Premium
Usefulness of specific immunotherapy in patients with severe perennial allergic rhinitis induced by house dust mite: a double‐blind, randomized, placebo‐controlled trial
Author(s) -
Varney V. A.,
Tabbah K.,
Mavroleon G.,
Frew A. J.
Publication year - 2003
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1046/j.1365-2222.2003.01735.x
Subject(s) - medicine , house dust mite , placebo , allergy , asthma , randomized controlled trial , allergen , immunology , alternative medicine , pathology
Summary 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.