Results Clinical efficacy was evaluated by symptom medication diary cards recorded for 4 weeks after 12 months of continuous treatment and compared with pre-treatment scores. Skin test reactivity was re-measured after 12 months of treatment to HDM, cat dander and codeine phosphate. After 1 year of treatment, the actively treated group showed a 58% reduction in diary card symptom scores (P<0.002) and a 20% reduction in the use of rescue medication. The placebo group had a 32% reduction in symptom scores (P=NS), but no reduction in rescue medication requirements. The active group showed 36% reduction in skin prick test sensitivity to D. pteronyssinus (P=0.006), while the placebo group values were unchanged. Skin reactivity to codeine was unchanged in both groups. No significant adverse reactions to SIT were encountered.
Conclusions One year of SIT for D. pteronyssinus in patients with poorly controlled rhinitis (±mild asthma) produced clinically useful improvement as shown by symptom–medication diary cards and reductions in immediate skin reactions compared with placebo treatment.

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Published date: 2003

Identifiers

Local EPrints ID: 27461
URI: http://eprints.soton.ac.uk/id/eprint/27461
ISSN: 0954-7894
PURE UUID: 2649aed5-799b-43de-9d90-e6dd033abd3c

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Date deposited: 25 Apr 2006
Last modified: 15 Mar 2024 07:18

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Contributors

Author: V.A. Varney
Author: K. Tabbah
Author: G. Mavroleon
Author: A.J. Frew

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